EDITORIAL
CREATING AND SUSTAINING HEALTHY WORK ENVIRONMENTS
PATRICIA GONCE MORTON, PHD, RN, ACNP-BC, FAAN Editor
M
uch has been written recently regarding bullying and the lack of civility in academic institutions. These unhealthy work environments contribute to employee dissatisfaction, turnover, conflict, and stress among faculty and staff. I have often heard faculty say things such as “Don't take a job at that school…The faculty has a lot of bullies…It is a toxic environment… The senior faculty are nothing but a bunch of prima donnas who make life miserable for the rest of the faculty.” To address the problem, colleges often bring in consultants on the topic of incivility and bullying to whip the faculty into shape and hope that after a day-long workshop, everyone will get along and work collaboratively. I don't know about you, but I have never attended one of these sessions where I felt inspired and hopeful when leaving. In my experience, throwing a few hour sessions at the problem of incivility and bullying has rarely made a significant impact in solving the problem. After having attended many of these sessions in my career, I am left to wonder if administrators really thought the sessions would make a difference or were they instead just looking for a quick solution that enabled them to check the box that they did something to solve the problem. What could really make a difference? What actually could help? I don't think the solutions are simple, and I believe that shifting from a culture of incivility and bullying to one of collaboration and tolerance for
8755-7223
differences will take any organization an enormous amount of time and deliberate effort. Creating healthy work environments requires changing long-standing cultures, traditions, and hierarchies. One possible solution that could help is for academic institutions to adopt the healthy work environment standards developed by the American Association of Critical-Care Nurses (2005). Little will change if academic institutions do not have a formal program in place to address the work environment. Although all must commit to the hard work of changing the environment, the onus is on organizational, departmental, and unit leaders to ensure that it happens. The leaders of the organization must walk the talk and drive the change. The American Association of Critical-Care Nurses has developed six standards for establishing and sustaining healthy work environments. The six standards align with the core competencies for health professionals recommended by the Institute of Medicine and reflect evidencebased and relationship-centered principles of professional performance. I believe that these standards are highly applicable in academia.
Standard 1: Skilled Communication Nurses must be as proficient in communication as they are in clinical skills. And these skills must include written, spoken, and nonverbal communication. Organizations must provide the education and reward system so that conflict-laden situations can be effectively negotiated.
Journal of Professional Nursing, Vol 31, No. 3 (May/June), 2015: pp 165–167 © 2015 Elsevier Inc. All rights reserved.
165 http://dx.doi.org/10.1016/j.profnurs.2015.04.002
166
EDITORIAL
To achieve skilled communication, we must include this content in our curricula so that the next generation of academicians has these skills. Colleges have to develop and implement codes of conduct, zero tolerance policies, and processes for handling disruptive behavior. Faculty and staff should be held accountable for their behavior and include communication as part of performance appraisals. Administrators need to role model skilled communication to ensure congruence between action and words.
Standard 2: True Collaboration True collaboration is a process, not an occurrence that takes a great deal of time and effort to achieve. The goal is that eventually the organization will be characterized as one where joint communication and decision making become the norm. In true collaboration, the unique contribution of each individual is respected. Skilled communication is an integral part of true collaboration as well as trust and mutual respect. Formal processes and structures may need to be developed and fostered to achieve true collaboration. Integrating interprofessional education into the curriculum is an important strategy that may help the next generation of academicians more easily achieve true collaboration. In our colleges, defining accountability and clarifying decision-making authority may be an important step in the process of true collaboration. Skilled communication is foundational to the process of true collaboration, but an organization may need to provide resources for dispute resolution when difficulties arise. Showcasing successful collaborations may be another important strategy.
Standard 3: Effective Decision Making Faculty and staff must be valued and committed partners in making policy, and leading and evaluating organizational initiatives. Yet, conflict often arises when people believe they are given a great deal of responsibility for work but have little input into the decisions that impact the work. The gap between responsibility and decisionmaking authority needs to be clarified. The development and implementation of a true faculty governance system is an essential component of effective decision making. Other strategies to achieve effective decision making in an academic organization include using data for decisions and creating a robust mechanism to evaluate those decisions. Policies need to be reasonable and kept up to date so that they may be effectively used to help guide decisions. Creating forums and other structures for staff and students to have a voice is another useful strategy.
Standard 4: Appropriate Staffing Providing adequate faculty and staff for a college is a significant challenge especially in an era of a nationwide faculty shortage and budget constraints. Careful attention must be paid to the appropriate match between students' and organizational needs and the skills and competencies of the faculty and staff. An inappropriate match hinders the achievement of excellence.
