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  • Kelly Willis, MSN, MBA-HM

Essential Components for a Healthy Work Environment

Updated: Mar 11

What comes to mind when you think of a healthy work environment in a nursing unit?

In my experience, it’s a place free from verbal, emotional, and physical abuse. A healthy environment does not tolerate bullying, backstabbing, intentional ignorance, scapegoating, intimidating behavior, or rudeness.

In short, it’s a place where both patients and employees feel safe, heard, and cared for.

These negative behaviors can take up valuable real estate in our brains. Unfortunately, a mind preoccupied with workplace issues is one that isn’t focused on the task at hand, and for nurses, even a small mistake can be deadly.

The Joint Commission states that healthcare is no place for bullying, and the American Nurses Association has a "zero tolerance" position statement on bullying.

If you want to see a positive change in your work environment, there are a few essential components that can help. While putting these ideas into practice isn’t always easy, it can be extremely positive for employers and staff alike.


Educating Leaders

Organizational leaders must be in the know about workplace bullying and incivility. From front-line leaders and charge nurses to senior management, everyone must be educated on the issues: what they are, how to identify them, and what can be done to prevent and avoid them. If you can’t spot the problems, how can you solve them?


Staff Education

Employees must also be able to identify workplace bullying and incivility and know how to deal with them when they occur. It’s helpful to have a written checklist of negative behaviors posted in the unit.

For ideas, check out see John Ohlmstead’s The Cure for Workplace Bullying. Using this Negative Behavior Checklist ensures that all staff are aware of expectations and know what behaviors are unacceptable. Posting a behavior of the month is a fun and effective way to engage staff in discussions regarding negative behaviors.


Accountability

A zero-tolerance bullying policy is worthless if not enforced.

So, what happens when you, as a leader, get a referral from a charge nurse or other team member regarding bullying or uncivil behavior?

First, put personal emotions and initial judgment aside. A leader must ensure they have both sides of the story by speaking to all staff involved, separately, together, or both. Don’t assume, take sides, or jump to conclusions as that approach can lead to misunderstanding. You might also fail to identify patterns of negative behavior that require progressive disciplinary action beyond coaching and mentoring.

Leaders must lead by example. If the leader displays negative behaviors, the team will see them as acceptable. Remember, "What you permit, you promote!”


Change Champions

If a healthy work environment initiative is new to a unit, it’s essential to have a few role models on the ground. A peer often holds more influence over employees than leaders or managers do. Choose a few champions that are as excited about the initiative as you are. They will model positive behavior for their coworkers and lead by example.


Gaining Senior Management Buy-In

For the initiative to succeed, it must be endorsed by senior management. Words without follow-through won’t cut it. Without tangible investment (rounding) and knowledge of the subject, a healthy workplace initiative will peter out.

If an organization truly has a zero-tolerance policy on bullying and incivility, it shouldn’t be difficult to weed out consistently problematic staff. Patterned offenders should be dismissed without pushback from management if coaching and progressive discipline prove ineffective.


This, of course, is just a brief list of essentials to help foster a healthy work environment in your unit. Ultimately, when it comes to policies around workplace bullying and incivility, consistency is critical. Hold staff and yourself accountable. The more consistent you are, the clearer it will be that negative behaviors will not be tolerated.

Identify positive staff role models who will help create a work environment that people like to be and want to stay in. Assure senior management buy-in to enforce a zero-tolerance policy.

Lastly, be patient. Building a healthy work environment takes time, consistency, and commitment, but the payoff is always worth it.


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