"Houston, we have a problem."

It is a privilege to be one of the 200-plus participants who gathered today at the “Creating Healthy Work Environments” conference in Indianapolis. Sponsored by the Honor Society of Nursing, Sigma Theta Tau International, our shared goal is to improve our organizations’ work environments.

Embedded in this goal are a number of requisite tasks: Problem identification, brainstorming solutions, action to create change, and challenging the status quo. We spent this day exploring a number of essential components of a healthy work environment.

So first, to refine our goal, a definition for healthy work environment (HWE). As some of us will confess to doing, I started my journey in this new thinking by consulting Wikipedia, only to find the comment, “The page ‘Healthy Work Environment’ does not exist.” I conclude that an entry in Wikipedia would be a valuable resource for any novice wanting to explore the subject. While not necessarily scientific, Wikipedia would provide us with a hub for this immensely important topic, pointing to the larger body of knowledge.

Undaunted, I moved on to an Internet search and located the advocacy initiative launched by the American Association of Critical-Care Nurses. AACN defines the essential components of HWE as skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership. Further, the components are outlined in the AACN Standards for Establishing and Sustaining Healthy Work Environments. Click here for the executive summary.

Throughout the day, the irony of the need to create HWE in our health care services was not lost on me. As nurses, we communicate, make decisions, work in staffed units, offer recognition and leadership … to patients. How is it that our work environments are not healthy? How is it that we don’t do this for each other? The importance of the issue was quickly validated by discussions that ensued throughout the day.

Reflecting on today’s discussions, I am struck by the active engagement of the presenters and members of the audience, who quickly moved to be active participants in this conference and were up at the microphone, sharing experiential knowledge. The stories offered by both the presenting experts and the audience, who ranged from clinical directors to educators to students, verified that the need for healthy work environments is urgent. Framing the discussion in Maslow’s hierarchy of needs, all were deeply passionate as they described incidents of incivility, lateral violence, bullying, threats to psychological and physical safety, and the need for skill-building to meet these challenges. Applause erupted multiple times as these common experiences were vividly articulated.

The described events conjured up images in my mind of challenges met by early explorers of the the New World when encountering hostile, uncharted environments. I muttered to myself, “Is this health care today? Can these problems be so far-ranging?” They are! No fewer than 20 testimonials validated this truth.

Discussions confirmed that there are solutions, strategies, and tools, derived from multiple fields—nursing, business, aviation safety—that are effective for creating healthy work environments. Some of the day’s lessons include:

• Policy means nothing without a culture that supports it.
• The beliefs, values, and actions of all health care professionals can be shaped to produce healthy work environments.
• Individual qualities needed for this journey are courage, being a good citizen of the organization, and generosity of spirit.
• A group of experts is not a team; team performance is a necessary, new, and trainable skill across the interprofessional care team.
• Living together with shared vision, mission, values, and norms of action creates the foundation for civility among working groups.
• Today, nurses are in an unprecedented position in health care to lead in the creation of healthy work environments for the betterment of the patient and family, health professionals, and the health care system.

Will the challenge require new skills? New actions? New mettle? You bet!

Are nurses “up to the task?” THE NURSES IN THIS GROUP ARE!

Conversations with colleagues throughout the day reaffirmed that the goal of healthy work environments is achievable. For nursing, this goal is not an option; it is a socially obligated mandate. Our patient’s lives and well being hang in the balance.

I look forward to tomorrow, to being part of the rising awareness of the problem and the sharing of additional strategies. I do so with the old axiom ringing in my ears, “If you are not part of the solution, you are part of the problem.” I know where I want to be in this journey!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.