1. Creating Healthy Chapter Work Environments
Rose Shaffer RN, MSN, CRNP-BC, CCRN
President
SePA Chapter AACN
Cardiology Nurse Practitioner
Thomas Jefferson University Hospital
Philadelphia, PA

2. Please “Engage” your cell phone and “Transform” it to off or to vibrate.
Thank You

3. AACN’s Healthy Work Environment Standards
In 2001, AACN made a commitment to actively promote the creation of healthy work environments that support and foster excellence in patient care wherever acute and critical care nurses practice
In 2005 the healthy work environment standards were published

4. AACN Healthy Work Environment Standards
The healthy work environment (HWE) standards uniquely identify behaviors that are often discounted, despite the evidence that they (contribute to creating unsafe conditions and) obstruct the ability of individuals and organizations (chapters) to achieve excellence

5. AACN Healthy Work Environment Standards
Skilled Communication
True Collaboration
Effective Decision Making
Appropriate Staffing
Meaningful Recognition
Authentic Leadership

6. The Evidence for HWE
There is evidence that unhealthy work environments contribute to (medical errors, ineffective delivery of care and) conflict and stress among health professionals

7. Consider These Potential Hospital Examples:
A night nurse chooses not to call a physician known to be verbally abusive. She uses her judgment to clarify a med order and administers a fatal dose of the wrong drug
Isolated decision making in one department leads to tension and frustration
Nurses are placed in leadership positions without preparation and support

8. Do each of these situations characterize poor and ineffective relationships or actions within hospitals?

9. Why Care About the Chapter Work Environment?
Unhealthy chapter work environments can also lead to conflict and stress among board members, committee chairs and chapter members, as well as any one else involved in the organization and therefore the important work of the chapter may not be accomplished!

10. Consider These Potential Chapter Examples:
A board member or committee member chooses not to address an individual on the committee who is verbally abusive or berating
There is isolated decision making by certain individuals on a committee or the board
Individuals are placed in leadership positions without adequate preparation and support for their role

11. Do each of these situations characterize poor and ineffective relationships or actions within the chapter?

12. Organizational Health
“An organization is not its products, markets or technologies. Rather it is in the repetitious patterns of how people relate to each other, gather and interpret information, solve problems, make decisions, manage conflict and implement change while accomplishing the organization’s purpose.”
Bushe, GR. Clear Leadership; 2001

13. Organizational Health
It is important to create an organizational culture that develops self-awareness and consciousness of its people, including nourishing its people with a healthy culture, coherent policies, and effective procedures
A healthy culture exists in an organization that listens to people and remains actively involved in how they feel about the services they provide
Kilman, RH Quantum Organizations:
A New Paradigm for Achieving
Organizational Success and Personal Meaning; 2001

14. Healthy Work Environments: Four Key Points
HWE do not sacrifice people at the expense of profit
HWE do not reduce everything to cost vs. benefit or profit vs. loss
HWE know that costs are multifaceted - they know that profit means to make progress, not just to make money
HWE are about moving from trapped potential to tapped potential
Heath, J, Johanson, W, Blake, N.
Healthy Work Environments: A Validation
of the Literature; Journal of Nursing Administration; 2004

15. “There is no power greater than a community discovering what it cares about.”
Margaret Wheatley
Organizational change and management author,
International educator

16. AACN’s Commitment
AACN is committed to creating work environments that are safe, (healing), humane and respectful of the rights, responsibilities, needs and contributions of all people, including patients, their families and nurses

17. Chapter Commitment
Chapters are committed to creating a chapter work environment that is safe, humane and respectful of the rights, responsibilities, needs and contributions of all chapter members within the organization

18. Standard #1: Skilled Communication
Chapter leaders
must be (as)
proficient in
communication
skills (as they are
in clinical skills)

19. Paulo Freier International Educator Community Activist
“We cannot be truly human apart from communication… to impede communication is to reduce people to the status of things”
Paulo Freier
International Educator
Community Activist

20. Communication Techniques
Instant Messaging
Voice Mail
Video Conferencing
Telephone
Face to face
Verbal
Non-verbal (including silence)

21. Skilled Communication
It is more than a one-way delivery of information…..it is a two-way dialogue in which people think and decide together
Chapters must make a priority to develop communication skills among it’s members - including written, spoken, electronic and non-verbal skills (that are on par with expert clinical skills)

22. Skilled Communication
Intimidating behavior and deficient interpersonal relationships lead to mistrust, chronic stress and dissatisfaction among committee members…… which may lead to unhealthy situations that contribute to nurses leaving the chapter (their position and sometimes the profession).

