Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level

Abstract There is growing evidence in the nursing literature regarding the positive impact of healthy work environments on staff satisfaction, retention, improved patient outcomes, and organizational performance. The establishment of a healthy work environment requires strong nursing leadership at all levels of the organization, but especially at the point of care or unit level where most front line staff work and patient care is delivered. Growing future nurse leaders is a long term quest. It can be challenging for today's leaders to predict what knowledge, skills, and abilities will be needed to lead in the future. This article presents a review of the literature regarding the importance of healthy work environments in healthcare organizations and the significant role of nurse leaders in building and sustaining these healthy environments. It also discusses the development of leadership skills by presenting the Nurse Manager Leadership Collaborative Learning Domain Framework, a widely used competency model for nursing leadership development that can serve as a useful resource in the development of leaders at the unit level. Citation: Sherman, R., Pross, E., (Jan. 31, 2010) "Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level" OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 1, Manuscript 1. DOI: 10.3912/OJIN.Vol15No01Man01 Keywords: business of caring, Clinical Nurse Leaders, communication, conflict management, development, emerging nurse leaders, healthy work environments, leadership, Nurse Manager Leadership Collaborative Learning Domain Framework, NMLC, nursing There is growing evidence in the nursing literature about the positive impact of a healthy work environment on staff satisfaction, retention, improved patient outcomes, and organizational performance (Aiken, Clarke, Sloane, Lake, & Cheney, 2008; Shamian & El-Jardali, 2007). Many organizations, including the American Association of Critical Care Nurses (2005), the American Nurses Credentialing Center (2008), the Institute of Medicine (2004), the International Council of Nurses (2007), and the American Association of Colleges of Nursing (2002), have outlined criteria that characterize a healthy work environment. The Nursing Organizations Alliance, a coalition of major nursing organizations throughout the United States (US), issued a joint position statement that identified the following nine key elements that support the development of healthful practice/work environments: * A collaborative practice culture * A communication rich culture * A culture of accountability * The presence of adequate numbers of qualified nurses * The presence of expert, competent, credible, visible leadership * Shared decision making at all levels * The encouragement of professional practice & continued growth/development * Recognition of the value of nursing's contribution * Recognition by nurses for the their meaningful contributions to practice (Nursing Organizations Alliance, 2004) Although much work has been done to identify what needs to happen in practice environments to maximize the health and well being of nurses, the achievement of these key elements has proved challenging for many organizations in today's turbulent healthcare environment (Laschinger, 2007; Ulrich et al, 2009). The establishment of a healthy work environment requires strong nursing leadership at all levels of the organization, but especially at the point of care or unit level where most front line staff work and where patient care is delivered. With the changes that have occurred in the nurse manager role over the past two decades, which include multiple-unit management and increased responsibility for budget, staffing, and regulatory compliance (Sherman, Bishop, Eggenberger, & Karden, 2007; Shirey & Fisher, 2008), leadership at the point of care is now often provided by nurses in roles such charge nurse, unit facilitator, or clinical nurse leader. …