Almost 10 years ago, upon hearing from its members about significant challenges, the American Association of Critical-Care Nurses (AACN) set out to help nurses improve their work environment. Nurses reported struggling with problems such as poor communication and collaboration on a daily basis. Significant improvements were needed to ensure patient safety and nurse retention.

In 2004, I published an article with Janie Heath and Wanda Johanson that was a review of the literature on healthy work environments based on the work done by Heath as part of her doctoral research. Data had been collected from 6 focus groups, and a review of the literature in 2003 and 2004 was performed. Participants in the focus groups were asked to describe healthy and unhealthy work environments. The participants described healthy work environments as having the key elements of caring practices, collaborative relationships, respect from...

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