New research from the American Association of Critical-Care Nurses (AACN) underscores the ongoing impact of the COVID-19 pandemic on nurses and the benefits of creating and sustaining healthy work environments (HWEs) to support nurse staffing, retention and optimal patient care.
Results from AACN’s fifth national survey of nurses are now published online ahead of the October 2022 print issue of Critical Care Nurse (CCN). “National Nurse Work Environments – October 2021: A Status Report” includes key findings from AACN’s survey of more than 9,000 nurses, compares the results with previous studies and recommends areas for improvement.
The 2021 survey was conducted two years earlier than regularly scheduled in an effort to assess the pandemic’s impact on nurses and their work environments. Key findings from the AACN survey include the following:
- The nurse staffing crisis has become significantly worse. Only 24% of the respondents said they have appropriate staffing more than 75% of the time, compared with 39% of respondents in 2018.
- Nurses’ intent to leave their current nursing position increased. More than two-thirds (67%) of respondents stated they intend to leave their nursing position within three years, compared with 54% in 2018.
- Among those who intend to leave, 36% plan to leave within the next year.
- Among those who intend to leave, respondents said top items that could very likely influence them to reconsider include higher salary and benefits (63%, up from 46% in 2018) and better staffing (57%, up from 50% in 2018).
- Satisfaction with being a nurse declined since the last survey. Only 40% of all respondents indicated they were very satisfied with being a registered nurse, compared with 62% in 2018.
- Nurses aren’t feeling safe and valued. Only 47% of the respondents agreed with the statement “My organization values my health and safety,” compared with 68% in 2018. This item had the highest correlation to job satisfaction.
Study co-author and AACN Chief Clinical Officer Connie Barden, MSN, RN, CCRN-K, FAAN, said, “Not surprisingly, the 2021 survey showed a decline in the health of nurses’ work environments. Unchecked, this decline can cause permanent damage to nurse retention and the entire healthcare system.”
Barden said, “A bright spot is that the study indicated implementation of the six AACN Standards for Establishing and Sustaining Healthy Work Environments (HWE standards) can be a game changer. Focusing on these standards is crucial to support nurse well-being, staffing and retention, which are necessary for optimal patient care.” After examining several key nursing challenges, AACN notes that workplaces that had actively implemented any of the six HWE standards showed better results than those that had not. The following includes some insights from the 2021 survey:
- In units that had implemented or were “well on their way” to implementing any of the six HWE standards, nurses’ perceptions of appropriate staffing were higher (44%) than in those that had not implemented the standards or had just begun (16%).
- Respondents working in units that had implemented HWE standards were half as likely to say they intend to leave their position in the next 12 months (26%), compared with those in units without implementation (52%).
- Fifty-five percent of nurses working in units that had implemented any of the HWE standards reported being very satisfied with being a nurse, compared with 34% of those working in units that had not.
- Regarding satisfaction with their current position, 33% of nurses working in units that had implemented the HWE standards reported being very satisfied, compared with 6% of those working in units that had not.
“Our findings indicate that unit or institutional implementation of the AACN HWE standards may mitigate the pandemic’s negative impact on nurses, which may help ease the current staffing crisis,” said principal investigator Beth Ulrich, EdD, RN, FACHE, FAONL, FAAN. She added, “Creating and sustaining healthy work environments is everyone’s responsibility, and this requires changing longstanding cultures, traditions and hierarchies. The benefits of doing so are increasingly clear, as are the consequences of inaction.”