AACN Survey: Work Environments Improving, But Still a Long Way to Go

A closer look at the AACN findings on employment conditions and more

While healthcare environments and the working conditions within have certainly improved over the past several years, a recent survey from the American Association of Critical-Care Nurses (AACN) suggests there’s still a long way to go to achieve ideal or even desirable status.

AACN released its findings this past April, their fourth national survey in their journal, Critical Care Nurse. Surveys are conducted quadrennially, once every four years, The complete findings are available online, and they report key findings from the survey of over 8,000 nurses, comparing the results with previous studies and recommending areas for continued improvement.

Among the findings:

  • For all items on the scale portion of the survey, there was improvement since the 2013 survey.
  • For every element, workplaces that have actively implemented the AACN Health Work Environment (HWE) standards had superior results to those that have not.
  • Appropriate staffing continues to be a major concern, with only 39 percent of nurses responding that they have the right number of nurses with the right knowledge and skills more than 75 percent of the time.
  • Nurses are highly satisfied with nursing as a career but less satisfied with their current jobs. Overall, 54 percent of respondents said they plan to leave their current position within three years.
  • More than 6,000 respondents (86 percent) reported experiencing at least one negative incident of verbal abuse, physical abuse, sexual harassment or discrimination in the past year. Patients and their families were the most frequently reported source of abuse. On average, abuse is less likely to happen when verbal and physical abuse policies are in place.

(Of particular interest is the statistic where 54 percent of people are planning to leave their current position within three years, a figure we will examine more closely in our upcoming 2019 Salary Survey Results.)

Over 8,000 critical-care nurses participated in this year’s survey, more than double the number that answered the inaugural 2006 survey.  The online survey has three parts: the 32-item Critical Elements of a Healthy Work Environment Scale, a series of additional questions to explore specific elements in greater detail, and questions about the demographics of participants and their employing organization.

Almost 2,700 participants responded to a question asking them to describe a best practice in their unit or organization that others could use to improve their work environment. A related question asking respondents to describe an issue in their unit or organization that concerns them received 3,300 responses.

Beth Ulrich, EdD, RN, FACHE, FAAN, is a professor at Cizik School of Nursing at The University of Texas Health Science Center at Houston, and a principal investigator on the study. She is also the editor of Nephrology Nursing Journal and an AACN consultant regarding HWEs.

“Healthy work environments are everyone’s responsibility–from the bedside to the boardroom,” Ulrich said. “Creating healthy working environments requires changing long-standing cultures, traditions and hierarchies. The benefits to doing so are increasingly clear, as are the consequences from inaction.”

“The health of critical care nurse work environments has improved since the previous study in 2013; however, there are still areas of concern and opportunities for improvement,” read the “results” section of the study. “Key findings include documented absence of appropriate staffing by more than 60 percent of participants; an alarming number of physical and mental well-being issues (198,340 incidents reported by 6017 participants); one-third of the participants expressed intent to leave their current positions in the next 12 months; and evidence of the positive outcomes of implementing the AACN Healthy Work Environment standards.”

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