Purpose: Improve overall engagement through utilization of the medical-surgical nurse’s voice – seeking out nurse’s ideas and recommendations for clinical and organizational operations during the COVID-19 pandemic.
Description: Nurse engagement is a concept often used to describe a nurse’s commitment to and satisfaction with their job. It has been linked to improved quality, safety, and patient experience outcomes (Wan et al, 2018). A key driver for nurse engagement is in listening and responding to the nurse’s voice (George & Massey, 2020). However, when a 356-bed community hospital conducted their annual caregiver engagement survey in October 2020, the results showed that only 37% of caregivers in the medical-surgical units and float pool felt engaged with the organization and the work they do. This quality improvement initiative was implemented by all nurse leaders over medical-surgical departments and focused on increased visibility by 1) being out on the floor dialoguing with direct care nurses (DCNs), 2) providing clinical care as needed, and 3) huddling to communicate concerns and seek feedback and input prior to changes impacting DCN’s work. This provided a true shared governance approach (George & Massey, 2020). Rather than solving problems from the top down, when challenges to patient care and/or operations were identified, nurse leaders sought out potential solutions from DCNs regarding such things as approaches to staffing and patient monitoring.
During the Southern California COVID-19 surge from December 2020 to February 2021, nurse leaders (directors, managers, assistant nurse managers) increased their visibility on nursing units and focused on seeking the input of DCNs prior to making operational decisions affecting patient care. DCNs had the opportunity to offer their ideas and opinions prior to implementation of changes to their practice (Mohamed et al, 2021). Their input was also used to monitor COVID-positive patients more efficiently and safely outside of the intensive care unit (ICU) setting.
Evaluation/outcome: The annual caregiver engagement survey in October 2021 showed that medical-surgical caregiver engagement increased from 37% to 61% overall, a 64.86% increase in engagement. Utilizing the DCN voice during the COVID-19 pandemic allowed clinical nurses and leaders to work together to improve overall caregiver engagement or nurse’s commitment to and satisfaction with their job. Additionally, caregivers felt that they were contributing to the solution, which anecdotally decreased nurse resistance to change when new initiatives were rolled out. Also of note, there was zero first-year turnover for DCNs in these areas during the same time period.
Evidence-based references 1. George, V. and Massey, L. (2020). Proactive strategy to improve staff engagement. Nurse Leader, 18(6):532-535. doi:10.1016/j.mnl.2020.08.008 2. Mohamed, S.A., Hendy, A., Ezzat Mahmoud, O. and Mohamed Mohamed, S. (2021). Mattering perception, work engagement and its relation to burnout amongst nurses during coronavirus outbreak. Nursing Open. doi:10.1002/nop2.1075 3. Wan, Q., Zhou, W., Li, Z., Shang, S. and Yu, F. (2018). Work engagement and its predictors in registered nurses: A cross-sectional design. Nursing & Health Sciences, 20(4):415-421. doi:10.1111/nhs.12424