RN satisfaction survey promotes positive change

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Best practice

RN satisfaction survey promotes positive change

Operating room (OR) nurses at Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE, were having trouble finding time for a hot meal. In fact, nearly 40% of them reported not being able to sit down for lunch without a patient interrupting.

“If we have nurses that are missing lunch breaks and not eating, then they are frazzled when they get back into the patient’s room, and they are going to be more prone [to] making mistakes,” says Daryl W. Miller, BSN, RN, senior director of perioperative services at Nemours. “If our employees are feeling nurtured, cared about, and provided for, they in turn will transcribe that into good-quality care for the patient.”

The lack of a lunchtime was just one of the findings from the Nemours OR nurses’ participation in the National Database of Nurse Quality Indicators RN Satisfaction Survey. Miller and Norine K. Watson, MSN, RN, CNAA-BC, director of nursing excellence, reviewed the full survey results and identified where dissatisfaction was most prevalent on the unit. Prioritizing the needs of nurses, including uninterrupted lunch breaks, became the focus of changes in the OR department at Nemours, a hospital that uses the 14 Forces of Magnetism to craft its strategic vision for nursing.

“We wanted to examine factors that impact the nurses’ work environment, along with their perception of job enjoyment,” Miller says.

Protecting the mealtime

The RN satisfaction data was reviewed by the staff and managers with the idea of creating a patient-free mealtime for nurses on the unit. They wanted to make the nursing lounge a protected zone where no one could pull a nurse away from his or her lunch break.

“We identified that the nurse would leave [his or her] warm food on the table to go into a patient’s room, to answer a question, and then the lunch break would be over,” Miller says. “The nurse was only eating for 10 minutes and [would be] in the patient’s room for 20 minutes.”

In the proposed plan, if an issue came up during a lunch break, the physician, manager, or patient would have to call the clinical coordinator. There was pushback from managers and physicians because creating this protected zone would mean fewer staff members on the floor. But the staff and managers were able to show the committee the significant effect a patient-free mealtime had on nurses. When OR nurses were surveyed in 2007, a year after the plan was put in place, 88% reported having the ability to sit down for a meal free of patients. In 2006, only 62% said they could sit down free of patients.

“That simple thing of creating space for nurses to be free of patients for a while improved their impression of the entire practice environment,” Watson says.

Identifying—and hearing—staff needs

Leaping off from the lunch hour changes, Miller wanted to go further and find out how to better meet the needs of staff members. He focused on rounding, an employee satisfaction principle discussed in Quint Studer’s book Hardwiring Excellence: Purpose, Worthwhile Work, Making a Difference.

Miller now rounds on his managers by going into their department, sitting down with them, and asking questions such as “What’s going on?” “What are your problems today?” and “What equipment don’t you have?” From here, Miller will walk through the department with the manager to look at the problems and then follow up with a memo to the correct person to fix those problems. For example, if stretchers are broken, Miller will look at them and then send a memo to the director of facilities. The director of facilities is then expected to follow up with the particular unit to resolve the issue.

“That’s the epitome of rounding and communication—if you are not touching your staff and talking to them, you might be going down the wrong path,” says Miller.

Get nurses to complete RN satisfaction surveys

Getting nurses to participate in an RN satisfaction survey can sometimes pose a problem because of time constraints. Plus, nurses need to know what’s in it for them. Increase participation by offering prizes to those who complete the survey. Check out a few ideas:

Offer a free coffee from the cafeteria or a coupon to a local coffee shop

Raffle off prizes such as T-shirts, tote bags, or coffee mugs that feature the hospital’s logo

Award pizza to the unit(s) with the highest participation

Raffle off movie passes or gift cards