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I do not know about you, but I have spent many hours over the course of my career, tormented by the task of selecting the Nurses Day gift. I have done this as a bedside nurse and as a nursing leader. It seems like it should be a simple process: Find out how much money you have per person and then find a gift that everyone will like. Hours, even days, are spent leafing through catalogs of mugs, pens, and lunch bags looking for just the right gift; something that screams "thank you" to every nurse who works in your hospital. After all, you do not want to pick something that will be viewed as cheap, certainly nothing that has been given out before. Moreover, with Nurses Week so close, sometimes overlapping National Hospital Week, you have to be careful not to give something that resembles, or is upstaged by, the gift to all hospital staff.
It should be an easy process, but in many work settings, it is not. Why is that so? For some organizations, they still use Nurses Week as the way that they dole out meaningful recognition for a career's worth of dedication and passion for patient-centered care. Perhaps they even count the service award banquet given to the 5-, 10-, and 15-year employees as a qualifying event. The sad reality is that this could not be further from the intention of the words meaningful recognition.
Ponder this thought for a moment. I think we would all agree that a key ingredient to a successful relationship with another human being requires some meaningful recognition. New relationships exude evidence of the use of this concept. Cards, flowers, small gifts, and phone calls with compliments are all examples of the use of meaningful recognition. How long do you think a relationship would last if after 3 months, the only time you heard a compliment from your new partner was once a year on the anniversary of your first date? I am sure we would agree-not very long!! And we would not be surprised to hear that the relationship did not work out. If asked our opinion as to the factors leading to the relationship's demise, we would probably say that someone did not make the other person feel valued and that you cannot expect a different outcome for someone who only acknowledges the other once a year. Could that, then, be the problem with Nurses Week for some organizations?
In the American Association of Critical-Care Nurses (AACN) standards for a healthy work environment (HWE) (Table 1), the section on meaningful recognition begins with the following statement: "Recognition of the value and meaningfulness of one's contribution to an organization's work is a fundamental human need and an essential requisite to personal and professional development. People who are not recognized feel invisible, undervalued, unmotivated and disrespected."1(p32)
Let's go back to the new couple scenario described earlier for a brief moment. Is this not exactly what happened to them? Lack of meaningful recognition most likely led to one person feeling undervalued and disrespected to say the least. You have to wonder how long it would take a nurse in that situation to tell the partner to stop coming around. The mere fact that AACN needed to publish the standards on the HWE is the first clue that too many nurses still tolerate unhealthy work environments and are lacking ongoing meaningful recognition.
When I talk to nurses who express concerns over a lack of meaningful recognition from their organization, I ask them what keeps them coming back to work every day. It's probably no surprise that they speak consistently about their patients. Ah, there is their meaningful recognition. That soft smile that fills the face of a patient as you introduce yourself, the grateful thank you that family members convey when you take their phone calls to give them updates, the gentle squeeze you feel when you take the hand of your patient and tell him that you will be back to check on him, and the feeling of pride that overwhelms you when the attending credits the patient's survival through the shift to your diligence in addressing his complex needs. This is the valued recognition of a nurse.
Take a closer look at these examples. They did not cost a thing and they did not take a committee to decide the best vehicle to deliver the message. They are not even something that might be noticed by others, but to that nurse, in that moment, they mean the world.
So maybe you could use another coffee mug. So be it. But let's vow not to let it stop there. The good news is that there are many examples across the country where nurses are receiving meaningful recognition on an ongoing basis. We know that the HWE standards have been adopted by many organizations and nursing leaders. Because we are focusing on Nurses Week, let me share some stories that I have come to hear from nurses I have met in my travels. Let's see how they measure up to communicating the feeling that nurses are valued and respected.
One story involves the establishment of a "Respite Garden" dedicated to nurses and other caregivers for their endless devotion to patient care. Each year, instead of an individual gift, another "item" is added to the garden in the courtyard. Past contributions have included a bench, an arbor, and a wind chime. The chief nurse plants flowers each spring and the groundskeepers keep them manicured. The gift is part of a weeklong celebration of the accomplishments of the department for the past year, capped off with the dedication of the next garden item and a visit from the CEO.
