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How can I improve the nursing culture on my unit?


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Nursing culture is shaped by many internal factors, including barriers such as poor communication between leaders and frontline nurses or a lack of respect from medical staff. If nurses are not well respected by their colleagues on the medical staff, then how do you think you can create a culture of excellence?

Leadership plays a critical role in affecting culture throughout the organization. For example, imagine what happens if you have a manager who practices nothing but a punitive style of management, thus creating an environment in which the staff is scared to accept accountability and fears punishment. This would affect the unit's culture in many ways—none of them positive. Therefore, it is imperative that leadership stand behind nursing and its vision to move toward a professional culture and a positive image of nursing. As a leader, it is important to create an environment for a culture that is professional, reaches excellence, has mutual respect, and inspires values.

Here are steps to help change the culture in your organization.

Step I: Define your current nursing culture (positives and negatives.) What are things that you like and dislike about the nursing culture in your organization? What are the things that you need to change? What are the barriers that will block change?

Step II: Identify the changes needed to enhance professional culture. Some changes take time, but there may be policies or changes in practice that can occur immediately. Don't forget to recognize and praise changes made throughout the year. Have you ever looked back and wondered what did we accomplish this year? Keep a log of all the changes made in nursing for the year, and then communicate this to your nurses.

Step III: Create a nursing vision and mission and then communicate this to the nursing staff. Creating a vision and mission will guide and provide structure for the nurses.

Step IV: Implement change that you can effect. Some changes will need to occur over many years, but these begin with the changes you can make now. Review the aspects of what you want to change, and then make it happen.

Laura Cook Harrington, RC, RN, MHA, CPHQ, CHCQM

(March 2010)