Achievement of appropriate staffing may require testing new models of organizing the work and determining alternate ways to be more efficient in carrying out the work. The development of new and innovative partnerships as well as joint appointments may be a solution. The hiring of “virtual” faculty, nonnurse faculty, and retired faculty may be effective ways to ease the burden of nurse faculty shortages. A careful analysis of faculty's work may reveal instances where staff can step in and do the work so that faculty can concentrate on teaching, scholarship, and service.
Standard 5: Meaningful Recognition Recognition and appreciation are fundamental human needs that often impact satisfaction and retention of employees. When employees feel unrecognized, they often also believe they are undervalued and disrespected by the organization, which can lead to poor morale and decreased productivity. In a healthy work environment, all members of the organization genuinely recognize each other for the value each brings to the work of the organization. Meaningful recognition of work is an essential element of a healthy work environment, but the challenge is to determine what is meaningful. Whatever strategies are used, it is important to create a culture of appreciation that is both top down and bottom up. For some, the opportunity for professional development may be meaningful because it promotes expertise and could lead to advancement. A formal recognition program for staff and faculty may be an effective approach. For others, a personal note from a supervisor or peer provides a valuable source of meaningful recognition.
Standard 6: Authentic Leadership Inadequately positioned and poorly prepared leaders create an enormous problem for any organization. Colleges need leaders with competencies in leading self, leading others, leading organizations, and leading systems. These leaders must be at the table when key strategic, operational, resource, and governance decisions are made. Achievement of authentic leadership for an organization requires leaders to commit to their own development and to serve as role models for others. To enhance the leadership skills of others, mentorship programs need to be developed and professional development opportunities provided. Leadership behaviors should be incorporated into the evaluation of all faculty and staff with commitment to improving skills when deficits are noted. With the challenges of dealing with incivility and bullying in the work place come many opportunities. Leaders of organizations must commit to creating and sustaining healthy work environments by creating the vision, culture, environment, infrastructure, and strategic direction. It is my hope that academic organizations will adopt the healthy work environment standards developed
EDITORIAL
by the American Association of Critical-Care Nurses as a tool to achieve this desired state. If we do not have a formal program in place addressing work environment issues, bullying and incivility will continue to characterize some organizations and the detrimental effects will be widespread.
167
Reference American Association of Critical-Care Nurses (2005). AACN standards for establishing and sustaining healthy work environments. Aliso Viejo:CA: American Association of CriticalCare Nurses.
CREATING AND SUSTAINING HEALTHY WORK ENVIRONMENTS
PATRICIA GONCE MORTON, PHD, RN, ACNP-BC, FAAN Editor
M
uch has been written recently regarding bullying and the lack of civility in academic institutions. These unhealthy work environments contribute to employee dissatisfaction, turnover, conflict, and stress among faculty and staff. I have often heard faculty say things such as “Don't take a job at that school…The faculty has a lot of bullies…It is a toxic environment… The senior faculty are nothing but a bunch of prima donnas who make life miserable for the rest of the faculty.” To address the problem, colleges often bring in consultants on the topic of incivility and bullying to whip the faculty into shape and hope that after a day-long workshop, everyone will get along and work collaboratively. I don't know about you, but I have never attended one of these sessions where I felt inspired and hopeful when leaving. In my experience, throwing a few hour sessions at the problem of incivility and bullying has rarely made a significant impact in solving the problem. After having attended many of these sessions in my career, I am left to wonder if administrators really thought the sessions would make a difference or were they instead just looking for a quick solution that enabled them to check the box that they did something to solve the problem. What could really make a difference? What actually could help? I don't think the solutions are simple, and I believe that shifting from a culture of incivility and bullying to one of collaboration and tolerance for
8755-7223
differences will take any organization an enormous amount of time and deliberate effort. Creating healthy work environments requires changing long-standing cultures, traditions, and hierarchies. One possible solution that could help is for academic institutions to adopt the healthy work environment standards developed by the American Association of Critical-Care Nurses (2005). Little will change if academic institutions do not have a formal program in place to address the work environment. Although all must commit to the hard work of changing the environment, the onus is on organizational, departmental, and unit leaders to ensure that it happens. The leaders of the organization must walk the talk and drive the change. The American Association of Critical-Care Nurses has developed six standards for establishing and sustaining healthy work environments. The six standards align with the core competencies for health professionals recommended by the Institute of Medicine and reflect evidencebased and relationship-centered principles of professional performance. I believe that these standards are highly applicable in academia.
Standard 1: Skilled Communication Nurses must be as proficient in communication as they are in clinical skills. And these skills must include written, spoken, and nonverbal communication. Organizations must provide the education and reward system so that conflict-laden situations can be effectively negotiated.