23. Skilled Communicators……
Focus on finding solutions and achieving desirable outcomes
Seek to protect and advance collaborative relationships among colleagues
Invite and hear all relevant perspectives
Call upon goodwill and mutual respect to build consensus and arrive at common understanding

24. Skilled Communicators……
Demonstrate congruence between words and actions, holding others accountable for doing the same
Have access to appropriate communication technologies and are proficient in their use

25. The (Healthcare) Organization (Chapter)
Establishes zero-tolerance policies and enforces them to address and eliminate abuse and disrespectful behavior in the chapter
Establishes structures and processes that ensure effective information sharing among (patients, families and healthcare) committee members and the membership

26. The (Healthcare) Organization (Chapter)
Establishes systems that require individuals and teams to evaluate the impact of communication on (clinical), financial and work environment outcomes
Team members demonstrate skilled communication to qualify for professional advancement (leadership positions within the chapter)

27. David Thomas Ethicist Ethics of Choice Training Program
“It is ethical to request, encourage and deliver feedback on all facets of individual and organizational performance. It is unethical to ignore, discourage or fail to give feedback.”
David Thomas
Ethicist
Ethics of Choice Training Program

28. Standard #2: True Collaboration
Chapter leaders must be relentless in pursuing true collaboration

29. David Thomas Ethicist Ethics of Choice Training Program
“It is ethical to be open to the possibility that your view is incomplete and therefore capable of revision. It is unethical to ignore information that could allow you and/or your organization to grow.”
David Thomas
Ethicist
Ethics of Choice Training Program

30. True Collaboration It is a process, not an event
It must be ongoing and built over time, eventually resulting in a work culture where communication and decision making between nurses….. and among nurses themselves becomes the norm
With true collaboration, the unique knowledge and abilities of each committee member are respected…….

31. True Collaboration
Requires skilled communication, trust, knowledge, shared responsibility, mutual respect, optimism, and coordination, which are integral to successful collaboration
Requires constant attention and nurturing……

32. Every Committee Member….
Embraces true collaboration as an ongoing process and invests in its development to ensure a sustained culture of collaboration
Acts with a high level of personal integrity
Demonstrates competence appropriate to his/her role and responsibilities

33. Every Committee Member….
Contributes to the achievement of common goals by giving power and respect to each person’s vote, integrating individual differences, resolving competing interests and safeguarding the essential contribution each must make in order to achieve optimal outcomes

34. The (Healthcare) Organization (Chapter)
Creates, uses and evaluates processes that define each committee member’s accountability for collaboration and how unwillingness to collaborate will be addressed
Makes available the time needed to resolve disputes

35. Archbishop Desmond Tutu Civil rights activist Nobel Laureate
“We are different so that we can know our need of one another, for no one is ultimately self-sufficient. A completely self-sufficient person would be sub-human.”
Archbishop Desmond Tutu
Civil rights activist
Nobel Laureate

36. Standard # 3: Effective Decision Making
Chapter leaders must be valued and committed partners in making policy, (directing and evaluating clinical care) and leading organizational operations

37. David Thomas Ethicist Ethics of Choice Training Program
“Individuals and organizations learn and evolve through conscious, deliberate action. Deliberate action is ethical. When the time to act has come, it is unethical not to do something.”
David Thomas
Ethicist
Ethics of Choice Training Program

38. The (Healthcare) Organization (Chapter)
Clearly articulates organizational values and committee members incorporate these values when making decisions
Establishes systems………..to facilitate data-driven decisions
Provides chapter members with support for and access to ongoing education focusing on strategies to assure collaborative decision making

39. The (Healthcare) Organization (Chapter)
Establishes deliberate decision making processes that ensure respect for the rights of every individual, incorporate all key perspectives and designate clear accountability
Has fair and effective processes in place at all levels to objectively evaluate the results of decisions, including delayed decisions and indecisions

