nursing practice  managing your career

Assessing Your Nursing Practice Environment

The ability to deliver quality, safe nursing care is dependent on resources available to the nurse, job satisfaction, economic stability, and leadership support.  Now, more than ever, nurses need a systematic way to assess the complex dynamics that influence the ability to practice in any health care setting.

In evaluating a practice environment, one needs to determine which aspects of the practice environment are most important to you and your practice. This is often influenced by previous experiences, education, personal beliefs and the professional position you are seeking. 

This tool is designed to assist you in evaluating the environment and recognizing what is important to you. Not all items will be applicable to every health care setting.

This tool will address:

• Professional Practice Environment

1. Shared Governance - “Give one example of a change brought about in the organization by Shared Governance.”
2. Magnet Status (Acute Care)
3. Nurse / Physician Relations 
4. Evidence Based Practice - What is in place to support this?
5. Delegation responsibilities (RN LPN CNA MA etc)

• Physical Practice Environment

1. Physical Layout of Work Area
2. Ergonomic Work Station
3. Break room, locker room
4. Safety 
   • Security, lighting, parking 
   • Fire Safety
   • Lift free policy
   • PPE available and encouraged, Needless systems
   • Lateral Violence policy
5. Electronic Medical Record – how long in use
6. availability of computer work stations 
7. security of PMI  

•   Staff Development/Education 

1. Orientation Program – length -# hours…
2. Experienced vs new graduate
3. Mentor/Preceptorship/residency program
4. Continuing Education required? Paid? – how much per year
5. Educational Resources/staff
6. Nurse education and clinical educators

• Salary and Benefits

1. Wage vs Salary – salary range
2. Expenses (certifications, education, moving expenses, etc)
3. Incentives and differentials – certification, shift, 
4. Benefits package
5. Annual Review process.  Self/peer

• Work Hours / Responsibilities

1. Full or Part time
2. Scheduled Breaks
3. Sick Leave Policy
4. Appropriate Staffing. How does the organization evaluate this? (Mandatory overtime, sick calls, pool RN’s)
5. Schedule – self scheduling vs automated. 
6. Float to other units
7. Collaboration structure (ancillary personnel)
8. How daily staffing is determined? (acuity, continuity of care, experience) 

• Leadership

1. Chain of Command
2. Positioning of the leadership in operational and governance bodies of the organization.
3. Support of leadership from the organization.  What education and development in communication, decision making, and collaboration is offered to leadership from the organization?
4. How does leadership support a healthy work environment?
5. How is the leadership evaluated? 
6. Who develops and controls the nursing budget?
7. How long has the immediate supervisor been in the role?  What is their education, experience to perform in this role? 

• Interview Processes