Journal of Professional Nursing, Vol 31, No. 3 (May/June), 2015: pp 165–167 © 2015 Elsevier Inc. All rights reserved.
165 http://dx.doi.org/10.1016/j.profnurs.2015.04.002
166
EDITORIAL
To achieve skilled communication, we must include this content in our curricula so that the next generation of academicians has these skills. Colleges have to develop and implement codes of conduct, zero tolerance policies, and processes for handling disruptive behavior. Faculty and staff should be held accountable for their behavior and include communication as part of performance appraisals. Administrators need to role model skilled communication to ensure congruence between action and words.
Standard 2: True Collaboration True collaboration is a process, not an occurrence that takes a great deal of time and effort to achieve. The goal is that eventually the organization will be characterized as one where joint communication and decision making become the norm. In true collaboration, the unique contribution of each individual is respected. Skilled communication is an integral part of true collaboration as well as trust and mutual respect. Formal processes and structures may need to be developed and fostered to achieve true collaboration. Integrating interprofessional education into the curriculum is an important strategy that may help the next generation of academicians more easily achieve true collaboration. In our colleges, defining accountability and clarifying decision-making authority may be an important step in the process of true collaboration. Skilled communication is foundational to the process of true collaboration, but an organization may need to provide resources for dispute resolution when difficulties arise. Showcasing successful collaborations may be another important strategy.
Standard 3: Effective Decision Making Faculty and staff must be valued and committed partners in making policy, and leading and evaluating organizational initiatives. Yet, conflict often arises when people believe they are given a great deal of responsibility for work but have little input into the decisions that impact the work. The gap between responsibility and decisionmaking authority needs to be clarified. The development and implementation of a true faculty governance system is an essential component of effective decision making. Other strategies to achieve effective decision making in an academic organization include using data for decisions and creating a robust mechanism to evaluate those decisions. Policies need to be reasonable and kept up to date so that they may be effectively used to help guide decisions. Creating forums and other structures for staff and students to have a voice is another useful strategy.
Standard 4: Appropriate Staffing Providing adequate faculty and staff for a college is a significant challenge especially in an era of a nationwide faculty shortage and budget constraints. Careful attention must be paid to the appropriate match between students' and organizational needs and the skills and competencies of the faculty and staff. An inappropriate match hinders the achievement of excellence.
Achievement of appropriate staffing may require testing new models of organizing the work and determining alternate ways to be more efficient in carrying out the work. The development of new and innovative partnerships as well as joint appointments may be a solution. The hiring of “virtual” faculty, nonnurse faculty, and retired faculty may be effective ways to ease the burden of nurse faculty shortages. A careful analysis of faculty's work may reveal instances where staff can step in and do the work so that faculty can concentrate on teaching, scholarship, and service.
Standard 5: Meaningful Recognition Recognition and appreciation are fundamental human needs that often impact satisfaction and retention of employees. When employees feel unrecognized, they often also believe they are undervalued and disrespected by the organization, which can lead to poor morale and decreased productivity. In a healthy work environment, all members of the organization genuinely recognize each other for the value each brings to the work of the organization. Meaningful recognition of work is an essential element of a healthy work environment, but the challenge is to determine what is meaningful. Whatever strategies are used, it is important to create a culture of appreciation that is both top down and bottom up. For some, the opportunity for professional development may be meaningful because it promotes expertise and could lead to advancement. A formal recognition program for staff and faculty may be an effective approach. For others, a personal note from a supervisor or peer provides a valuable source of meaningful recognition.
Standard 6: Authentic Leadership Inadequately positioned and poorly prepared leaders create an enormous problem for any organization. Colleges need leaders with competencies in leading self, leading others, leading organizations, and leading systems. These leaders must be at the table when key strategic, operational, resource, and governance decisions are made. Achievement of authentic leadership for an organization requires leaders to commit to their own development and to serve as role models for others. To enhance the leadership skills of others, mentorship programs need to be developed and professional development opportunities provided. Leadership behaviors should be incorporated into the evaluation of all faculty and staff with commitment to improving skills when deficits are noted. With the challenges of dealing with incivility and bullying in the work place come many opportunities. Leaders of organizations must commit to creating and sustaining healthy work environments by creating the vision, culture, environment, infrastructure, and strategic direction. It is my hope that academic organizations will adopt the healthy work environment standards developed
EDITORIAL
by the American Association of Critical-Care Nurses as a tool to achieve this desired state. If we do not have a formal program in place addressing work environment issues, bullying and incivility will continue to characterize some organizations and the detrimental effects will be widespread.
167
Reference American Association of Critical-Care Nurses (2005). AACN standards for establishing and sustaining healthy work environments. Aliso Viejo:CA: American Association of CriticalCare Nurses.
