Nurse Engagement Part 1: What It Means For Your Organization

According to the American Nursing Association, nurse engagement is best described as a nurse’s commitment to their profession, organization, job, and overall job satisfaction. More often than not, we tend to focus on the more obvious consequences of unengaged nurses and the impact on quality, patient experience and critical safety which do have very real consequences under a value-based system. However, low engagement can also place a financial strain on hospitals with one study from 2013 estimating hospitals lose an average of $22,2000 annually from decreased productivity for every one disengaged nurse1.  To add to that, this estimate does not take into account the cost of replacing nurses who decide to leave the organization due to low engagement or the costs incurred from training new hires to replace them.
Factors Contributing to Low Engagement
Unfortunately, like many other things in life the honeymoon effect on nurse engagement can be very real. That is to say, that the ANA listed length of time with an organization as one of the factors in decreased engagement with nurses reporting a drop in engagement after their first six months with an organization. Moreover, research also suggests that nurses closest to the bedside reported the lowest engagement, which can further impact patient experience and quality of care.
And while the length of time with the organization and proximity to the bedside are more difficult factors to manage, the good news for leaders is that two other leading factors for nurse engagement can be more easily managed. The ANA also reported that shift length had a significant impact on employee engagement as evidenced by the fact that “percentages of nurses reporting burnout and an intention to leave the job increased incrementally as shift length increased. The percentage of nurses who were dissatisfied with the job was similar for nurses working the most common shift lengths, 8–9 hours and 12–13 hours, but it was higher for nurses working shifts of 10–11 hours and more than 13 hours.”1 Self-scheduling and more effective staffing techniques have also been shown to help reduce nurse burnout.
Out of a list of 10 different engagement drivers, the leading motivators for nurse engagement reported by the ANA were1:

  • I like the work I do
  • My work is meaningful
  • I enjoy working with my coworkers
  • Employees in my work unit make every effort to deliver safe, error-free care
  • My work unit provides high-quality care and service

Lowest-scoring items for nurses are almost all related to their engagement to the organization including1:

  • This organization takes steps to reduce unnecessary procedures
  • My work unit is adequately staffed
  • Different levels of this organization communicate effectively with each other

Luckily for leaders, all of the leading drivers for engagement indicate a commitment to quality patient care and the nursing profession, and are something that can be reinforced through supportive leadership strategies which we will be exploring in part two of the “Nurse Engagement” blog post.
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