Team,
Thank you to everyone who attended last week’s CNO Town Hall or participated via Zoom. If you’d like to hear my remarks and learn more about Magnet redesignation and our resource nurse program, click here to view the presentation.
One of the things we talked about at the meeting was results from the November 2024 Press Ganey employee engagement survey. We’re very pleased that our scores improved on five of seven key nursing indicators, but I’d like to focus on “autonomy,” our lowest-scoring category and the only score lower than both 2022 and 2020.
The following four questions combine to determine the autonomy category score:
- I am involved in decisions that affect my work
- When appropriate, I can act on my own without asking for approval
- Within my scope of nursing practice, I have the freedom to act on what I know is in the best interest of the patient
- I have the opportunity to influence nursing practice in this organization
The American Nurses Association (ANA) defines nurse autonomy as “encompassing a nurse’s ability to make independent clinical and nursing practice decisions within their scope of practice, while also respecting patient autonomy and the right to self-determination.”
Of course, it’s easier to have autonomy in your personal life than working as a nurse because the brand of shampoo you buy, what you eat for dinner and where you send your children to school are all decisions that affect you and your family, not your patient’s life or the safety of others.
As nurses, we must follow UAMS policy, evidence-based practices, providers’ orders and patient preferences, and we must remain within our scope of practice, but we’re far from mindless robots. We are critical thinkers, and we have an obligation to raise questions and concerns. In order to advocate for our patients, we must be involved in decisions that affect practice.
The benefits of nurse autonomy are what you probably think they are – better patient care because nurses can take quick action (within scope of practice), lower mortality and fewer complications because nurses can make decisions that improve patient safety, and, for nurses, increased job satisfaction, less burnout, and better teamwork.
In the coming weeks and months, watch for opportunities to promote autonomy for yourself and your colleagues, particularly recent graduates and others new to UAMS. Here are some ways UAMS nursing leaders are working to support nurse autonomy:
- Set clear expectations and clarify scope of practice
- Create a culture of trust and collaboration
- Practice shared decision-making
- Promote professional development
As managers, preceptors, and nursing leaders, we can promote nursing autonomy by being present and engaged, teaching nurses about the decision-making process, encouraging them to participate in this process, and coaching and supporting nurses through early decisions.
As nurses, you can help develop autonomy by engaging in quality improvement projects, the resource nurse program and shared governance and exploring opportunities to innovate. As a teaching hospital with a strong foundation in research, UAMS is a place where we don’t settle for the status quo. It’s what attracts a lot of nurses to UAMS, and we want to ensure that we are always open to new and different ways of doing things. New ideas should never get an immediate “that’s the way we’ve always done it.”
As I mentioned at the Town Hall, we have lots of new nurses at UAMS now, and we will be hiring more in the coming months. This is a pivotal time in creating a culture that supports nursing autonomy. If you have questions, don’t hesitate to ask your manager, a colleague or the Center for Nursing Excellence.
Autonomy will also be one of the topics we’ll discuss at the next Talk with Tammy session from 11:00 a.m. to noon on Thursday, March 13. Click here to register for this session or the one at 7:00 to 8:00 a.m. on Thursday, May 15.
Being able to make decisions that help you and your patients is an important part of our “Thrive in 25” mantra for this year. Please advocate for yourself, your colleagues and your patients. It’s important for all of us.
Tammy Jones, PHD, RN, NE-BC
Chief Nursing Officer
Associate Vice Chancellor for Patient Care Services & Clinical Operations
Perioperative, Interventional & Imaging Services Division