If you’ve been a nurse for any length of time, you are quite familiar with the pervasive ways nurses torture each other. The old eat their young; nurses get thrown under the bus in front of important people (sometimes patients); the day shift battles with the night shift; and, nurses come to work only to find they have been pulled to another unit (where they’ll be tortured). These experiences certainly don’t convey the culture of caring so many of us expect to find in healthcare.
Our research shows that disruptive behaviors show up in four common ways:
- Yelling, criticizing, gossiping, and arguing in patient care areas
- Treating float nurses, travelers, and agency nurses in an unsupportive, disrespectful manner
- Wars between the day shift and the night shift
- Eating our young
The good news is that with a few simple strategies, you can shift your culture from one of cruelty to a culture of caring! Here are just 4 best practice tips based on our 4, Cultivating a Culture of Caring, Initiatives (We’ll have 4 more in Part 2, later this month):
Create Sacred Spaces in Patient Care Areas
One of the most common behaviors reported by healthcare employees is being yelled at or openly criticized in front of others. Unfortunately, many times this happens in front of patients.
No matter how hard I try, Jackie always finds fault with how I leave my patients at the end of my shift. What makes it worse is that she berates me in front of my patients during shift report. It’s so embarrassing!
Patients frequently witnessed interactions between me and other nurses and asked, with concern, “Are you okay after what she said to you?” or “Sounds like she is having a really bad day,” or “I felt really uncomfortable seeing that interaction, but most of all I feel bad for you.”
I don’t have to tell you how behaviors like these negatively impact nursing performance, employee well-being, patient satisfaction, and outcomes.
One viable solution is to establish sacred spaces in all areas that patients can hear us.
Most commonly used for religious purposes, sacred spaces are usually identified by something physical, such as a temple or symbol, and a ritual-based practice that occurs within that space, such as prayer. But non-secular sacred spaces exist too.
In your sacred spaces, you commit to, as a healthcare team, avoid any criticizing, yelling, cursing, or gossip as a way to protect patients from our badness.
Best Practice Tip #1 – Decide where your department’s sacred spaces are
Your sacred spaces should be any space where patients and their family members can hear you. This includes the hallways, nurses’ station, and the patient’s rooms!
Best Practice Tip #2 – Identify a “sacred space” symbol
Sometimes we forget that patients and their families can hear everything we say at the nurses’ station. By selecting a symbol, and placing that symbol in the areas you’ve identified as a sacred space, everyone is reminded to only communicate respectfully in that area.
Creating sacred spaces for your patients is not only the right thing to do for them, it’s the right thing to do for employees. We get so caught up in our work we sometimes forget that healthcare is a service industry in which we are called to serve our public and each other. By honoring and defending the spaces where we intimately care for our patients, we demonstrate respect for the one sacred and precious life we each have.
Roll Out the Red Carpet for Floaters and Travelers
One of the most-anxiety provoking situations for employees is to come into work and find out they have been pulled to another unit for their shift. Why? Because employees who get pulled are usually treated like gum on someone’s shoe.
Float staff, agency, and travelers frequently receive the worst patient assignments. We exclude, ignore, and torture them. I’ve heard nurses say, “Well, travelers and agency nurses make the big bucks, they should expect to get the worst patients.” Imagine any of the following happening to you:
You get pulled to another unit where they won’t give you the code to the staff bathroom. You have to leave the unit and find a public bathroom.
You get pulled to another unit where the staff hides the blood pressure cuffs and won’t give you a med cart.
As an agency nurse, you are regularly assigned to all the isolation, incontinent, and dementia patients.
Why do nurses treat people who are there to help them so horribly? Is it because they make more money? If their mom were a patient on their unit, would they still give someone who has never worked on their unit the worst assignments just because they make more money? I bet not.
Rolling out the red carpet means you treat all people who don’t normally work on your unit like guests in your home. By rolling out the red carpet, you demonstrate the respect all humans deserve, and patients ultimately receive better care.
Best Practice Tip #3 – Give them the easiest assignments
You may be tempted to give the floater the difficult patient everyone else has been dealing with, or the busy patients, but don’t. Remember, part of their time and energy will be used just to get used to your unit. By giving them the easiest patients, you are ensuring they can acclimate to your unit and focus on why they are there – patient care.
Best Practice Tip #4 – Thank them for being there – for helping – for being guests in your home
Before they leave for the day, every employee should thank them for being there. If they feel appreciated, they will come back
We have an ethical responsibility to make decisions based on what’s best for the patients we serve. How you treat staff who float to your unit is a reflection of the type of care you provide as a team. You are only as good as the weakest member on your team. By rolling out the Red Carpet Treatment, you ensure a stronger, more cohesive, healthy workforce!
By acknowledging the challenges that exist and taking conscious action, a culture of caring is possible!
Stay tuned for Part 2 where you learn about how to address the “shift wars” and what you can do to protect your new employees from getting “eaten alive”!
Click HERE to read 8 Best Practice Tips to Create a Culture of Caring – Part 2
