During her first address as president-elect of the American Association of Critical-Care Nurses (AACN), Lisa Riggs stated, “We can create the workplaces we want and need when we use our voice.” How do we begin to create those workplaces when there is such uncertainty in health care today? Hospitals are making constant changes and cutting costs to improve efficiency, greatly impacting nurses’ work environments. As a result, nurses are concerned about and struggling with challenges such as staffing, collaborative relationships, participation in decision-making, and communication. Ulrich et al2–4  have done several surveys of nurses’ work environments since 2006. Results have shown that, whereas there is some variation in responses over time, in general there continue to be significant work environment issues that must be addressed to optimize the safety and quality of patient care. The surveys consistently have shown that nurses rate the environments in their...

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