Nursing & Healthcare News

“Nurses Don’t Like to Work Short-Staffed”

AACN study highlights the need for healthy work environments

Three registered nurses in blue scrubs are walking into a patient's room

As healthcare organizations around the country grapple with mounting nursing shortages, a new study from the American Association of Critical-Care Nurses (AACN) emphasizes the importance of providing healthier work environments in order to attract and retain nurses.

Lower Job Satisfaction

Back in October 2021, the AACN conducted the fifth in its series of large-scale nurse work environment studies, assessing nurses’ feelings about their units and organizations.

The survey questionnaires included questions about appropriate staffing, authentic leadership, communication and collaboration, effective decision-making, meaningful recognition, and physical and psychological safety.

AACN survey data has consistently demonstrated that when a nursing workplace scores well in these areas, nurses’ job satisfaction tends to be greater, reducing turnover.

There is cause for concern in the results of the latest study. Recently published in the journal Critical Care Nurse, results show that nurses’ work environments have declined in nearly every area since the previous survey in 2018.

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Consequently, only 14 percent of 2021 respondents said they were very satisfied with their current job, down from 29 percent in 2018. Two-thirds of 2021 respondents said they plan to leave their current position within the next three years — and more than half of those respondents (36 percent) planned to leave within six to 12 months.

Staffing Shortfall = Vicious Cycle

The survey data makes clear that inadequate staffing is already a major problem: Fifty-one percent of the 9,335 working RNs who responded to the 2021 survey said their unit has appropriate staffing less than half of the time.

Only 24 percent of 2021 respondents said their unit is appropriately staffed at least three-fourths of the time, down from 39 percent in 2018.

“That should be scary to a lot of people,” says Beth Ulrich, RN, Ed.D., lead author of the 2021 and 2018 studies.

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These results are especially concerning because staffing shortfalls can quickly become a vicious cycle: Nurses are more likely to report planning to leave a unit that lacks appropriate staffing, and that trend becomes more pronounced the longer the problem goes unaddressed. “Nurses don’t like to work short-staffed,” Ulrich remarks.

Improving Retention

The study authors warn that simply hiring more nurses will not be enough to stem this tide unless healthcare organizations also focus on improving work environments. “[I]f you bring new nurses into an unhealthy work environment,” says Ulrich, “they will go right out the back door.”

“Fortunately,” the authors note, “the study data also powerfully show that actively focusing on the work environment makes a difference, and across the board, results are improved when the environment is addressed.”

Another effective strategy may be to pay nurses more. Sixty-three percent of the 2021 respondents who reported planning to leave their current jobs said higher salary and benefits would be likely to change their minds.

“It is time for bold action, and this study shows the way,” the authors conclude.

You can read the full study in the August 1 online edition of Critical Care Nurse. Learn more about the AACN Healthy Work Environment standards and how to implement them.

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