How Nurses Can Detect an Unhealthy Work Environment

Phoenix VA Hospital
Phoenix VA Hospital

When you're looking for a new nursing position, the quality of the work environment will play a big role in determining whether you'll be happy or miserable on the job. Fortunately, you can get an indication of that intangible but important element while you're interviewing -- if you know what to ask and what to look for.

Before Your Interview: Do Your Research

Check if the hospital has achieved Magnet status from the American Nurses Association. That designation should indicate a healthy environment, says Jean Mills, RN, MS, clinical instructor with the University of Illinois College of Nursing. While it doesn't guarantee harmony among employees, Magnet status is awarded to hospitals where nursing delivers excellent patient outcomes, nurses report a high level of job satisfaction, the nurse turnover rate is low and appropriate grievance procedures are in place. If an institution does not have Magnet status, ask if it is working to achieve it.

Also, consider the hospital's reputation and study its mission to see if it meshes with your values.

During the Interview: Ask Specific Questions

Your interviewer -- likely your future manager -- will probably ask how you handle particular situations. Answer the question, and then turn it around by asking, "If interpersonal conflicts occur on your unit, how do you handle the situation? How do you support your staff?" A lack of open dialogue during the interview is a warning sign of an unhealthy environment, Mills says.

Other questions to ask include: "What channels are available to me if I have a problem I can't resolve on my own?" and "What if I have an issue with a staff member or physician?"

In addition, find out how assignments are made. Are responsibilities distributed fairly, or does the staff give less-experienced nurses less-desirable assignments instead of considering their growth needs?

Ask the interviewer to describe the personalities of the people on the unit, suggests Patricia McLaughlin, MPA, MSN, RNC, staff nurse with the Association of Women's Health, Obstetric and Neonatal Nurses. Find out how much self-governance exists in the unit and in the overall organization, she says. Do staff nurses have the opportunity to help draft or rewrite policies and procedures?

Ask to see hard data on staff retention and turnover rates, both for the entire hospital and for the unit you're interviewing with, suggests Kathleen Bartholomew, RN, MN, author of Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other. You can also ask about the number of grievances the unit has had.

You can even ask to read the minutes of the last few staff meetings, where the manager should have documented any major problems on the unit, Bartholomew notes.

Observe: Take a Tour

In addition to asking questions, you can learn a lot through careful observation.

Look at the unit manager's office, McLaughlin suggests. Is her door open? Is the office located in a place where staff can easily access her?

Tour the unit. Is it clean? How does it smell? If it's not clean the day you're there, chances are it won't be clean when you're working there either.

Beyond taking a tour, ask to spend at least an hour on the floor, Bartholomew says. The ideal time is morning, when physicians are making their rounds and the shift is changing, she advises. Note the relationships and how conflicts are handled. Do the people seem relaxed? Is there humor? How do the staff nurses interact with each other, especially with the incoming shift? Do they feel free to approach each other with updates? How do staff interact with the manager? Are the physicians approachable?

Meet and Greet

Ask to speak with key people, including:

  • Your future manager, if you haven't done so already.
  • A nurse who's a veteran of the unit.
  • The most recently hired nurse or a nurse who has just finished orientation.

You can also ask to speak with a nurse preceptor or mentor in person or over the phone.

After doing all this, you should have a pretty clear idea whether the atmosphere is friendly or fierce, cooperative or cutthroat before you accept a job offer.

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