Monday, February 12, 2018

Nursing Trends and the ANA, Part 2 of 2

One of the premier nursing organizations gathering information about nurses is the American Nurses Association (ANA). In my previous post, we delved into the results of a 2017 ANA survey based on responses from approximately 6,000 nurses. Today we're going to dive back in for part 2 of our 2-part series.

Nursing trends 2018

The second part of the ANA's survey involving 6,000 nurses focused on self-care, incivility, and how their employers support them in the workplace. These are issues that are written about constantly, yet here is data that gives us a snapshot -- somewhat representative, but certainly not scientifically so -- of how nurses are feeling about these very important issues that impact their every day lives at work. Let's break it down.

Self-Care Habits

When questioned about their self-care habits at work and home, a full 73% of nurse respondents reported improving their eating habits, while 66% had increased their levels of physical activity.
While 56% had reduced stress, 41% had improved sleep, and 35% were taking more breaks. Over 30% of the nurses reported getting at least 7 hours of sleep per night (likely the ones without babies in the home!). Only 15% stated that they were regularly able to sleep for 8 hours, but this may also likely be true for many non-nurses in our sleep-deprived society.

Incivility and Bullying

Bullying, defined for the purposes of the survey as "repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient", was reported to have been frequently experienced by 10.17% of respondents. 24.5% reported never having experienced bullying at all, and 33.47% had experienced it "very rarely". A 4.32% cohort of respondents had "very often" been on the receiving end of bullying.

Incivility was defined for the survey as "rude and discourteous actions, such as demeaning others, gossiping, or using non-verbal insults (eye-rolling, deep sighing, and finger pointing)". 10.4% of nurses participating in the survey reported having experienced incivility very often, while 18.85% stated it was often. Only 7.46% stated they had never been on the receiving end of such behavior, and 38.96% reported having "sometimes" been subjected to incivility.

In terms of intervening when witnessing bullying, 63% had actually intervened to put an end to an event of bullying, and the situations described included:
  • An older nurse defending a younger nurse
  • Addressing the "chain of command" in response to bullying
  • Putting a stop to verbal abuse
Organizations and Healthy Environments

In terms of support for creating a healthy work environment, the nurses broke down thus:
  • Rated their organization as completely supportive: 17%
  • Rated their organization as somewhat supportive: 36%
  • Rated their organization as not supportive at all: 10%
Other Trends

62% of the nurses stated that their workload had increased in the last year.

Major challenges at work included:
  • Documentation
  • Turnover and recruitment of staff
  • Understaffing
  • Communication with colleagues
  • Fears of nurse shortages
  • Fears of being asked to do more in less time
  • Concerns about spending less and less time with patients
On the bright side, nurses identified emerging technological advances, the increasing popularity of higher education among their nurse colleagues, and increased involvement in nurse leadership as positive workplace trends. 92% stated that their workplace utilized an EHR.

Some nurses reported that their employers were addressing staffing issues, listening to nurse input, using evidence-based protocols, using more nurse practitioners, and stepping up staff education and interdisciplinary communication. Achieving Magnet status was also seen as a very positive step taken by a number of hospital facilities.

What Direction Next? 

As we can see from these survey results, incivility and bullying are real-life issues impacting countless nurses. While nursing experts like Dr. Renee Thompson are combating bullying head on, healthcare organizations need to do more to curb and eradicate lateral and vertical violence from within. There's simply no place for such aberrant behavior in our workplaces.

While I am not at all surprised by the data regarding the relative supportiveness of organizations in terms of creating healthy workplaces, knowing that so many nurses are working in suboptimal environments is distressing. With high overall attrition rates of new nurses from the profession coupled with an aging nursing population moving towards retirement, healthy workplaces are a key component of recruitment and retention of high-quality staff who feel a sense of loyalty and being cared for by their employers.

An encouraging part of this portion of the survey is the fact that a large percentage of the nurse respondents are upping their game when it comes to self-care and personal wellness.

I would have liked to have seen a breakdown of the survey participants in terms of work setting. My relatively safe assumption is that the vast majority of respondents were hospital nurses, and since only about 60% of all nurses in the U.S. actually work in hospitals, the survey may likely be skewed in that direction. I would like to see a representative sample of the entire profession that includes nurses in home health, hospice, long term care, case management, research, tele-health, and other non-acute career settings. It would be extremely interesting to see the differences in nurses' perceptions based on their area of specialty and type of employer/organization.

Overall, it is our collective and individual responsibility to improve our workplaces, demand what we need from our employers, and create the future that we desire and deserve. Thank you to the ANA for elucidating important data that will help us get to where we want to go.


Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. Keith has written for,, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog,, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality and social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and intelligent cat, George.

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