Give good design and make nurses feel valued

Nurse retention rates and job satisfaction could be significantly improved through the provision of better designed hospital wards, with dedicated space for briefings and collaboration, paperwork, rest breaks and professional development, according to a new study by international design practice HASSELL.
The Design Matters For Nurses study, involving consultation with 74 nurses and nurse managers from Australia and the UK, was carried out with the University of Melbourne’s Health Systems and Workforce unit to determine how hospital workplace design affects nurse attraction and retention in both countries.
The study, released for International Nurses Day (May 12), found there were slightly different design factors involved in the attraction and retention of staff; employee attraction generally related to the appearance of the workplace, and retention related to its efficiency and effectiveness.
It found poorly designed wards can have a negative impact on workflows and morale, and can contribute to a culture that devalues what nurses do and how they work.
“Nurses can feel as though their hard work is taken for granted, but one way to counter this perceived lack of appreciation is to provide a comfortable, effective and efficient workplace that supports nurses to do their job well,” says HASSELL Principal Megan Reading, herself a former acute care nurse.
“In our conversations with nurses, we found that the condition of the facilities they worked in corresponded to how valued they felt by management - whether they had a proper break area, space to debrief or complete paperwork away from patient beds, or a room for meetings and training.”
She says hospitals are complex workplaces but, like any well-run organisation, retaining a contented and sustainable workforce requires a focus on the interactions between workplace design, organisational culture and work processes.
The HASSELL-led study notes there are a number of ways that wards can be configured for greater efficiency and convenience for nurses – for instance, using more natural light, locating break areas close to clinical areas, decentralised equipment storage and automating stock delivery to avoid long trips for supplies and medication. However, a successful design relies on a collaborative approach with the staff who will use it.
It also says there are trends from other workplaces that can be applied to hospital design – such as staff zones with flexible social and meeting spaces to encourage staff interaction and provide opportunities for multi-disciplinary working and knowledge sharing.
University of Melbourne researcher Dr Lucio Naccarella says Australia’s shortage of nurses was expected to blow out from 13,000 this year to 109,000 nurses in less than a decade, and it was important that hospitals turn their attention to what competitive factors they can address to avoid inadequate staffing levels now and in future.
“Our work shows that it is not just about pay,” Dr Naccarella says. “While that is important, the team environment, organisational culture and hospital design also influence a nurse’s decision of where to work.”
The report concludes that altruism often carries nurses through challenging working conditions, but to demonstrate how highly nursing staff are valued – especially in a competitive hiring market - hospitals need to ensure nurses are provided with appropriate spaces to complete their work, find respite and learn, all while remaining close to their wards.
“Nurses have incredibly stressful and physical jobs and small considerations in design can have a big impact on workflows and staff communication, and hence job satisfaction and staff retention,” Megan says.
The study was jointly funded by HASSELL and a Research Connections grant from the Department of Industry, Innovation and Science.