1. Hader, Richard RN, PhD, CNA, CHE, CPHQ, Editor-in-Chief

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"Keep your feet moving, keep your feet moving, I don't want to see your feet standing still," urges my son's soccer coach to motivate his team. In turn, the boys keep the ball in constant motion, passing it and ultimately scoring. Similarly, as nurse leaders, we need to avoid stagnation and provide the vision, direction, and plan of action that'll improve the work environment's quality for our staff.

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Strength in numbers

Studies indicate that when the number of registered nurses (RNs) providing care increases, patients' clinical outcomes improve. 1 Faced with budget limitations, the international nursing shortage, and higher patient volume and acuity, we may find it insurmountable to increase the number of bedside RNs. Nursing vacancies in hospitals are predicted to reach 800,000, or 29%, by 2020. 2 If we're to counter this problem, creative leadership and teamwork remain pivotal.


Inaction will disenfranchise and demoralize an already challenged workplace. Like the coach of a sports team, we must inspire our staff to teamwork and a commitment to goal achievement. Providing proper guidance requires a thorough understanding of staff's needs and the issues that frustrate and disenchant them.


Supplying the right number of staff at the right time with the right skills in a cost-effective and productive manner proves complex. To achieve this goal, assemble a team of highly committed and goal-oriented nurses who can formulate a decisive action plan.


Play by play

Staff nurse forums can assist us with identifying key themes nurses believe will enhance their ability to perform. Ask important questions that will help develop strategies to enhance the work setting. Do you maximize technology use? Do you objectively measure nurses' workload to ensure that an appropriate number of staff provides patient care?


Once you've collected the data, develop a plan to communicate it to your staff and other key constituents. Your plan should be action-oriented and must allow the participation of many, which will create a sense of ownership and personal commitment to achieve.


It's unlikely that we'll quickly resolve the nursing shortage. The situation will, however, require that we all become active participants who keep our eye on the ball and our feet moving to enhance nurses' work environment, one move at a time.




1. Aiken, L., Clarke, S., Sloane, D., et al.: "Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction,"Journal of the American Medical Association. 288(16):1987-1993, 2002. [Context Link]


2. Health Resources and Services Administration, Bureau of Health Professions, National Center for Health Workforce Analysis: "Projected supply, demand, and shortages of registered nurses: 2000-2020"; available online: [Context Link]