When asked about what makes their teams thrive and routinely exceed benchmarks on the Magnet Nursing Excellence survey, nurse leaders of the most satisfied and successful staff across the country have remarkably similar answers. Trust and individual empowerment are at the heart of every response. 

Nurses from the Johns Hopkins Kimmel Cancer Center outpatient infusion team and the medical-surgical inpatient units, two areas that consistently score above benchmarks on the Nursing Excellence Survey, shared some of their keys to success. 

Accessible Leaders Who Encourage Autonomy

It’s literally an open door for some nurse managers on the medical-surgical units. Anne McMurray, M.S.N., R.N., R.N.-B.C., nurse manager of one of the hospital’s medical-surgical units says, “We keep the door open, and our nurses can come in and out to discuss things. It makes them feel like we are a part of the team.”

Maria Roberts, B.S.N., R.N., R.N.-B.C., McMurray’s counterpart nurse manager in the hospital’s second medical-surgical unit, says her approach is leadership by servitude. “I’m out there on the unit, hands on. They can text me. They can come to me at any time for anything — they know I’m in the thick with them.”

At a time when face-to-face interaction might be limited due to COVID-19 infection control restrictions, both nurse managers have a daily group text with their teams to help them feel more connected. This became a crucial touchpoint for their clinical nurses during the pandemic, as their teams were often redeployed to other units. McMurray says one nurse responded back to the group text on a hard day saying, “This has made me feel less alone, thank you.” 

McMurray and Roberts credit their focus on the importance of accessibility to their own nurse leader, Medical-Surgical Nursing Director Christine Inglisa, M.S.N., R.N., N.E.A.-B.C. “We have an amazing director, we’ve learned from the best — she’s been amazing through this whole journey,” Roberts notes.

In the medical oncology infusion center, Nurse Manager Katie Evans, B.S.N., R.N., O.C.N., makes individual connections with her nurses a priority. “It’s challenging with a team so large, but we do our best to make sure that each individual feels very valued as who they are and that they know they are irreplaceable on our team.” 

Oncology Nursing Director Onyinye Mkparu, M.S.N., M.B.A., R.N., O.C.N., says that she also tries to check in with all her nurses, including Evans. She says that she “makes the effort to go to team meetings, do rounds with them, check in on them when I see them in the hallways.” She also meets quarterly with the entire oncology nursing team to give them a platform for any unresolved issues. 

Emphasis on Individual Growth and Professional Development

Mkparu feels her role is to empower her nurse managers, like Evans, and the members of her team. “I have a team of expert clinical nurses and expert leaders. All I’ve got to do is empower them to succeed. And they’ve consistently excelled.” 

Evans adds that the unit itself establishes high expectations for nursing excellence, including requiring nurses to complete an oncology certification upon hire. She also makes sure that she can be flexible with scheduling so team members have the time and energy to not only tackle challenges at home, but also complete certification courses and take on pilot projects to improve oncology practice — whatever their individual learning and career goals might be. “I support the individual success of my team members, and then, when they come to work, they are giving 110% to our unit.“     

Protected time for individual growth is also a part of the medical-surgical units’ approach. As one example, “We worked with the nursing education team to offer a class for medical-surgical nursing certification onsite at the hospital,” says Roberts. “We talked it up to encourage people to attend and adjusted schedules to make sure that attendees were not on the clinical schedule for the two days for the training.” 

Fostering Transparency and Communication About Shared Goals

Both teams talked about the importance of clear communication about the great things going on and the areas for improvement. 

Roberts says that nursing sensitive indicators are something addressed at every huddle, especially those that can continue to be improved. McMurray adds that her staff feels empowered to speak up and give suggestions to tackle pressing issues. That has led to some really innovative work around documenting compliance in patient medical records and new compliance initiatives for preventing central line infections in the medical-surgical units. Roberts’ team took the initiative to develop and share a new structure and process for fall prevention — a focus of many conversations in her unit.  

In the infusion center, Evans and Mkparu have set clear expectations from the outset. They meet regularly with the team to maintain a dialogue about what’s going well and what can be improved. A clear understanding of the challenges has also led clinical nurses in this unit to think outside the box and create new pilots for best-practice challenges like injections and administering monoclonal antibodies, work that will improve the care across the unit.  

Just as important as discussing the improvements, all these highly effective nurse leaders say there’s another key to satisfied, motivated clinical nurses — celebrating and recognizing success. Roberts in medical-surgical says that when six of her seven nurses completed the medical-surgical certification program, it was the, “proudest I’m going to be for a very long time.”

Both Evans and Mkparu also emphasize the importance of two-way communication. “We report back to them the benefits of their hard work as a team. It’s been so great to report their nurse satisfaction scores to them. Knowing the results of this work is so important to keeping our team moving forward,” Evans says. 

The nurse leaders from these units don’t focus on reaching individual satisfaction benchmarks or drilling down into the data behind each question on the Magnet Nursing Excellence Survey. Instead, they focus on treating their teams like the professional, empowered and excellent care providers they are. 

By making personal connections and empowering nurses to take ownership over their growth and the care they provide, they’ve created a culture of success that has consistently led them to earn high marks from their clinical nurses year over year on almost every measurement of nurse satisfaction.