Letter to the Editor by Kimberly Osterhout, RN to “Nurse Engagement: What are the Contributing Factors for Success?”

The Patient Experience: Capturing the Intricacies of Contributing Factors

April 28, 2017

Response by Kimberly Osterhout, RN to “Nurse Engagement: What are the Contributing Factors for Success?” Christina Dempsey and Barbara A. Reilly (January 31, 2016).

Dear Editor:

I am writing regarding the article, “Nurse Engagement: What are the Contributing Factors for Success?” (Dempsey & Reilly, 2016). The purpose of this letter is to offer supplemental support related to nurse engagement. I support continued research about nurse engagement and believe this is significant issue in nursing today. Dempsey and Reilly (2016) further discuss compassion fatigue and burnout, as a result of disengagement. I write to expand on the research and discuss another model used as a means of empowering and engaging nurses.

To determine what promotes empowerment and engagement among nurses, we must find the root of the opposite problem: disengagement. The working environment is increasingly demanding which leads to burnout and fatigue, as mentioned in the article. The Patient Protection and Affordable Care Act (2010) has changed healthcare reimbursement. Nurses are the largest workforce team in a healthcare setting, thus their role in the reimbursement infrastructure is significant. It is more important now than ever for nurses to provide quality care due to the influence of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHP) scores on reimbursement.

As mentioned above, the importance of nurse engagement is crucial. Larkin, Cierpial, Stack, Morrison, & Griffith, (2008) promoted engagement and empowerment through nursing committees, using Kanter’s (1993) theory of structural empowerment as the basis of their work. Larkin et al. (2008) noted that this theoretical perspective guided a process to help empower employees to accomplish their work in more meaningful ways. For these structures to be beneficial and empower/engage employees, they must be implemented by organizational leaders. Using this structure may then improve work environments, which in turn can increase nurse satisfaction. When nurses are satisfied with their workplace and the work they do, they are, by definition, engaged.

Overall, nurse engagement is a serious concern in our workforce. Engagement needs to be addressed so that nurse and patient outcomes are not negatively affected. Kanter’s theory (1993) offers just one way to contribute to the success of keeping nurses engaged. Engaged nurses take pride in their work and provide quality care. In addition, they are at a decreased risk for burnout and fatigue that Dempsey and Reilly (2016) discussed.

Given concerns such as nurse shortages, increased workload, and rapidly changing processes, I believe that nursing leadership teams would benefit from implementing structures based on Kanter’s work (1983), with the goal of keeping all nurses engaged. Everyone’s job should be to encourage and implement changes that promote nurse engagement.

Stay empowered and stay engaged,

Kimberly Osterhout, RN


Dempsey, C., & Reilly, B.A. (2016). Nurse engagement: What are the contributing factors for success? OJIN: The Online Journal of Issues in Nursing, 21(1). doi:10.3912/OJIN.Vol21No01Man02 Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-21-2016/No1-Jan-2016/Nurse-Engagement-Contributing-Factors-for-Success.html

Kanter, R.M. (1993). Men and women of the corporation (2nd ed.). New York, NY: Basic Books.

Larkin, M., Cierpial, C., Stack, J., Morrison, V., & Griffith, C., (2008). Empowerment theory in action: The wisdom of collaborative governance. OJIN: The Online Journal of Issues in Nursing, 13(2). doi:10.3912/OJIN.Vol13No02PPT03. Retrieved from:http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/vol132008/No2May08/ArticlePreviousTopic/EmpowermentTheory.html

Patient Protection and Affordable Care Act (PPACA) Pub. L. No. 111-148, §2702, 124 Stat. 119, 318-319. (2010). Retrieved at www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf