Infected: The Fast Spreading Virus of Low Nursing Morale

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    We’ve all seen it. Unhappiness among those at the frontline can begin with a few small grumbles among close peers. Fast forward a few weeks and without any support, intervention, or remedy from leadership this fast moving virus can overtake even the most efficient of units.

    Infected: The Fast Spreading Virus of Low Nursing Morale

    Change is a constant in the nursing profession. However, it can be difficult to maintain professional flexibility in a field with ever changing policies, procedures, and daily routines. Many changes are usually evidence based these days and meant to improve the safety or effectiveness of patient care. With that, most nurses are usually on board and willing to comply despite the discomfort. When leadership demonstrates support and an openness to feedback from staff, it can make or break a new policy change. This is especially true when trying to implement multiple changes in a short time. When staff feel supported and able to voice their difficulty in adjusting to new challenges they are more willing to push through and make it successful. Everyone likes to feel like they are part of a change for good.

    With nurses pulled in so many directions, being asked to do more with less, frustrations can reach an all time high quickly. Nurses are held to incredibly high standards daily. There is no room for error when handling another human's life. It seems despite our best efforts to always do our best we are constantly told what we could do better - and that can be disheartening over time. We are told, “lower infection rates, increase patient satisfaction, eliminate error rates in specimen collection, increase documentation” and more. Can we handle all of this? Yes.
    Yes we can, just not when paired with lack of staff. The virus grows…

    Nurses are resilient. Somehow you find yourself and others banding together, making it work. But now, vacations are being denied. You’re constantly being asked via email, text, phone and facebook if you can cover or pick up shifts - either to help your struggling unit stay afloat or allow your fellow comrade attend an event away from work. Discontent continues to grow. You can see the virus spreading; lunch breaks turn into vent sessions, staff meetings are uncomfortable, your peers look tired and as you walk the halls you overhear complaints at every turn. It’s everywhere. Coworkers begin to talk about finding other work. Some leave. This only increases the issue at hand, especially if the all mighty budget ‘can’t support replacing staff at this time’. Puss is starting to form around this growing wound…

    Desperate for an antidote you look upward to your leadership and administration, hoping for a swift recovery. Have they noticed the rampant spread too? Maybe this virus doesn’t grow past the patient ridden halls and call bells, unable to be seen behind a closed office door. Too weak individually, feeling quarantined and isolated the infected begin to voice their concerns as a whole. Here’s where either the cure comes or death is near...

    There is no doubt that on an unit such as this leadership is feeling the pressure too and may likely have their hands tied from those above them. An unfortunate middle man expected to become a shaman with potentially limited resources. But going back to the principles above, simple acknowledgement of discomfort and support of staff frustrations can go a long way. Morale can be a difficult thing to pick back up if the issues at hand are unable to be fixed in the foreseeable future. Difficult but not impossible, there are a few ways around it:


    • Host a pep talk instead of another meeting (letting staff know leadership is aware and commending staff on their survival skills and hard work thus far)
    • Discuss ideas for how to work together with staff on scheduling/vacation requests (instead of just denying with no remedy - as being denied much needed time off on an increasingly stressful unit only increases burnout more rapidly)
    • Suggest/help staff plan a night out (a way to blow off steam, increase rapport and maybe even have a little fun)
    • Collaborate with staff on the issues causing low morale (otherwise, if this looming virus is left unattended, staff simply become more & more disengaged over time, unable to exert any more energy and will eventually go elsewhere to work in a disease free setting)


    Working on or leading a unit with low morale is trying for all involved. Ultimately it helps to remember that all parties usually just want to be heard, acknowledged and improve current conditions. There is no roadmap to chart this course. No perfect elixir or antibiotic for curing the lingering virus of low morale. When everyone demonstrates open, honest communication with transparency, a more collaborative environment can begin to heal itself.
    Last edit by Joe V on Oct 19
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    7 Comments

