5 Reasons Why Nursing Staff May Disengage from their Work

By Rose O. Sherman, EdD, RN, FAAN

“Celebrate what you want to see more of.” Tom Peters

A frequent challenge that I hear from nurse leaders involves staff disengagement. One nurse leader recently lamented that “Many of my nurses make it very clear that they are here to do their 12 hours and go home. We have practice councils and can’t get participation. We have a clinical ladder in place, and staff don’t even take the time to put together a portfolio that could result in a higher rate of pay. We have an excellent tuition reimbursement program, and I can’t convince some of our staff to go back for their BSN. How can I promote a higher level of professionalism when they are not engaged.”

Research by the Gallup corporation and others shows that engaged employees are more productive. They are more profitable, more customer-focused, safer, and more likely to withstand temptations to leave. Why staff disengage from their work is an interesting question. The literature on employee engagement provides some important guidance for nurse leaders. Here are five possible reasons in today’s health care environment for staff disengagement:

1. Fatigue from lack of sleep

Jim Loehr and Tony Schwartz in their work The Power of Full Engagement argue that adequate rest is essential to full engagement. Fatigue depletes physical energy and makes us more vulnerable to negative emotions. This lack of sleep is a serious problem in nursing today with the 12 hour tour. Geiger-Brown & Trinkoff who study the impact of the 12 hour tour report that nurses sleep on average only 5.5 hours between 12 hour tours when a minimum of 7 hours is recommended for full engagement.

2. Feeling devalued and unrecognized

Leaders must show that they value employees. In First, Break All the Rules, Marcus Buckingham and Curt Coffman present a strong case to suggest that it is the first line manager who has the strongest impact on employees feeling valued and connected. Nurses want to know that their work matters and that they are contributing to the organization’s success in a meaningful way. This has to be verbalized. Great nurse leaders look to build strong teams; they create an environment that fosters trust and collaboration. Gallup surveys indicate that being cared about by colleagues is a strong predictor of employee engagement. Nurses who work in environments where horizontal violence is tolerated and they are victimized may disengage from their work.

3. Lack of connection to the organization’s mission, values and goals

Engaged employees are fully engaged with and enthusiastic about their work. If a nurse begins to feel that the organization’s mission, values and goals are not congruent with how he or she wants to practice nursing, disengagement can occur.

4. Dissatisfaction with the job and benefits but fear or lack of options to pursue other professional opportunities

Nurses want to feel proud about their jobs, their performance, and their organization.Researchers who study disengagement report that the process often begins when a staff member starts to feel that their needs or expectations are not being met by their organization’s management. They may rethink the wisdom of having accepted their current position, and even start to think about leaving the organization. Unfortunately even in nursing, the options to move to another environment in today’s health care system may be limited for staff. When this happens, staff can disengage, remain with the organization but cease being productive.

5. Too few opportunities for growth and development

Most nursing staff today look for opportunities to develop their skills and mastery at their jobs. Mastery is a desire to get better and better at something that matters. This requires opportunities to learn, practice and make mistakes. When environments don’t support this learning, staff can disengage and lose interest in their work. If a staff member does not see future opportunities for growth, they may resist returning to school for a higher level of education.

There are compelling reasons to keep staff engaged in their work. Research done in hospitals who have received magnet designation clearly indicates that a more satisfied and engaged staff promotes better patient outcomes. While employees definitely share responsibility for staying engaged, nurse leaders also play an important role in promoting the type of passion and enthusiasm that leads to staff engagement.

Read to Lead

Amabile, T. & Kramer, S. (2011). The Progress Principle: Using Small Wins to Ignite Joy, Engagement and Creativity at Work. Boston: Harvard Busines Press.

Buckingham, M. & Coffman, C. (1999). First Break all the Rules: What the World’s Greatest Managers do Differently. Simon and Schuster.

Geiger-Brown, J. & Trinkoff, M. (2010). Is it time to pull the plug on 12-hour tours: Part 1. The evidence. Journal of Nursing Administration, 40 (3) 100-102.

Loehr, J. & Schwartz, T. (2003). The Power of Full Engagement. New York: Free Press.