Promoting wellness and being healthy are key to the redirection in health care. How then can nurses promote wellness and advocate for health if they themselves are not healthy? Focusing on nurses and their health and well-being as a part of thinking about healthy workplaces prompted submissions on numerous aspects of healthy strategies. This issue is designed to aid nurse leaders who support the importance of a healthy workplace in expanding or redesigning approaches they already take.
Since at least 2003, when the Institute of Medicine released its report, Keeping Patients Safe: Transforming the Work Environment of Nurses,1 various professional societies and health care organizations have addressed the issue of the environment and its influence on care. For example, the American Association of Critical-Care Nurses identifies 3 key initiatives, one of which is healthy work environments.2 As a profession, nursing still embraces the original focus on key aspects of the work environment for nurses that affect patient safety and improvements in work conditions that would likely increase patient safety. In addition, we now are equally concerned about the workplace's synergy with the concept of engagement. As Bargagliotti3 pointed out, when nurses are engaged, high levels of personal initiatives result, which in turn lead to lower mortality rates and higher financial returns. Thus, healthy workplaces are beneficial not only to nurses and their patients but also to the organization.
Rivera et al4 found that nurse managers play a critical role for direct care nurses in their engagement. Numerous authors have addressed the role of nurse managers as the "lynchpin," "the face of administration," and "the reasons direct care nurses leave or stay." Triolo, in an interview for the Gallup Business Journal, said, "When we take nurse managers away from their mission, move their offices off the units, and put them in meetings all day long, they get a disconnect with why they're in nursing in the first place, which is to grow and develop others and to help other people."5 This activity of growing and developing staff occurs more readily when staff see examples of being cared for and nurtured. Some strategies to achieve healthy workplaces may be costly, others are very inexpensive. To ignore the latter is not possible, even for the most frugal organization.
How nurse leaders acknowledge the need for nurses to be healthy can be exhibited in numerous ways. For example, creating specific programs to address health, supporting nurse managers as the "face" of nursing leadership to many direct care nurses, supporting spirituality, and addressing compassion fatigue are specific ways of providing evidence that the workplace is concerned about its workers.
As we know, workplace environments and healthy workers are not issues related only to nursing and health care. The World Health Organization defines that 5 keys must be of concern, and the first is leadership commitment and engagement.6 Without that value in place, it is hard to promote healthy environments or to support healthy behaviors for nurses. The fifth key is sustainability and integration and without ongoing commitment from an organization's nursing leadership, meeting the challenge of a healthy work environment would be impossible.
-Maria R. Shirey, PhD, MBA, RN, NEA-BC, FACHE, FAAN
Professor and Assistant Dean for Clinical
Affairs and Partnerships
The University of Alabama at Birmingham
Birmingham, Alabama
-Patricia S. Yoder-Wise, EdD, RN, NEA-BC, ANEF, FAAN
Dean Emeritus and Professor Emeritus
Texas Tech University Health Sciences
Center, School of Nursing
Lubbock, Texas
President
The Wise Group, Lubbock, Texas
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