Another story also involves a weeklong celebration, where every day contains a new list of events. There are luncheons to acknowledge different work groups and their contribution to improving patient care, such as the skin care team, where each nurse who has participated is deemed a "champion" and the Nightingale awardees are announced. Massages, flowers, and even Tastykakes are all rewards offered to staff throughout the week.
By this point, you might be asking yourself, "How are these tangible items any different than a coffee mug for communicating meaningful recognition?" Good for you!! You are right. A freshly baked brownie left on a table in the nurses' station with a card that says, "Great Job!! Happy Nurses Week!!" is by itself a shortcoming for making people feel valued. The difference in the organizations whose stories I have told is that the staff members feel that they are valued because in addition to Nurses Week, they receive timely and specific feedback regarding their behaviors that are noticed and valued.
The truth is that there are many great things that a lot of organizations are doing to acknowledge the wonderful contributions of nurses, not just during Nurses Week but all year long. The secret to getting the point across that this is not just something we do in May but every day is to start finding ways to recognize the contributions of others on a routine basis. Let's not leave it just to the leadership of our hospitals to give the recognition. Peer recognition is very valuable and yet often overlooked. Some people are just "naturals" at acknowledging good deeds done by others and make it look easy, whereas others need a more deliberate approach.
A good starting place is with a handwritten note left for someone who has made a difference. If your first reaction to this suggestion is "Who has time to handwrite a note?" then I ask that you stop to remember a time when you received one. How did it make you feel? Are you one of the ones who has saved the note in a wooden box or a drawer of memories? If so, you do not need much convincing about the power that a handwritten note can have on someone, especially if it contains a brief, but specific notation of the behavior that deserves recognition. It might read something like: "Jane, thanks for taking the time to deal with Mr. Sims' family. They were so upset and you made them feel comfortable with their decision to follow his advance directive. I am proud to work with you." How long could that possibly take? Moreover, in today's world of e-mail fatigue, it is really nice and unexpected to get something that someone has written out by hand.
If you are already cranking out thank you notes, then perhaps you are ready to take the next step. I have seen the power of this next idea firsthand. We were publicly posting notes that we received from patients and families for others to read when we decided to place some blank cards next to the bulletin board to provide an easy way for anyone to thank a staff member for going the extra yard. Probably, one of the most meaningful cards found hanging on this board came from a 6-year-old grandchild of one of our critically ill patients. The little girl simply wrote: "Thank you nurses for getting my Pop Pop well so he can read to me again." I found nurses standing in front of the board with tear-filled eyes and their arms wrapped around the shoulders of their coworkers. This simple little message sent the biggest thank you to nurses who were working so hard to make sure that the statement came true. Again, I would like to point out that this concept really did not cost anything other than a good idea.
Here is the challenge: How do we turn Nurses Week into meaningful recognition without the focus being on how much money we are spending? Let's take another look at the coffee mug. What if the presentation of the mug to the nurse was accompanied by a very thoughtful and individualized recognition of a valuable contribution made by that nurse? That scenario would fit the intention of meaningful recognition. Perhaps coworkers could provide examples of these contributions and the person giving out the mug could thank them for this specific action.
So, this year, get yourself involved in the Nurses Week celebration and take a moment to insist that meaningful recognition fits the intention of the AACN HWE standard. Better yet, today, okay tomorrow, find someone you have been meaning to thank for a deed that improved your day or the day of a patient and write him or her a note to say you noticed. I would love to see you share your ideas for making meaningful recognition part of your routine operations. Take a moment to visit AACN's HWE Web page at http://www.aacn.org/AACN/hwe.nsf/vwdoc/HWEHomePage and sign on to the "community" where you can post your ideas, suggestions, and thoughts as they relate to this topic.
There are bound to be challenging days ahead of us and we are up to it. Certainly, a little meaningful recognition could help us take the next one head on. Let's make every day "Nurses Day."
Let me start by thanking all of you for making sure that all critically ill patients have a competent and compassionate nurse at their side to face their challenges. Happy Nurse's Everyday!!
1. American Association of Critical-Care Nurses. AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence. Aliso Viejo, CA: American Association of Critical-Care Nurses; 2005. [Context Link]
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