Key Changes in How Nurses View Their Work

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

This is the third blog summarizing research I presented at the AONL Research Foundation Keynote at the AONL meeting in New Orleans meeting. My topic was the Evolving Role of Nurse Managers in the New World of Work. To prepare for this presentation, we sought input from nurse managers through five focus groups conducted in February and March 2024. I promised the 141 managers who participated in this research that I would share their feedback in this blog, as many could not attend the conference. In previous blogs, I have written about the impact of staffing shortages on the nurse manager role and what recommendations nurse managers have to improve their roles.

Today, I will focus on seven fundamental changes that nurse managers now see in nurses’ views of their work.  These changes include the following:

1. Nursing staff today are more focused on their lives and less on their work – nurse managers see profound changes in how nurses view their work. Where once there was discussion about work-life balance, contemporary nurses seek ways to fit work into their lives. Some trends observed include working fewer hours, immediate use of paid time off, skyrocketing requests for FMLA, a decline in willingness to work nightshift, and a desire for weekends off.
2. New staff accept positions and clarify that they don’t plan to stay on units beyond a year or two – nurse managers report that new nurses arrive with their career plans. They see jobs more as tours of duty on a longer career trajectory. Forming core teams has proved challenging in a one-and-done environment.
3. Staff today are less committed to organizations and shared governance – nurse managers see a pronounced change in staff trust in organizations and a willingness to become involved in shared governance efforts. Many new staff won’t attend meetings on their day off even if compensated. Some report not understanding professional governance and whether these groups have any outcomes.
4. Nurses will make job changes for pay increases or quickly leave positions if unhappy – many nurse managers report shock at how quickly contemporary nursing staff decide that “things are not working out” in a position. Staff leaving during orientation is not unusual.
5. Nurses now demand answers when units are short-staffed and are less willing to accept professional accountability – nurse managers report that holding nurses accountable for their professional practice has become much more challenging. When managers try to discuss missed nursing care or missed documentation, nurses will often respond – you fix the staffing, and I will get everything done.
6. Younger staff talk openly about exhaustion, burnout, and stress – nurses today talk more openly with their leaders about their mental health and well-being. Nurse managers worry about crossing the line between a leader coach and a therapist. Leaders report that emotional conversations are exhausting and they worry about their own compassion fatigue.
7. Nurses now challenge leaders about decisions and are sometimes disrespectful – nurse managers report an uptick in disrespectful behavior toward leaders. Decisions made by the administration are openly discussed and criticized. Some social influencers encourage this behavior. One manager noted that, “Lashing out and disrespect to leaders seem to be an acceptable behavior for nursing staff now. As leaders, we need to pause and learn not to be reactive yet set boundaries. We must pull these nurses aside and inform them that their behavior is not okay.”

We are in a new world of work. Nurse managers report that not only has the work itself changed and become more complicated, but workplace norms and workforce views are changing. These changes impact the nurse manager’s role, activities, and coaching conversations. In our next blog, I will discuss what nurse managers want executives to know about their roles and how to better support them.

© emergingrnleader.com 2024

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