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Joyful practice

A call to action

Section Editor(s): Raso, Rosanne MS, RN, NEA-BC, FAAN

doi: 10.1097/01.NUMA.0000552742.71824.e3
Department: Editorial
Free

Editor-in-Chief, Vice President and CNO, NewYork-Presbyterian/Weill Cornell, New York, N.Y.

I can't imagine either leadership or clinical practice without joy.

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One year ago, we published the results of our Wellness Survey describing the sources of stress and joy for our respondents, and our editorial focused on increasing resiliency to better manage stressors inside and outside the workplace. Three years ago, the Quadruple Aim was crafted, adding workplace health to the Institute for Healthcare Improvement (IHI)'s Triple Aim, and our editorial centered on the obvious connection to the nursing workforce. Has anything changed in 3 years?

At the very least, it seems that everyone is more attentive to healthcare provider burnout. Press Ganey recently published the white paper “Burnout and Resilience: A Framework for Data Analysis and a Positive Path Forward” and the IHI produced the “Framework for Improving Joy in Work.” The National Academy of Medicine has created intraprofessional working groups as part of its Action Collaborative on Clinician Well-Being and Resilience. And the American Nurses Association's Healthy Nurse, Healthy Nation initiative is in its second year, paying attention to both physical health and quality of life.

Will awareness and this call to action bring back joyful practice? I hope so. I can't imagine either leadership or clinical practice without joy. For a profession that's all about making a difference in people's lives, enjoying our work seems like a critical component. Maybe joy is a close cousin to employee engagement—the holy grail of performance improvement, workforce productivity, and even shared governance.

Of course, we're talking about a balance between job stressors and work rewards. As a “glass half full” person, I'm always looking at the bright side. Is that fair to staff members who are struggling with stressors and feeling half empty? Probably not. As leaders, we must identify and assess regularly, as well as drive change and manage workplace stressors at the individual, department, and organizational levels.

The electronic medical record has received bad press lately for adding strain to the work environment: its tedium, detail, lack of intuitiveness to how clinicians think or work, connectivity issues, and more. Some of this is related to burdensome regulations and accreditation standards, legal expectations, the “click this or get dinged” (hundreds of times per shift) method, and the “if it isn't documented, it isn't done” approach. Many of our staff members would agree with this issue and there are many organizations working on it.

There are numerous other ways you can help restore, maintain, and elevate joyful practice within your sphere of influence. What about teamwork, staffing, finding meaning, recognition, listening, participative decision-making, wellness, barrier reduction, and every other element of healthy work and professional practice environments? We can and must look for and tackle them all.

And let's not forget simply having fun at work. When I visit a unit or department and see smiles or even team playfulness, or spot their celebratory social media posts, I know they're experiencing joy at work. Are you?

I like the positive approach, focusing on joy rather than burnout. There's shared accountability for joyful practice just like everything else we do. Let's join in total support of the remarkable attention that joy is receiving. It has the power to advance true patient-centeredness, our nation's health, and workforce well-being. Joyful practice is a call to action we can all endorse wholeheartedly.

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