Nursing Job Satisfaction
Higher Nursing Job Satisfaction Is Achievable
No Bad Handoffs ➔ Better Shifts ➔ Happier Nurses
We’re living in a new era where hospital nursing is more complex than ever. 50% of bedside nurses now say they’re burnt out, nursing job satisfaction is plummeting and turnover rates are spiking.
Nurses choose hospitals that find meaningful ways to care for them, and we leave the ones that don’t. Nurses prefer hospitals that:
- Reduce their stress
- Help them get familiar with patients as quickly as possible
- Reduce unnecessary variation in communication
- Make them feel part of a high-performing team
- Have a collaborative work culture
Nurses First™ can help you with each of these.
“When you get good report, your day will be better.”
– Walela, Bedside Nurse
The best way to support nurses and improve nursing job satisfaction is to give them the resources they need to do their best work. That includes an efficient, standardized handover that lets them hit the ground running, wasting less time searching for information, and more time for what they like to do: problem solving and proactively getting ahead in their day.
Less stress can mean lower turnover. Nursing turnover fell to less than 3% on the unit where we first developed our standardized communication processes.
Behaviors become habits, and habits become culture. You’re already doing a lot to support your nurses. You can get the most out of those efforts by transforming the most stressful part of a nursing shift, the first 30 minutes, with an efficient Change of Shift Huddle and a Structured Bedside Handover.
Voices from the Frontline
“We had a Medical Emergency Team response one night. And one of the new Grad nurses was in charge of this patient, she gave handover to the MET team as they arrived. And I was so proud of her. She did an amazing job and the MET team just looked at her and from their eyes she could have been a nurse with 20 years experience.”
– Charge Nurse
“[This] is a skillset that we knew we needed…Staff watched the video and had immediate interest, asking “Where do we sign up?”
– CNO
“I think a lot of the value from change of shift huddle in the morning is you get how many people are leaving, how many surgeries you expects, DNRs, high fall risks, runs through all of the important things that you need to know if something’s happening in a room and it’s not your patient and you just happen to run in, you can say I remember this patient’s high fall risk and take the right actions.”
– Nurse
“Physicians seek out that nurse”
– Brittany, RN
“She came back to the ward really proud and really confident that she’d given it a great handover”
– Amy, RN
“[It elevates] what nurses have to communicate. It’s professionalism, it’s accuracy…So learn it, stick with it, follow our lead and you won’t be sorry.”
– CNO
“Help her to be a great member of this team, even if it’s only for today”
– Sarah, RN
“From their eyes she could have been a nurse with 20 years experience”
– Ellen, RN
“The bedside report that we use in bedside handover gives you a head to toe assessment. It keeps you organized so you’re not bouncing between subjects. And it paints a better picture that way.”
– Nurse
“I try to listen to which patients either have fallen or we’re very worried about falling because if the bed alarm goes off and you’re the only person sitting in the nurses station, you want to know how fast should I run to that bed alarm? I think that’s very useful information that we parse out in the morning huddle.”
– Charge Nurse
“I try to listen to which patients either have fallen or we’re very worried about falling because if the bed alarm goes off and you’re the only person sitting in the nurses station, you want to know how fast should I run to that bed alarm? I think that’s very useful information that we parse out in the morning huddle.”
– Nurse
“It has truly changed the way that we start our shift…it’s just amazing how this has played out.”
– Director of Nursing
“You’ve got a structure and you make sure you don’t miss anything. It’s really easy to just write in the information and as you go through you think of something that you didn’t even remember at the time, but because it’s already there to sort of remind you, it helps with bringing on that memory. But I think [Nurses First] is really good.“
– Student Nurse
“There is no way in the past that would have happened”
– Ron, MD
“I think change of shift huddle is exciting. The nurses really enjoy that and they take time to prepare the change of shift huddle … it’s unbelieveable. They’re doing a great job at it. So I think that’s something that’s really enjoyed.”
– Unit Nurse Manager
“It’s been amazing how this has played out.”
– Kathy, AVP
“This is the way healthcare should be.”
– Patient
“We see the benefits of having the uniform process.”
– Amy, RN
“Less time in hospital, the freeing up of beds. The care is better. The communication is better.”
– Chair Regional Health Authority
“When you do it this way you have a cohesiveness on the unit”
– Ashlie, RN
“I think it cuts out all the unnecessary information that isn’t needed that nurses may just pass on that doesn’t need to be included. So it keeps us focused on the patient and what they’re here for and the medical facts and not social things or other things that can sometimes creep into report.”
– Nurse
“A young nurse had to handover a patient to the ICU team, went over there with absolute confidence standing in front of ICU physicians and nurses all staring at her. She didn’t feel nervous because she just pulled out the bedside handover tool and she just went through it like we do on the ward, systems approach, and then she looked at everybody. She expected all these questions to come, but she’d covered everything. Not even the doctors had any questions and she came back to the ward really proud and really confident that she’d given it a great handover.”
– Charge Nurse
“We’re incorporating [the] patient more with the bedside handoff reports so they’re more aware of what’s going on with their care. And, their questions and their input.”
