Voices from the Healthcare Frontline
Jonathan Willoughby, RN, is the charge nurse of the step-down unit at a hospital that serves a community of over 250,000. I spoke to him to get his unique perspective on nursing, critical care, and employee engagement in healthcare.
How did you get started as a nurse?
I became a nurse because I was fascinated with the human body and how amazingly complex it is. My mom’s a nurse as well and it felt natural and I was interested in the physiology of how the body works. When I was going to graduate I wanted to go into the ER like most people did, but a lot of people I talked to said to start on just a regular med-surg floor to get your hands wet and get more comfortable before you start going into critical care.
I moved from the ER to the cardiac unit which turned out to be really good because I got to work with the heart which is one of the cooler organs in our body. From there they needed more critical care beds in the unit and offered me a position there. I had been doing charge nurse on and off on the critical care floor and then they wanted full-time charge nurses so that’s where I am.
How is the culture at your hospital affected by employee engagement?
I can definitely see that the more engaged employees are the “better” employees. In this current era, it seems like the only people who are serious about making change are the engaged employees. In every workplace, there are a lot of problem-oriented people and a few solution-oriented people.
You go around and ask people and there’s a never-ending list of problems. But not everyone is engaged enough or dedicated enough to try and fix those problems. They’re perfectly happy just talking about it. That’s natural and not just a healthcare issue, but I do see that there is trust that is built when employees see things that are actually changing. Even with people that are very problem-oriented, they do appreciate the change.
It’s difficult to keep track of all the problems. Some of them are really simple and could be fixed in an hour, and some are difficult and require communication throughout multiple departments and take months. We’ve been talking about how to get more engaged employees. It’s kind of like the chicken and the egg. If employees see that their feedback helps enact change then maybe they’ll take it seriously and join in to be part of the solution, but we can’t get that much change when there aren’t people offering feedback.
Your organization doesn’t currently use Waggl. How do you give feedback?
“There’s a couple different ways we give feedback. We have employee engagement surveys and typically they are done once a year. This past year, however, we did two. The second one was done in October and we got the results in November, and the next survey was in January. It takes a long time, at least a month, to get the results back. Currently, the surveys are very basic and seem to just touch the surface level in hopes of obtaining a high participation rate as a reflection of employee engagement.
The hospital as a whole wants employees to be engaged because higher employee engagement, statistically, gives you a better facility and a better culture.
What’s the hardest part of your job?
The overwhelming amount of charting. More than that, it’s that most of the charting is simply done for regulatory purposes. It’s very rarely about helping the patient and it’s very disruptive because you really have to sit down and complete it and it takes a huge amount of the day.
What about the most rewarding part of your job?
The teamwork. When I came on shift for direct-care last week I encountered a critical situation with a patient who couldn’t at that point speak for themselves. Within two hours, I had assembled a team of myself, a doctor, a pharmacist, a wound-care nurse, and a plastic surgeon. I was able to get all these people here to come up with a plan and initiate it. All in all, it could have been a lot worse. As a team, we can come together with everyone bringing their own specialty.
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