3 Strategies to Reengineer a Positive Work Environment


The emphasis on self-care and burnout prevention after the pandemic has almost become white noise in nursing, but are we actually practicing these wellness strategies?

Not nearly enough, says Wendy Perera, MBA, MSN, BSN, RN-BC, NEA-BC, Alumnus CCRN. “Basic human needs for bio-breaks to go to the bathroom, stay hydrated, and take a lunch break to recharge are not being met for too many nurses, including those who work in perioperative settings.”

The root cause may stem from nurse leaders on the brink of burnout themselves, Perera suggests.

When she surveyed an audience of more than 200 periop leaders at the Leadership Summit at AORN Expo 2023 to ask if they take dedicated lunch breaks in their busy schedule, an estimated 95 percent of the room responded “no.”

She’s also hearing staff nurses wanting to get more involved and have a voice in shaping a workplace they want to stay in. That’s why Perera is encouraging the leaders she works with in her role as a nurse executive consultant and executive coach to bring multigenerational wants and needs together. “Leaders can’t do it alone and they shouldn’t, because multiple perspectives are required to rethink as a team what today’s positive work environment can look like.”

Envision and Create a New Kind of Periop Workplace

That said, Perera shared three strategies to help teams leverage generational skills and expectations toward building and sustaining a more positive periop work life:

Strategy #1: Reverse Mentor

“While more experienced nurses should participate in knowledge sharing, mentorship does not always have to be someone older or more experienced than you,” Perera said. She realized this through the pandemic when she took a break from her executive role to work on the critical care frontline. “A younger nurse taught me it was okay to have boundaries for my personal well-being while still being there for my patients.”

Action Step: Tap into fresh ideas from new nurses to brainstorm how self-care can become a cultural norm. “Remember, not being given time for self-care during a shift or building time off into the schedule is a deal-breaker for younger generations (whether or not they are vocal about it),” Perera said.

Strategy #2: Encourage Escalations

Every nurse should feel comfortable and encouraged to voice a concern because “there is an inverse relationship with number of escalations and psychological safety … organizations with high psychological safety often have a high number of escalations.” However, some nurses may see escalations as a “write-up” and something negative.

Action Step: Leaders should have frequent active conversations with teams about how to use escalation systems. They can leverage their escalation system to set the example that reporting a concern spurs improvement.

Strategy #3: Share Governance

While it can be challenging to relieve nurses from a procedure or surgery schedule to attend in-person meetings every month, leaders need to remember that creativity in communication can sustain a successful perioperative shared governance program.

Action Steps: Encourage every perioperative department to participate in some type of structured improvement activity. Perera suggested the following unit-based governance team projects that can help support a more positive work environment:

  • Redo the break room(s) to create a more restful space;
  • Start a healthy workplace initiative; and
  • Create interdisciplinary rules of engagement for communication during meetings, huddles, procedures, and in the break room.

For more guidance tackling the daily challenges you face, start planning to attend the Leadership Summit at AORN Global Surgical Conference & Expo 2024 from March 9-12, in Nashville. Book your hotel now.

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