AACN Study Underscores Pandemic Damage and the Benefits of Healthy Work Environments

New research from the American Association of Critical-Care Nurses (AACN) underscores the ongoing impact of the COVID-19 pandemic on nurses and the benefits of creating healthy work environments to support nurse staffing, retention and optimal patient care.

Results from AACN’s fifth national survey of nurses are now published online ahead of the October 2022 print issue of Critical Care Nurse (CCN). “National Nurse Work Environments – October 2021: A Status Report” includes key findings from AACN’s survey of more than 9,000 nurses, compares the results with previous studies and recommends areas for improvement.

The 2021 survey was conducted two years earlier than regularly scheduled in an effort to assess the COVID-19 pandemic’s impact on nurses and their work environments. Key findings from the survey include the following:

  • The nurse staffing crisis has become worse. Only 24% of the respondents said they have appropriate staffing more than 75% of the time, compared with 39% in 2018.
  • Nurses’ intent to leave their current nursing position increased. More than two-thirds (67%) of respondents stated they intend to leave their current nursing position within three years, compared with 54% in 2018.
    • Among those who intend to leave, 36% plan to leave within the next year.
    • Among those who intend to leave, respondents said top items that could very likely influence them to reconsider include higher salary and benefits (63%, up from 46% in 2018) and better staffing (57%, up from 50% in 2018).
  • Satisfaction with being a nurse declined since the last survey. Only 40% of all respondents indicated they were very satisfied with being a registered nurse, compared with 62% in 2018.
  • Nurses aren’t feeling safe and valued. Only 47% of the respondents agreed with the statement, “My organization values my health and safety,” compared with 68% in 2018. This item had the highest correlation to job satisfaction.

Study coauthor and AACN Chief Clinical Officer Connie Barden, MSN, RN, CCRN-K, FAAN, said, “Not surprisingly, the 2021 survey showed a decline in the health of nurses’ work environments. Unchecked, this decline can cause permanent damage to nurse retention and the entire healthcare system.” 

Barden said, “A bright spot is that the study indicated implementation of the six AACN Standards for Establishing and Sustaining Healthy Work Environments (HWE Standards) can be a game changer. Focusing on these standards is crucial to support nurse well-being, staffing and retention, which are necessary for optimal patient care.” In examining several key nursing challenges, workplaces that had actively implemented any of the six HWE Standards showed better results than those that had not. The following include some insights from the 2021 survey:

  • In units that had implemented or were “well on their way” to implementing any of the six HWE Standards, nurses’ perceptions of appropriate staffing were higher (44%) than in those that had not implemented standards or had just begun (16%).
  • Participants working in HWE Standards implemented units were half as likely to say they intend to leave their position in the next 12 months (26%), compared with those in units without implementation (52%).
  • Fifty-five percent of nurses working in units that had implemented any of the HWE Standards reported being very satisfied with being a nurse, compared with 34% of those working in units that had not.
  • Regarding satisfaction with their current position, 33% of nurses working in units that had implemented the HWE standards reported being very satisfied, compared with 6% of those working in units that had not.

 “Our findings indicate that unit or institutional implementation of the AACN HWE Standards may mitigate the pandemic’s negative impact on nurses, which may help ease the current staffing crisis,” said principal investigator Beth Ulrich, EdD, RN, FACHE, FAONL, FAAN. She noted, “Creating and sustaining healthy work environments is everyone’s responsibility and this requires changing long-standing cultures, traditions and hierarchies. The benefits of doing so are increasingly clear, as are the consequences of inaction.”

Access the full-text article by visiting the CCN website at http://ccn.aacnjournals.org.

About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly peer-reviewed clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. CCN enjoys a circulation of more than 130,000.

About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with more than 130,000 members and over 200 chapters in the United States.

American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme