Letters of Advice
Solutions to the nursing crisis can be activated on the floor, among nurses who support one another

by Tom J. Bates

I was at work the other morning, once again wondering how in the world the nursing shortage is going to be solved. I am a nursing supervisor and this subject comes up often, especially after making multiple phone calls to staff nurses and registries to find help.

Many contributing factors affect the nursing shortage: declining enrollment in nursing schools, shortage of nursing school faculty, increasing average age of RNs, aging baby boomers, job burnout, and high turnover and vacancy rates. Education and advertisement campaigns, coalitions, committees and state, federal and local legislation all speak to the urgency of solving this crisis.

One significant strategy to improve the nursing shortage is to take personal responsibility for improving the quality of the work environment. It is easy to see how different personalities combined with a stressful work environment can result in tense andtimes-explosive situations. In a hospital setting, these situations are not abnormal.

It is the way we sometimes handle these situations with each other that destroy trust and respect and-occasionally-discredit the profession. Some have even considered quitting nursing or steering others away from it-not the best outlook for a profession with a projected need of 400,000 RNs nationwide by 2020, according to a study by Peter Buerhaus, Ph.D., RN, FAAN, and colleagues published in the Journal of the American Medical Association (June 14, 2000).

How can each of us contribute to solving the nursing shortage? I propose we use a modified version of the ACLS acronym:

A Assertive communication
C Compassion and caring
L Life modeling
S Support

Assertive communication

Wouldn't it be nice if every time one of your co-workers made you angry, you could communicate your dissatisfaction to them in a positive, healthy way that resulted in a win-win situation?

Through assertive communication, individuals or groups come together and confront problems in a direct and respectful manner. Disagreements may remain, but both parties leave with their dignity intact. Furthermore, disagreements are kept confidential, thus keeping the rumor mill from running rampant.

Occasionally, third-party mediation is warranted for highly sensitive or volatile issues, but the end result is the same-a win-win situation for both parties.

Compassion and caring

When trying to recruit new graduates, we often say "we eat our young" as one of the reasons why new nurses are discouraged or leave our hospital. This cliché needs to be eradicated. New nurses have different learning curves and understanding this will help decrease frustration when someone "just doesn't get it."

Furthermore, we need to stop being tattletales, especially against new graduates by gossiping about their mistakes. This type of environment simply drives nurses away.

Seasoned nurses (including new hires and registry nurses) need care and compassion, too. A simple "Do you need help with anything?" or words of encouragement at just the right time can communicate powerfully that you value your co-workers and are concerned for their welfare.

Life modeling

Life modeling refers to modeling behaviors that serve to create a positive work environment. This requires honest and sometimes difficult introspection to root out any negative behaviors.

Life modeling also entails being a positive ambassador for nursing. We do an excellent job of telling people how miserable our profession can be, but we need to focus on communicating the victories. Exciting people with positive and powerful nursing stories can revitalize our co-workers while helping to recruit a new workforce.

Support

Bearing each other's burdens can be difficult when you already feel stretched thin meeting your patients' needs. However, when staff engages in collaborative support, our jobs become easier, we become connected emotionally and, ultimately, we create a positive work environment that people want to be a part of.

"ACLS" is by no means the only way to create and maintain a positive work environment, but it is a good start for a profession gasping for help. I suspect that many of us in health care today have lost touch with what makes us excited about nursing.

Let's try to create an atmosphere in which people experience the joy of caring for another human being as only a nurse can.

©NurseWeek Publishing