How to spot a nursing unit with a great culture

There are so many things to think about when you’re looking for your first nursing job. What specialty area of medicine should you workin? Are you more interested in pediatrics or adults, emergency medicine, the operating room or a medical floor? Do you want to work days or nights, eight-hour or 12-hour shifts? The decisions can be overwhelming. Another area of consideration that is sometimes overlooked, but can be just as important, is the culture of the organization and/or department.

Finding the right culture can make all the difference as to whether you’re happy in your job, says Katy Donner, BSN, RN, a clinic nurse in Plastic and Reconstruction at Village Pointe Health Center. It shapes the way you and your colleagues interact at the workplace. A healthy culture promotes strong relationships amongst the employees. It will contribute to the quality of services, such as nursing care, job satisfaction, patient and personnel safety and personnel turnover rate.

It has been shown to have an impact on positive patient outcomes, such as reduced mortality and length of stay, increased quality of life and decreased pain level.

Be aware of subcultures

Not only do your values need to mesh with that of the organization as whole, but you also need to be aware of subcultures within different departments, says Donner. Consider shadowing in different departments during nursing school to make sure your personality meshes with the values of the areas you are considering.

If you don’t have an opportunity to float or shadow in a specific area or unit first, try talking to others who work there. You’ll likely get a pretty good sense of the culture and how happy the nurses are fairly quickly. 

Quick questions to ask yourself:

When evaluating whether an organization or certain area of a hospital is a good fit for you, ask yourself the following questions:

• Do you see yourself fitting in?
• Does the thought of working in this area or organization scare you?
• Do the people working there have a positive attitude and seem happy?
• Do you agree with how the patients are being cared for?
• What is the feedback from other nurses who work in the area?
• Is there a high turnover?
• Does there seem to be a lot of complaining?

The secret sauce

So what’s the secret sauce to a positive workplace culture? Nebraska Medicine nurses agree that it typically embodies some essential values and characteristics that include the following:

Pride and respect for the organization

“This is essential,” says Donner, who has been with Nebraska Medicine for more than 15 years and says she has never thought about working anywhere else. “I’ve always been proud to work for Nebraska Medicine. They are leaders in so many aspects of medicine and I agree with their integrity and morals.”

Appreciation for colleagues

Donner says she loves working in the Plastic and Reconstruction clinic, and that is partly due to the relationship she has with other providers in the clinic. “There’s a feeling of mutual respect,” she says. “I feel like we’re all appreciated for what we do and what we bring to the table. Everyone takes accountability for their responsibilities and does what needs to be done. We all have the patients’ best interests in mind. For most of us, it’s more than a job. There’s a sense of belonging, purpose and satisfaction in what we do. We all want to be here.”

Good communication

If there’s not good communication, things can go downhill quickly, notes Donner. “The physicians in this clinic are good teachers, and we all communicate well with each other, so we know we’re on the same page,” she says.

Look for an organization that is open to communication, keeps it employees informed and encourages an open forum for new ideas to improve the workplace.

Mentoring

Is there a focus on mentoring, nurturing and doing things together? Most nurses agree that having good mentors will go far in helping you grow professionally and become more knowledgeable and confident in your skills.

Team building and collaboration

Opportunities for open discussions, sharing of ideas and team building can also make your work environment more rewarding. Nebraska Medicine has a shared governance structure for nurses that has become an important vehicle for collecting the voices of nurses all over the organization in all types of nursing practice issues. The Shared Governance councils meet to discuss issues related to patient care and professional nursing practice in that department or unit.

Autonomy

Professional autonomy means having the authority to make decisions and the freedom to act according to your professional knowledge base. To gain autonomous practice, you must be competent and have the courage to take charge in situations in which you are responsible. It’s something that most nurses develop and appreciate over time.

Being able to work independently was important to Donner. “I am allowed to manage my time and prioritize what I need to do,” she says. “My skills and professional abilities are respected.” 

Commitment to innovation and improvement

Is the organization open to identifying areas of improvement and making changes when necessary? In today’s rapidly changing health care environment, improving the quality and performance of health care practice should be vital to any organization to ensure the delivery of reliable, cost-effective and quality health care with the goal of enhancing patient outcomes.

As a nursing professional, you have an important role to play in helping to ensure that changes are made in ways that will improve processes and patient outcomes. Do some research to find out if the organization has a system in place to facilitate process improvement to maximize efficacy?

“Being in an academic medical center offers vast opportunities to be on projects and pilots which help facilitate major hospital changes,” says Michelle Schulte, MSN, RN-BC, ambulatory supervisor for the Dermatology clinic at Lauritzen Outpatient Center. “Nebraska Medicine wholeheartedly embraces the values of innovation and teamwork on these committees and I believe nurses should take those opportunities by the horns and go with it! Our nursing voice is important!”

Is it time to make a change?

If you find yourself in an area that isn’t working for you, Schulte recommends talking to someone about it first and let them know how you’re feeling – whether that’s a nursing professional development specialist, nurse supervisor or manager. “Keeping that open communication allows for more personal growth during transition times in a new job or career,” says Schulte. “Give it some time. Don’t give up too quickly. Give yourself six months to a year in a new area. Remind yourself that we continue to grow and mature from difficult experiences and that may include working with different types of people.”

If it’s still not working for you, the good news is, there are usually lots of opportunities to make a change and find a better fit.