To help retain nurses, fix communication: NASA TLX survey

nurse walking through hospital roomAccording to Becker’s Hospital Review, personnel shortages of all types were at the top of the list of pressing concerns for healthcare CEOs in 2021, eclipsing financial concerns for the first time in 17 years. Shortages of nursing staff are causing closures and service delays that impact care quality, patient access and financial recovery as health systems seek to bounce back from the worst impacts of the pandemic.

Research shows that a healthy work environment – one that is supportive of the whole human being and is patient-focused and joyful – is correlated with staff retention for nurses.1 In other words, nurses are more willing to stay in job environments where they feel supported, can practice quality care, and find room for joy in the day-to-day.

Given how central communication is to nursing work, we wondered how communication task load might contribute to nurses’ perception of their work environment. In 2021, we surveyed more than 500 nurses globally and asked them to gauge the mental, physical and temporal demand of a communication experience from their most recent shift using the NASA Task Load Index (TLX). In addition to measuring demand, the NASA TLX also asks the nurse’s perception of performance, effort and frustration levels.

Nurse Communication Challenges Increase Task Load and Frustration

The nurses in our survey described an array of communication challenges ranging from delays and trouble accessing people with the knowledge and authority to advance care for patients, to interpersonal challenges, and even failures of communication technology. In fact, although we didn’t specifically ask respondents to describe a communication challenge, only 17% described communication that was smooth and easy.

Whenever a communication issue was present, nurses’ perception of mental and temporal demand was higher than when communication went smoothly, regardless of what the challenge was. And when load was higher, so were effort and frustration – and perceived performance went down.

Situations that create high effort and frustration and lower perceptions of performance are ripe for producing burnout and attrition.

Nurse Leaders Can Lead the Charge for Unified Communication

For too long, communication challenges have been viewed as “just part of the job” for nurses – a burden they carry to fix inefficiencies created by disparate and disconnected systems and fragmented technology solutions. But with staffing shortages as acute as they are now, system leaders can’t afford this mindset any longer.

Nurse leaders can help mitigate the communication task load carried by frontline nurses by:

  • Championing unified communication and collaboration platforms that unite all team members on the same communication solutions.
  • Creating communication standards that help manage interpersonal conflict – both within and across team roles.
  • Involving frontline nurses in the selection and refinement of communication technologies.

This investment in core processes and technologies is an essential response to the current staffing crisis, but it also creates the foundation for more efficient and effective practice going forward. Because every nurse, every doctor, every tech, every patient and every family member deserves an effective and reliable communication experience.

Click here to read the full report.

1 Raso R., et al. “Clinical Nurses’ Perceptions of Authentic Nurse Leadership and Healthy Work Environment.” JONA Volume 50, Number 9, pp 489-494. 2020.

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