A Healthy Workplace Promotes Quality Care

Nursing BC, Oct 2004 by Searle, Howard

Because a healthy work force and a healthy workplace are integral ingredients in providing top-quality patient care, health authority leaders need to focus attention on creating a healthy work environment for their employees, concluded British Columbia's Auditor General Wayne Strelioff in his June 2004 report In Sickness and in Health: Healthy Workplaces for British Columbia's Health Care Workers (available online at bcauditor.com/auditorgeneral.htm). ". . . inadequate attention to work environment issues . . . has resulted in health care workers - and even their patients and families - feeling the effects of workplace stresses."

We have known for a long time that there is a direct correlation between the quality of nurses' practice environments and job satisfaction, productivity, recruitment, retention, and most significantly, the quality of client care (RNABC policy statement Nursing Practice Environments for Safe and Appropriate Care - pub. 397). That's why RNABC has been promoting its Guidelines for a Quality Practice Environment for Registered Nurses in British Columbia on which we have made presentations to registered nurses and senior management in B.C.'s health authorities. Implementation of these guidelines would go a long way toward rectifying the deficiencies in the work environment noted in the auditor general's report and help to reduce the demand for overtime due to sick calls, etc.

To their credit, employers have made physical improvements in their organizations, such as installation of ceiling lifts and implementation of MSI prevention programs and no-lift policies, that have resulted in a gradual reduction in musculoskeletal injury claims and in millions of dollars in savings paid by the health authorities to WCB for claims. However, as Strelioff points out, this approach focuses on addressing the symptoms, but fails to correct the underlying causes.

A safe and healthy work environment requires not only a safe physical environment, but it also requires a healthy psychosocial environment for employees - which is free of abnormal levels of stress - and a support system that encourages employees to adopt and maintain healthy lifestyles.

In their responses to the auditor general's report, the health authorities shared many of the goals and concerns raised in the report and expressed their intent to try to achieve the goal of healthy workplaces for their employees. This must include addressing factors, such as increasing workloads, lack of supports, lack of respect, poor communications and deteriorating interpersonal relations, in order to create a more effective practice environment and improved patient care.

It is exciting news for registered nurses in British Columbia that the Office of the Auditor General has formally acknowledged that health care workers are staying away from work in droves because of heavy workloads, highly stressful work environments and other factors, causing huge payouts of tax dollars for overtime and sick time, and that employers must act immediately to enhance work environments in a way that will reduce absenteeism and injury rates, and will enhance retention and recruitment of staff. It is significant because confirmation that the problem exists goes half-way toward creating solutions.

According to RNABC's Guidelines for a Quality Practice Environment for Registered Nurses in British Columbia, "Creating quality practice environments is a shared responsibility of governments, employers and nursing organizations." As registered nurses, we have a responsibility to participate in creating a practice environment that promotes safe care. RNABC's Guidelines for a Quality Practice Environment for Registered Nurses in British Columbia support our mandate to protect the public and can be used by registered nurses to evaluate and improve practice environments.

BY HOWARD SEARLE, RN, BSC, CNN(c)

RNABC PRESIDENT

E-MAIL HOWARD SEARLE AT president@rnabc.bc.ca