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Health care workers gave their employers a "wake-up call" in a recent survey of employee attitudes, as they revealed that work stress has diminished their commitment to their employers and their careers.
About one in five respondents said they don’t intend to stay at their current jobs for the next several years. One-third said they would leave for a slight increase in pay.
As an industry, health care scored lower than the national average for all employers in every major category of the Healthcare @Work survey,1 conducted by The Loyalty Institute of Aon Consulting in Miami and sponsored by the American Society for Healthcare Human Resources Administration in Chicago, a membership organization of the American Hospital Association (AHA).
The survey results were presented at the American Occupational Health Conference in Chicago in April, a conference of the Atlanta-based American Association of Occupational Health Nurses (AAOHN).
The work force shortage is both a cause and an effect of the discontent shown on the survey, notes Erin H. Wilkins, senior consultant and director of the Healthcare @Work study. The health care work force has endured downsizing and restructuring, as well as the impact of declining enrollment in nursing programs. The average age of nurses is rising nationwide as fewer young recruits enter the field.
"Doing more with less obviously places a greater amount of stress on employees in health care than in other industries," she says.
"The impact to the organization of the extreme stress is a less-committed work force, a less-productive work force," Wilkins says. "If people are so stressed out on a daily basis, they are going to be tired at work, sick, or they’re going to leave."
Aon surveyed 3,433 health care employees in 2001 to determine their views on workplace practices and their commitment to their organizations. Concerns were greatest in the area of stress and workload. Some 56% of respondents said their employer didn’t meet their expectations for creating a stress-free environment or providing an adequate staff load.
Those results add to growing evidence of problems in the health care work force. More than one in seven hospitals reported a severe shortage of nurses — RN vacancies of more than 20% — in a study conducted by First Consulting Group of Long Beach, CA, for the AHA and other health care organizations.2
"I think it’s very important for organizations to take a step back and look at themselves," Wilkins says. "Other than money, what can we do to attract and motivate and retain the work force we need to be successful?"
From its data, Aon creates a "Performance Pyramid," with safety and security at the bottom and work-life harmony at the top. The bottom level needs must be met before highest-level needs can be fully addressed, Wilkins says. Work/life harmony actually scored well, largely because health care workers reported a sense of teamwork. Some 83% of respondents said the willingness of their co-workers to help each other in times of high workload met or exceeded their expectations.
However, 43% of health care workers said their employers failed to meet their expectations for safety and security. Those concerns focus more on psychological issues than physical safety, Wilkins says. For example, 35% of RNs and technical employees said they believe their organization was not doing enough to create an environment "free from fear, intimidation, or harassment."
That includes feelings employees may have about how they are treated by patients, as well as management, physicians, and co-workers, Wilkins notes.
What can employee health professionals do to help employees relieve stress and to improve their work environment?
Employee health professionals detect physical symptoms of stress and can discuss health and productivity issues with human resources managers, says Deborah V. DiBenedetto, MBA, RN, COHN-S/CM, ABDA, an occupational health consultant based in Yonkers, NY, and president of the AAOHN. "People will show up for blood pressure checks, headaches, minor complaints, without ever addressing the real issues. It’s a missed opportunity," she says.
Employee assistance programs can offer support for stressed-out employees, adds MaryAnn Gruden, MSN, CRNP, NP-C, COHN-S/CM, employee health nurse practitioner with Western Pennsylvania Hospital in Pittsburgh. "Employee health can be an advocate for the employee. We can direct them to get some help, whether their stress is work-based or home-based."
Employee health professionals also should look for signs that work stress is contributing to injuries, notes Gruden, who is also executive president of the Association of Occupational Health Profes-sionals in Healthcare. "Where are their injuries occurring? Are they occurring on a shift where employees have worked 12 hours or have been required to work overtime? Certainly, you want to look at the root cause [of injuries], but you also have to look at other factors." Understanding the link between stress, workload, and injuries may help convince administration to address staffing issues, she notes.
Hospitals that respond to these common concerns may benefit in recruitment and retention, Wilkins says.
"I’m not surprised either that there’s decreased commitment to the employer [among a significant number of health care workers]," Gruden says. "People are looking for someplace where it’s better."
1. Aon Consulting. Healthcare @Work: Aon Consulting Workforce Commitment Report 2001. Miami; 2001. Web site: www.aon.com.
2. First Consulting Group. The Healthcare Workforce Shortage and Its Implications for America’s Hospitals. Long Beach, CA; 2001. Web site: http://www.aha.org/workforce/resources/Content/FcgWorkforceReport.pdf.