Nurse Work Engagement - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, FAAN

One of my students recently assumed a leadership role on a unit and has found her nursing staff to be very disengaged from their work. She explained her dilemma “they come in and do their 12 hours and leave……I can’t even get them to work on their professional portfolios to move them up on the clinical ladder.” Unfortunately, my student is not the only leader who is having this experience. Recent nationwide research conducted by the Advisory Board indicates that only 32.8% of Registered Nurses are engaged in their work and 7.4% are actively disengaged. Statistically, professional nurses have lower work engagement and higher disengagement rates than other frontline staff in healthcare agencies. This is troubling because nurses contribute substantially to the patient care experience and are also crucial in efforts to transform healthcare.

What is Engagement?

There is a lack of consensus in the literature about a definition for work engagement and how to best measure it. Conceptually, it has been linked to empowerment, job satisfaction, job involvement and organizational commitment. Staff engaged in their work have been noted to exhibit passion, commitment and a willingness to invest in themselves to help their organizations succeed. Work engagement has been found to be higher among nurses working for nurse managers who practice authentic leadership and are themselves engaged in their work. Workload, level of organizational change, decision latitude and career development opportunities have also been found to have impact on levels of engagement along with the level of job stress. The ability to effectively engage employees is now recognized as an important business differentiator. In healthcare, it has been shown to impact quality of care, patient satisfaction and safety.

Promoting Engagement

. So how can we better promote organizational loyalty and engagement. Here are five key strategies:

Promote identification with the organization: help staff to see how the mission and values of the organization are consistent with his or her personal values.
Connect staff to the success/status of the organization: encourage staff to develop a sense of pride in an organization by showing how their contributions matter in the organization’s accomplishments and status.
Create security: give staff a sense of security about their employability and potential career paths within the organization.
Provide recognition and opportunities to build skills: validate the skills and worth of staff and promote camaraderie and teamwork. 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.
Build trust: build an environment of trust and transparency. Demonstrate that as a leader, you trust your staff and can personally be trusted.

Even with the use of these strategies, the quest to improve employee engagement is ongoing. What works to engage employees needs to be revised over time. The health care environment has become one of constant change and employees needs change as new generational cohorts with different attitudes, values and beliefs join the workforce. Leaders need to view employee engagement as an going journey that demands intentional interventions. During the past decade, healthcare agencies have experienced unusually low turnover BUT this is changing and turnover rates are beginning to increase. I predict that within the next two years – engaging and retaining staff will soon become one of our highest leadership priorities.

Read to Lead

Advisory Board (April 2014). The National Prescription for Nurse Engagement.