Culture. Culture is such a powerful word. We can think of culture as the substance from which yogurt emerges or the substance used in labs to grow organisms. Culture can also be used to refer to people who are refined in their behavior. We can also use the word to describe the nebulous sense of a place where we work or visit. The first definition of culture offered by the Merriam-Webster dictionary (https://www.merriam-webster.com/dictionary/culture) - the customary beliefs, social forms, and material traits of a racial, religious, or social group - is the meaning that has the most relevance for nursing.
Traditionally, nursing has focused on the roles of chief nursing officers and other clinical leaders in creating an organization-wide culture that makes nurses want to stay with an organization. Some literature even refers to turnover as nurses leaving their managers (not the organization per se) because the culture of the unit was not conducive to quality care or a supportive place to work. Hospitals and a few other health care organizations compete in the best-place-to-work programs that exist across the country. We are reminded that an organization's culture is critical to its success.
Major awards for nursing care, such as Magnet, Beacon, and Lantern, are given only to those places where nurses are happy to work and feel they are valued for their ideas and care. On its website, for example, the Emergency Nurses Association asks applicants for a Lantern Award to tell their story with regard to the following core areas:
* Leadership - Practice: qualities that foster professional pride, confidence, and a community of support for emergency nurses;
* Leadership - Operations: operational improvement activities and development of systems and processes;
* Education: instilling knowledge and competency through quality and accessible education;
* Advocacy: how the future of the emergency nursing profession and quality patient care is influenced through advocacy and innovation in your emergency department;
* Research - Practice: advancing the emergency nursing profession and practice through quality improvement, research, and the evaluation of clinical outcomes.
Creating that culture takes work. For all of us in nursing education, the challenge is to create a culture where faculty want to work and where students want to learn. We are, after all, setting the expectations for what our learners should expect in the workplace. That means not only do we have a shared respect for students, faculty, staff, and administration, but also we have created policies that foster such behaviors - and we live by them. We have little tolerance for uncivil behaviors, and we strive to create a sense of belonging, where minority populations are identified by far more than percentages or numbers. We create environments of questioning so that we all learn, and we invite diverse opinions so that our knowledge of how others see the world is enriched.
Importantly, we can now use the newly revised National League for Nursing (NLN) Hallmarks of Excellence (http://www.nln.org/professional-development-programs/teaching-resources/hallmark) to guide our work in creating exemplar learning situations. The NLN Hallmarks include expectations for engaged students; diverse, well-prepared faculty; a culture of continuous quality improvement; an innovative, evidence-based curriculum; innovative, evidence-based approaches to facilitate and evaluate learning; resources to support program goal attainment; and commitment to pedagogical scholarship.
We also expect those who represent us to exhibit the same behaviors as in this example from the NLN. League staff addressed an issue promoted by the District of Columbia where the association is headquartered - that of traffic congestion in the district. Based on their work in addressing transportation benefits and creative program incentives to help make the District of Columbia one of the healthiest, greenest, and most livable cities in the United States, the NLN has been awarded the status of Silver Employer Ambassador by goDCgo, a Department of Transportation initiative (see https://godcgo.com/employer/employer-ambassadors-program/ for details).
When we operate from the stance of having a purpose of being our best, we create cultures of caring, excellence, and integrity (three of the NLN's four core values, http://www.nln.org/about/core-values). And, if we are smart, we not only incorporated diversity (the fourth value), we embraced it for the richness it contributes to any culture. I invite you to examine your own organization to determine what you can do to foster a culture where those engaged in nursing education thrive and experience joy. Our ultimate reason for being - our potential patients - deserve our best.
P.S. As we go to press, the United States is on stay at home mandates from states, cities and counties. We are all doing our part to address the pandemic many of us never expected to see. Whether you are teaching online for the first time (we applaud you for your quick conversion), shifting from a teaching role to one of direct care (we applaud you for using your full talents), advocating for resources for the frontline workers across the country who are faced with horrific demands (we pray for you and your families) or supporting the efforts by staying at home (everyone who has to be out thanks you!) we know you are part of the solution. If you did not receive my letter to the membership, please visit http://www.nln.org/docs/default-source/default-document-library/pat-membership-e.