40. Robert F. Allen Advocate for cultural change and wellness
“People will not believe in an organizational change effort unless they have the opportunity to plan it, experience it, provide feedback, and own it. Involvement supports and sustains motivation, the essential ingredient for change.”
Robert F. Allen
Advocate for cultural change and wellness

41. Standard # 4: Appropriate Staffing
Staffing must ensure the effective match between (patient) needs and (nurse) competencies

42. Appropriate Staffing of Committees
Chapter leaders must ensure the effective match between the needs and desires of volunteers who want to join a committee
There must be enough people on committees and those people should attend meetings regularly

43. The (Healthcare) Organization (Chapter)
Has policies in place that are solidly grounded in ethical principles and support the professional obligation of nurses to do the work of the chapter

44. Standard # 5: Meaningful Recognition
Chapter leaders must be recognized and must recognize others for the value each brings to the work of the organization

45. Johann Wolfgang von Goethe Philosopher, poet, playwright
“Treat people as if they were what they ought to be, and help them to become what they are capable of being.”
Johann Wolfgang von Goethe
Philosopher, poet, playwright

46. Committee Members
Understand that everyone is responsible to (play an active role in the organization’s recognition program and) meaningfully recognize contributions of others

47. The (Healthcare) Organization (Chapter)
Has a system in place………that ensures a……… focus on recognizing all committee members for their contributions and the value they bring to the work of the organization
Has a recognition system that reaches from the committee level (bedside) to the board room, ensuring individuals receive recognition……..

48. David Thomas Ethicist Ethics of Choice Training Program
“It is ethical to offer feedback to those from whom you or your organization receive services. It is unethical to allow outstanding performance to go unacknowledged … just as it is unethical not to provide feedback to those whose performance or service threatens the optimal performance of your organization.”
David Thomas
Ethicist
Ethics of Choice Training Program

49. Standard # 6 Authentic Leadership
Chapter leaders must fully embrace the imperative of a healthy work environment, authentically live it and “ENGAGE” others in it’s achievement

50. Psychologist, Business Author, MacArthur Foundation Fellow
“Managers assume that job security is of paramount importance to employees. Among workers, however, it ranks far below desire for respect, a higher standard of management ethics, increased recognition of employee contributions, and closer, more honest communication between employees and senior management.”
Robert H. Rosen
Psychologist, Business Author, MacArthur Foundation Fellow

51. Chapter Leaders…..
……successfully translate the vision of a healthy work environment
Excel at generating …. enthusiasm for achieving the standards that create and sustain healthy chapter work environments
Role model skilled communication, true collaboration, effective decision making, meaningful recognition and authentic leadership

52. The (Healthcare) Organization (Chapter)
Provides support for and access to educational programs to ensure that chapter leaders develop…….skilled communication, effective decision making, true collaboration, meaningful recognition…….

53. The (Healthcare) Organization (Chapter)
Ensures chapter leaders…… participate in key decision making…..have access to essential information and the authority to make necessary decisions
Provides a (formal) co-mentoring program for all chapter leaders - chapter leaders actively engage in the co-mentoring program

54. Edgar Schein Organizational behavior and culture pioneer
“One of the most decisive functions of leadership is the creation, management, and when necessary, the destruction and rebuilding of culture.”
Edgar Schein
Organizational behavior and culture pioneer

55. The Six Standards…..
Represent evidence-based and relationship-centered principles of professional performance
Are designed to be used as a foundation for thoughtful reflection and engaged dialogue about the current realities of each work environment, including chapter work environments

56. What are the Benefits of a Healthy Chapter Work Environment?

57. Some Benefits of Chapter HWE’s
Better communication; less frustration among committee members/chairs
Collaborative relationships, group cohesiveness, & authentic leadership resulting in a “can do” attitude to ensure the survival of the chapter
Efficiency and productivity in decision making and the work of the chapter

58. Some Benefits of Chapter HWE’s
Increased respect for others opinions
More satisfied committee members who may “spread the word” of the chapter, thereby potentially increasing membership and future leadership in the chapter
Other benefits???

59. Questions?
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