In 2001, the American Association of Critical-Care Nurses made a commitment to actively promote the creation of healthy work environments that support and foster excellence in patient care wherever acute and critical care nurses practice. This commitment is based on the Association’s dedication to optimal patient care and the recognition that the deepening nurse shortage cannot be reversed without healthy work environments that support excellence in nursing practice.

There is mounting evidence that unhealthy work environments contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals. Negative, demoralizing and unsafe conditions in workplaces cannot be allowed to continue. The creation of healthy work environments is imperative to ensure patient safety, enhance staff recruitment and retention, and maintain an organization’s financial viability.

The Association has put forth 6 essential standards for establishing and sustaining healthy work environments.1 The standards uniquely identify systemic behaviors that are often discounted, despite growing evidence that they contribute to creating unsafe conditions and obstruct the ability of individuals and organizations to achieve excellence. The public repeatedly identifies nurses as the profession most trusted to act honestly and ethically. Five times since 1999 nurses have topped Gallup’s annual survey of honesty and ethics among professions.2 The public relies on nurses to bring about bold change that ensures safe patient care and sets a path toward excellence. These standards honor the public’s trust.

“If you dare to be powerful,” AACN President Connie Barden urged association members in 2003, “if you are ready to make a promise that will make a difference, I challenge you to join me in making your promise public.” Barden signed a public statement of her personal commitment to create a new future with healthy work environments that benefit everyone. She called for nurses to do the same by promising to:

  • Identify the most pressing challenge in their immediate work environment.

  • Initiate discussions with their colleagues to find solutions to this challenge.

  • Remain actively involved in the solutions until they are working.

The American Association of Critical-Care Nurses has committed to acting boldly, deliberately, and relentlessly until issues that obstruct creation of healthy work environments are resolved. In response to Barden’s call, AACN defined 2 strategic platforms that now guide the Association’s work environment initiatives:

  • Work and care environments must be safe, healing and humane, and respectful of the rights, responsibilities, needs, and contributions of patients, their families, nurses, and all health professionals.

  • Excellence in acute and critical care nursing practice is driven by the needs of patients and their families and is achieved when nurses’ competencies are matched to those needs.

These landmark standards to establish and sustain healthy work environments represent another important step in fulfilling AACN’s commitment. We challenge you to join us in creating healthy work environments by making these standards the norm. This requires the commitment of each nurse, each unit and each organization. We invite your thoughtful and decisive implementation as an individual, an organization, or an association.

American Association of Critical-Care Nurses. AACN standards for establishing and sustaining healthy work environments: a journey to excellence.
Am J Crit Care
Moore DW. Nurses top list in honesty and ethics poll. The Gallup Organization. Available at: Accessed December 17,