Increasingly, employees are asked to do more with less. Arguably, this is the goal of Capitalism: to squeeze out as much work as possible for the least amount of money in order to maximize economic growth. I don’t think that this is a particularly helpful way to approach healthcare, as I believe that it is a basic human right, not a privilege, and that relationships with other people are fundamentally inefficient but extremely important.
In nursing the pressure to perform and maximize efficiency can be particularly difficult to cope with, as increased workloads leave less time to spend with patients and their families which is an important part of our job. It may not seem like having a conversation is “work” but it is through conversations that patients communicate their needs, hopes, fears, and values (among other things). By getting to know our patients, we are able to ensure that we provide care that meets their needs and treats each individual holistically, rather than as a list of tasks on our daily to-do list.
Building positive relationships with co-workers and leaders are also essential to creating a positive working environment where nurses and other members of the healthcare team can work together to deliver high-quality patient care. Investing time and energy into these relationships is not efficient in the short term but pays dividends down the road in terms of staff retention, decreased voluntary absenteeism, decreased short-staffing (which leads to more sick time and burnout, etc.), and of course reduced time spent recruiting, interviewing, and training new hires. It’s not rocket science that people who like their co-workers and their work environment are more likely to stay than those that dread coming in to work every day. Strong relationships also facilitate good communication and trust among team members and generate shared understandings of work processes, as well as who knows what, and who to ask when you need help.
While we cannot ignore the tasks that need to be accomplished, as these are obviously important, we need to change how we think about relationships in the workplace. Culturally, we have a tendency to judge relational work as “non-work” when in fact connecting to others in the workplace is very valuable (and sometimes extremely challenging) work. Unlike patient care tasks that are easy to quantify and check off, it seems artificial and contrived to make a checklist that says “talked to each of my patients about their concerns”, “invested in my relationship with Susan by asking her about her son’s wedding”…etc. I would also argue that most of us are naturally social and interested in other people so we do a lot of this work anyway and that trying to maximize relational “efficiency” by reducing these things to tasks is ridiculous (and insulting).
I understand that healthcare is expensive and many of the pushes to increase efficiency are driven by our aging population, aging workforce, government austerity, union wage increases, and the economic recession of 2008 (to name a few things). It is complicated. However, we need to invest in people and create healthy workplaces that foster a sustainable workforce and allow our healthcare professionals time to invest in relationships with patients. Pushing people harder and harder to produce more with less is not a long-term solution and will cost us more in the long-run – not just in terms of money, but in quality of life, happiness, and patient care.
Maybe the next time you see a nurse, doctor, or healthcare leader talking with a patient or a colleague, you should acknowledge that they are engaging in valuable work. Just because we’re not doing a task like inserting an IV or giving a medication doesn’t mean that it’s not important.
Emily Read, PhD, RN 