– Nurse
“If we have relieving staff, we use the huddle to introduce them. Everybody says hi, we let everybody know their name and who they’re working with so that people can see them in the corridor and check in if they’re okay and they know their name. It historically has made the relieving staff really feel welcome and valued and happy within the unit and happy to come back to the unit as well.”
– Charge Nurse
“There’s a couple of times that we’ve had patients that have needed a little bit more emotional support. And so that’s been noted in the change of shift huddle, which I think is really appropriate, especially for us [nurses] because we’re all in and out of each other’s rooms for most of [the] shift.”
– Nurse
“I think it cuts out all the unnecessary information that isn’t needed that nurses may just pass on that doesn’t need to be included. So it keep us focused on the patient and what they’re here for and the medical facts and not social things or other things that can sometimes creep into report.”
– Nurse
“I really like the quality safety checklist with the Foley Catheters. Sometimes I think they get left in longer than they’re supposed to. People forget about it. You know, foley was in and this has been in for so many days, can we do a voiding trial on this patient?”
– Nurse
“There’s a great continuity and a safety net effectively for every patient, every time, every day.”
– Sarah, Charge Nurse
“Often in our medical system I think patients sometimes feel they’re left out: what’s going on with their treatment, when are they going to see their doctor next. It was incredible what I saw… Less time waiting for an in-patient bed, shorter hospital stays, better patient outcomes, and an increased patient and family, and staff satisfaction.”
– CNO
“[Nurses First bedside handover] gives you information and it gives you a reliance on your, on your team member that you’re going to get the information you need to have a great experience with that patient.”
– Director of Nursing
“Nurses first has given us that structure that I think we need as nurses.”
– AVP Acute Care
“If I had to tell myself something now that I wish I knew three, six months ago, it would have been, we should have done this sooner. We should have been after Nurses First a year ago.”
– AVP Acute Care
“I’m not worried about going to work anymore.”
– Nurse
“Nurses hear [the information] for the entire floor. So it triggers you to say, okay, so 21 has a bed alarm. That’s not my patient, but 21 has a bed alarm, so I need to make sure that if something happens in that room, I [know when I] go in there, we’re all responsible.”
– Nurse
” I think the good thing about the [Nurses First] bedside handover is that you can tweak it to your unit. So handovers before would not have been potentially as accurate as what I would like them to be or expect them to be. Whereas now we’ve got this process and yeah you could give that handover and it’d be 98% accurate.”
– Unit Nurse Manager
“We rolled out hospital-wide almost overnight. We were able to embed the same process for change of shift in every unit. We were able to free our nurses to focus on care, not information gathering.”
– CNO
“Having something already filled out by the previous nurse, handing it to you, and you going in together, you’re just looking along and you can listen, you’re not worried about writing down and that’s made this much easier.”
– Nurse
“The change of shift huddle kind of gets everybody ready, gets everyone there and … gives you a positive attitude for the day and you know incoming admissions, discharges, what’s planned.”
– Nurse
There’s great power in beginnings.
Change the first 20 minutes of each shift,
and you change the culture of your unit
Team Huddle
Our nurses didn’t feel like a team and started each shift more like a group of individuals running around. So we began a Change of Shift Huddle which takes 3 minutes. The off-going charge nurse reads through a standard form to the oncoming shift. It’s the most professional, efficient team meeting you’ll see anywhere in the hospital and starts with a 1-page form. You can use ours. Tens of thousands of nursing shifts have used it.
Bedside Handover
As nurses, we dread getting bad handoff. When there’s no structure, each nurse gives report their own way and it feels less safe and more stressful.
So our units decided to standardize each bedside handover. The heart of our handover is a structured, single-page shift report form using an ISBAR framework, Review of Systems outline, and it’s customized for the unit. It’s presented top to bottom by the outgoing nurse, then handed over with our patient.
Safety and Quality
The assurance of quality and safety is the single most significant responsibility of leaders in healthcare delivery. It’s a cornerstone of our careers.
The hand-off process is pivotal to patient safety. Many breaches of patient safety occur around change-of-shift. Most hospitals have adopted some level of bedside handover by now, but telling nurses to give report at the bedside doesn’t reduce unnecessary variation. Every nurse has their own way of giving report and nursing handover is typically inconsistent and unstructured.
Patient Satisfaction
High patient satisfaction scores are achievable and it’s a natural result of hardwiring a daily “wow moment” for each patient.
HCAHPS scores are driven by “top box” positive responses, but it’s hard to impress every patient every day. Asking stressed-out nurses to also be “customer service agents” isn’t the best approach.
Nurse Engagement
We’re living in a new era. Hospital nursing is more complex than ever and 50% of bedside nurses now say they’re burnt out. Turnover rates are spiking. Nurses choose hospitals that find meaningful ways to care for them, and we leave the ones that don’t. They prefer hospitals that:
-Reduce stress
-Help them get familiar with patients as quickly as possible
-Reduce unnecessary variation in communication
-Make them feel part of a high-performing team
-Have a collaborative work culture