  3. by   Lnv5135
    Great article and it's very true in the process of how it goes on a unit that is constantly short.
  4. by   Daisy4RN
    Good info but I have yet to see any "leader" attempt this sincerely and probably never will, most either don't care or just gave up also. Sad!
  5. by   Elfriede
    The fish stinks from the head.
    As long as businessmen lead a healthcompany, their first aim is to devide the carestaff.
  6. by   kbrn2002
    Good article with some good ideas that sadly rarely if ever get implemented. Management is aware when morale goes down the toilet, if they are not they are oblivious and have no business being in a management position. But being aware of staffing issues and having the ability to actually do anything about it are two very different things. The nurse managers have zero control over budget, very little if any input on the ability to hire additional staff and don't always have good options for vacation coverage.

    I agree that having the floor staff get involved in the problem solving process is a good thing. I don't agree that hosting a "pep talk" is an effective way to do that. I've been involved in too many of those "go team, go!" talks that don't accomplish a darn thing. Sometimes acknowledging to the whole group that you know about their problems but don't have the power to actually do anything about it can backfire badly. Organizing a staff night out also sounds good in theory but way too many things can go wrong there, especially if there is alcohol involved. Not to mention that not everyone wants to socialize with their coworkers off the clock. If there is already an "in group" on that unit and there probably is, after hours socializing will only enforce that and further exclude staff not in that group.
  7. by   3ringnursing
    We find ourselves in the midst of low morale currently - being forced to use a new software program for implementing Medicare lists that isn't applicable to all nursing staff, isn't effective, and a poor choice to chose to implement with 4 months left of the year.

    This software's greatest benefit is a tracking tool for management to see whom is actually using it, and whom is doing their extraneous work - otherwise it isn't user friendly, triples the work effort per person, and slows down production by greater than 80%.

    Does this sound like a good software tool? No, it doesn't to us either, but upper echelon management doesn't want to hear the flaws and problems we that we using this tool are encountering. WE. ARE. USING. THIS. SOFTWARE. PERIOD.

    We desperately need the proffered Medicare reimbursement money for our indigent patient population, and we are being told get this done no matter what (we each do various other things primarily when not working on this list - I don't want to say what so as not to give too much away about where I am employed) but it feels like we are being told we must accomplish this task - but with all limbs restrained, wearing blind folds and ear plugs!

    Some nurses have never done this before. I have for years - and even I am lost.

    What is a peon level nurse to do other than take it, and try?

    Suggestions are welcome.
    Last edit by 3ringnursing on Aug 13
  8. by   Ashley Hay, BSN, RN
    Quote from kbrn2002
    Good article with some good ideas that sadly rarely if ever get implemented. Management is aware when morale goes down the toilet, if they are not they are oblivious and have no business being in a management position. But being aware of staffing issues and having the ability to actually do anything about it are two very different things. The nurse managers have zero control over budget, very little if any input on the ability to hire additional staff and don't always have good options for vacation coverage.

    I agree that having the floor staff get involved in the problem solving process is a good thing. I don't agree that hosting a "pep talk" is an effective way to do that. I've been involved in too many of those "go team, go!" talks that don't accomplish a darn thing. Sometimes acknowledging to the whole group that you know about their problems but don't have the power to actually do anything about it can backfire badly. Organizing a staff night out also sounds good in theory but way too many things can go wrong there, especially if there is alcohol involved. Not to mention that not everyone wants to socialize with their coworkers off the clock. If there is already an "in group" on that unit and there probably is, after hours socializing will only enforce that and further exclude staff not in that group.
    You make some really valid points regarding management & the potential for a pep talk to head south quickly, especially if there is no power to change any of the outstanding issues. Thanks for reading!
  9. by   Ashley Hay, BSN, RN
    "...it feels like we are being told we must accomplish this task - but with all limbs restrained, wearing blind folds and ear plugs!"

    Unfortunately, I think every nurse can relate to this exact feeling surrounding many daily issues. So frustrating. Thanks for your comment!

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