Nursing leader sees challenges, pushes for nurses to be ‘part of the solution’

Theresa Davis has spent 37 years as a nurse, and about half of those years have been at the bedside.

As she moved into the second half of her career, Davis began to realize how much she enjoyed leading nurses and working to make systems better. Now, as president of the American Association of Critical-Care Nurses, she is perfectly positioned to pursue those goals.

“When I discovered the project side and the building side and the design side and the leadership side, I also found another exciting area of nursing that I really thrived in,” Davis says. “I wouldn't have thought that in my early days. But, you know, as I grew through my career, I found a lot of golden nuggets in that side, like ideas and things that I learned that could help nursing into the future.

“So my passion towards the end of my career is really, how do I help nurses thrive in this industry? And how many challenges there are? How do I help them feel positive and inspired? It's really a gift that I get to do that,” she says.

• Read more: Nurses in hospitals: Burnout by the bedside

In a recent interview with Chief Healthcare Executive®, Davis discussed her role and the challenges ahead in improving the work conditions for nursing. She also discusses the changes that have come on during COVID-19, and some of the challenges in training nurses, and the valuable qualities younger nurses are bringing to the industry. (See part of our conversation with Theresa Davis. The story continues below.)

Hopeful for change

The nursing industry is undoubtedly facing challenges, with many nurses leaving jobs because they feel burned out and unsupported by their employers. Davis recognizes those challenges, but says she recalls similar difficult periods for nursing in her career.

“I think of nursing as like a continuance,” Davis says. “So it's the ebb and flow of these challenges. This has happened before, I mean, not in the same way. COVID really changed the game. We never went through something like COVID. But we have been through trying times before.

“So I'm very hopeful,” she adds. “I see the challenges. And I've seen challenges before. I think that if we are involved in the decision-making, if we are part of the solution, nurses, that they're going to create something, an environment that they can thrive in. And so I'm hopeful.”

Davis notes that the future of nursing “won’t look the same. But I'm a strong believer in change and being a part of that change.”

She’s encouraging nurses to push and help create a better work environment.

“What I tell people is: ride that wave,” Davis says. “Don't jump off before the change is done, because the change is exhilarating, right? There's a lot of excitement that happens in change.”

• Read more: Many nurses aren't getting help. That needs to change.

Creating better environments

This spring, the American Association of Critical-Care Nurses is launching a Healthy Work Environments National Collaborative. The organization is working with teams at more than three dozen hospitals to create better workplaces, improve quality and improve retention of nurses. The program will last for two years.

“We do a lot of research out there, and it doesn't get to the bedside right away,” Davis says. “But with implementation science, it accelerates that ability to get the learnings from the research to the bedside right away. And that's the work that AACN is going to do with Healthy Work Environments, and I am so excited to see that happen.”

Years ago, the association developed a set of six standards for healthy work environments, which include skilled communication, collaboration and appropriate staffing, and has encouraged health systems to adopt those standards to improve the work environment for nurses.

“You can change your organization, you can change at the unit level, the department level and the whole organization, if you really put those six standards into place,” Davis says.

The association has also developed a separate program, the Clinical Scene Investigator (CSI) Academy, which helps train nurses to lead peers in making unit-based changes that can reduce adverse events and improve outcomes.

Embrace training younger nurses

Many nurses have entered the healthcare industry with the goal of making it a career. Younger nurses don’t see it that way, Davis says, “and that’s not necessarily a bad thing.”

“It’s something we need to manage,” she says. “It's something we need to understand.”

Some younger nurses may want to only spend a couple of years in the profession before getting additional education and pursuing different positions.

“I think it's something we must adapt to, and be prepared that they may come in for just a couple years, and then move on to something else,” Davis says. “There'll be new nurses coming behind them. So I see a lot of hope. But I also see a lot of work ahead. But we nurses must be a part of the design of that.”

The COVID-19 pandemic, particularly the early months, impeded the training of younger nurses, Davis says.

“These nurses didn't get the clinicals that we got because of COVID,” she says. “They couldn't come into the hospitals, they couldn't do the clinicals in the way that we did it. And so they came in with less hands-on experience. And I can tell you as a nurse, it's not until I put my hands on things that I really learned about it.”

Nurses and health systems need to consider that in mentoring less experienced nurses.

“I think we have to take a step back and understand that they came into a different world,” she says. “And we have to show them where we are today. And so our mentoring has to be very intentional, and patient.”

Davis also encourages more experienced nurses to embrace the role of mentoring.

“There's so much we can learn from each other,” Davis says. “I absolutely love new nurses. I love mentoring. I love teaching. And when I hear that nurses are too tired to mentor or teach, I worry about that. Because that is a characteristic of a nurse. It's so valuable because you learn every time you teach someone.

“It's so important that we be sure that nurses realize mentoring and teaching is a part of our role,” she adds. “And it's who we are. And it's how we learned in the first place.”