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Health Care Industry

Employee morale and patient safety

AORN Journal, Dec, 2004 by Suzanne C. Beyea

In today's health care environment, many employers are concerned about employee morale and make efforts to support high levels of staff satisfaction. Most health care organizations conduct regular staff satisfaction surveys and address the findings through staff meetings, salary and benefit improvements, and strategies to resolve other identified issues. Despite these efforts, many nurses can describe a time when they personally experienced an episode of low morale or worked with colleagues who were unhappy in their work situations.

SHARING UNHAPPINESS

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Many nurses have worked with a colleague who always seems to be having a bad day. Such colleagues are known to grumble about working conditions, their coworkers, management team members, physician colleagues, assignments, or work hours. These individuals not only are unhappy with almost everything in their work lives, they seem to enjoy sharing their misery with anyone who will listen.

Usually, these employees are not willing to offer constructive criticism or suggestions for positive change. In fact, their focus often is on gathering support for their negative views. Furthermore, when they have identified a problem, they often expect someone else to fix it. These individuals do not seek solutions to problems and, in fact, may not believe they even can be part of the solution.

Individuals with low morale simply may not like their jobs; however, instead of actively pursuing another role or position, they return to work each day with a pervasive sense of unhappiness. These individuals often seem to enjoy trying to ensure that their coworkers are equally unhappy.

THE EFFECTS OF Low MORALE ON PATIENT CARE

Low morale can contribute to negative outcomes at both the patient care level and the department level. A member of the health care team experiencing low morale may perform at a lower standard of practice than usual. Imagine a circulating nurse saying, "Don't bother with counts. We're just too busy, and nobody cares if we do them." This is an example of how low morale can negatively influence patient care and quality outcomes. A dissatisfied nurse may cut corners or not pay attention to details while providing care. This may be as simple as not verifying a patient's consent or surgical site or not paying attention to tourniquet time. A general malaise about work can contribute to a lower standard of practice and may greatly increase the potential for errors.

Department-level problems can occur when a staff member calls in sick for a "mental health day," leaving a department understaffed. This type of behavior can limit a clinical department's ability to provide care and may lead to delays in surgery. In some environments, understaffing may limit a department's ability to provide care in a manner consistent with practice standards. In some departments, nurses relate experiences of having one circulating nurse for two OR suites or procedures when normally there would be one nurse per procedure. Excessive sick days can result in other nursing staff members working overtime, which can lead to fatigue and potential errors. One team member's negativity and low morale can contribute to an entire department developing low morale and an overall lowering of standards of care and safety practices.

A REAL PROBLEM?

In certain clinical situations, legitimate reasons exist for staff members to be unhappy and experience low morale. Nurses and other staff members may be required to work overtime, work in understaffed departments, have excessive on-call requirements, or lack adequate supplies and equipment to provide care. Managers may be unresponsive to workers' concerns or fail to address them in a timely manner. Under these conditions, nurses may perceive the work environment as unsupportive, hostile, or unhealthy.

Nurses and their colleagues should carefully assess the reality of their situation. Are they working in an environment that has potential to improve? Are there changes that can be made with the support of colleagues or managers that will contribute to more positive outcomes? Are they contributing to the morale problem, or are they part of the solution?

Regardless of whether low morale stems from a legitimate issue directly affecting employees or the spreading of negativity, it must be addressed. Resolving issues of discontent entails

* identifying the nature and source of the problem,

* dealing directly with negative coworkers,

* taking responsibility for one's own attitude, and

* being part of the solution, all while continuing to provide quality patient care.

Identify the problem. If a team member believes a particular situation could--or should--be better, he or she first must determine the nature and source of the specific problem. Does a problem actually exist, or is it simply perceived based on the complaints or dissatisfaction of others? Are colleagues unhappy because of unsatisfactory working conditions, or because they do not like the work they are doing and the related responsibilities?

Health Care Industry

Employee morale and patient safety

AORN Journal, Dec, 2004 by Suzanne C. Beyea

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