What makes a nurse's day extraordinary

A small group of experienced nurses were asked to describe the characteristics of an extraordinary day at work. The one universal theme was 'making a difference'. The authors say it is important for managers to know what motivates nurses in order to avoid costly staff burnout and turnover. 'Making a difference' did not necessarily mean saving a life or even a positive clinical outcome but improving care for patients and/or their family. The authors call for more research in the area.

Nurses asked to describe what makes a day at work extraordinary say it is making a difference to patients, even if that difference isn't as grand as saving a life, according to researchers from the United States.

Writing in the journal Nursing Management the authors, from Bristol Hospital in Bristol, Connecticut, say that knowing what motivates nurses is important for healthcare managers.

'To prevent costly nursing burnout and turnover, hospital managers need to create environments that foster satisfaction. To achieve this they must understand what nurses want in a job and if this changes over time, but at present this is undefined and elusive.'

Other reasons nurses offered for an extraordinary day included being able to 'teach somebody something', working well with colleagues as a team, and establishing a good relationship with the patient and their family.

But a typical comment from one of the nurses was: 'The days I am most disappointed are those days where I feel like I made no difference at all... when it comes to just a plain old ordinary day and one that's extraordinary it's that - making a difference.'

An extraordinary day for the nurses in the study did not necessarily depend on a good clinical outcome either, say the authors,

One nurse explained: 'I think being able to accept your death is one of the biggest parts of life, and I'm impacting that person's life... their life... their choice to die and I'm making it better... If I can make an angry family into an accepting family... when the patient and family do well, that means the world to me.'

The authors say the results of their qualitative study are not generalisable but add that it is a step towards learning what nurses value.

They suggest more qualitative studies are necessary to enable nurses to say in their own words what they find meaningful about their jobs.

'Only nurses can communicate what contributes to the accomplishments that keep them motivated and engaged. This can be revealed only by their descriptions of past positive experiences and not by anyone on the outside of the profession looking in.'