How to improve nurse engagement and strengthen patient care

Why should you care about nurse engagement?

According to market research conducted in 2023 by PRC, only 45.1% of registered nurses working in hospitals are “fully engaged” with their work. As a leader at your healthcare facility, do you have the time and resources to replace over half of your nursing workforce if they were to resign from factors contributing to disengagement?

If your nurses feel disengaged, they will likely feel:

• High stress levels
• Burnout
• Intent to leave

At a time when the healthcare industry is struggling with a nurse staffing shortage, disengaged nurses demand urgent attention.

Nurse engagement is likely affecting your facility more than you realize. Are you dealing with high turnover, and call outs? In this article, we explore the profound implications nurse engagement has and how modern solutions can help address nurse retention and staffing challenges.

What is nurse engagement?

Nurse engagement is the level of energy, commitment, emotional investment, and overall satisfaction nurses feel toward their work, when working with their patients, and in their organization. This can show up in whether nurses want to stay, pick up shifts, and contribute positively to the team

It means that nurses truly feel an intellectual and emotional connection with their work, their facility, and, naturally, their patients.

Nurse engagement is often described in 3 core pillars:

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How disengaged nursing teams impact the healthcare industry

Nurse engagement is not only an internal issue within a facility: it significantly influences patient care. 

• A fully engaged nurse provides high-quality care and is invested in the success of their facility. 
• Conversely, disengagement can compromise the quality of healthcare and the overall patient experience.

Impact on patient care quality

Disengaged nursing teams are more likely to experience breakdowns in communication, missed details, and reduced continuity of care. 

When nurses are emotionally or cognitively checked out, they may have less bandwidth to anticipate patient needs, coordinate with interdisciplinary teams, or speak up about safety concerns. 

Over time, this can contribute to lower patient satisfaction, increased errors, and avoidable care delays.

Higher levels of burnout and turnover

Disengaged nurses are more susceptible to experiencing burnout, adding fuel to the existing nurse staffing crisis.

Financial drain for the facility

Disengaged nurses are more likely to leave their jobs, forcing facilities to invest time and money in finding and training another long-term hire. 

Because nurse recruitment can take 86 days on average, facilities may not have a choice but to invest in short-term solutions while looking for another nurse.

What factors can lead to nurse disengagement?

Factors contributing to nurse disengagement include workload, compensation, workplace culture, and leadership.

Overwhelming workloads

Few things impact engagement more directly than workload. When nurses consistently face unmanageable demands, their sense of control and professional satisfaction diminishes rapidly. Even the most dedicated team members can feel burned out when chronic workload strain persists.

Several issues commonly drive this feeling of overwhelm:

• Insufficient staffing levels: Chronic understaffing forces nurses to stretch their time and attention across too many patients, leading to physical and emotional exhaustion. It also reduces the time available for high-quality, personalized patient care—something most nurses find intrinsically rewarding.
• High patient census: Seasonal surges, unplanned admissions, and population growth can all result in patient-to-nurse ratios that exceed safe or sustainable levels. These periods increase stress and make it difficult for staff to meet the expectations of patients, families, and supervisors alike.
• Excessive administrative work: Documentation, charting, and compliance reporting, though essential, often consume significant portions of nursing shifts. When administrative duties overshadow clinical care, nurses may feel their professional skills are underused and undervalued.

The cumulative effect of these factors can lead to decreased productivity, reduced patient satisfaction, higher turnover rates, and in severe cases, safety concerns. Facility managers play a key role in addressing workload-related disengagement by prioritizing staffing optimization, streamlining documentation processes, and leveraging technology that reduces administrative burden.

Inadequate compensation and benefits

Nurses need to feel appreciated not only through recognition and gratitude but also through fair and competitive compensation packages that reflect their skill, responsibility, and dedication. 

Beyond base salary, the structure and accessibility of benefits strongly influence nurse engagement. Health insurance, retirement plans, paid time off, tuition reimbursement, and mental health resources are all components that help nurses manage professional and personal demands. 

When these benefits are limited, confusing, or difficult to access, nurses may feel their well-being is not a priority for leadership.

Facility and team culture

A facility’s culture shapes how nurses experience their work each day. When the environment fosters collaboration, respect, and shared purpose, engagement rises naturally. However, a negative or fragmented team culture can quickly erode morale and drive disengagement.

Common warning signs of unhealthy workplace culture can include:

• Poor team cohesion: When communication breaks down or trust is lacking among nurses and interdisciplinary teams, collaboration suffers. This can lead to conflicts, inefficiencies, and a sense of isolation among staff.
• Lack of belonging: Nurses who feel excluded from key decisions or unsupported by peers are less likely to invest emotionally in their work or the team or organization’s mission.
• Bullying among nursing teams: Unaddressed disrespect, gossip, or intimidation creates psychological distress that undermines performance and retention.

These factors contribute to nurses wanting to leave their roles or not working at their best.

Lack of leadership support

Nurses need to trust that their supervisors advocate for them, listen to their concerns, and empower them to make decisions that improve patient care. When leadership support is weak or inconsistent, nurses may feel their expertise is undervalued, leading to frustration and disengagement.

A lack of autonomy or visible career progression further amplifies this effect. Professional development—through training, mentorship, and advancement opportunities—is essential to keeping nurses motivated and confident in their growth. 

Without these, even skilled and dedicated nurses can feel stagnant or disconnected from organizational goals.

10 Strategies to improve nurse engagement

Here’s what you can do to help your nurses.

1. Prioritize engagement as a strategic goal

With downstream effects on turnover, staffing costs, and patient care, nurse engagement needs to be a leadership priority. Consider applying these strategies for prioritizing engagement:

• Conduct anonymous engagement surveys to protect psychological safety.
• Listen to your team to get a base understanding of where team engagement stands.
• Utilize nurse leader rounding to communicate effectively with your nursing staff.
• Track metrics to measure engagement and understand trends over time.

Above all, remember that listening without follow-up can be more discouraging than not asking at all. When nurses see leadership take real action based on their feedback, this helps to motivate them and grow engagement over time.

2. Elevate nurse voices with shared governance

Empower nurses to take ownership of their practice through shared governance. This model distributes decision-making authority, allowing nurses to influence policies, workflows, and care initiatives. Involving nurses in critical decisions not only improves processes but also communicates trust and respect, two major drivers of engagement.

3. Codify recognition into team rituals

The need for recognition is a fundamental aspect of human nature. As part of their day-to-day work, you can encourage your teams to recognize the positive aspects and wins they have.

Creating structured recognition channels helps sustain morale and reinforce positive behaviors. For example:

• Use digital boards or internal chats for “daily shoutouts” or “digital high-fives.”
• Ask team leads to highlight one success story in every shift huddle.
• Celebrate milestones like work anniversaries or certifications.

Embedding appreciation into team rituals signals that every contribution counts and that nurses’ hard work is visible.

4. Pursue Magnet designation

A hospital that earns the Magnet designation is regarded as the epitome of nursing excellence and a leader in medical innovation. 

Working toward Magnet hospital status can improve engagement by aligning the facility around nursing excellence. The Magnet framework fosters empowerment, professional growth, and innovation through:

• Encouraging nurse-led research to improve clinical outcomes.
• Promoting strong nurse leadership development.
• Establishing a culture of recognition for high performance.

Even if full Magnet designation isn’t currently attainable, implementing some of its principles—such as evidence-based practice councils—can boost engagement across units.

5. Expand professional development opportunities

Professional growth is a core component of engagement. Nurses who see a clear path forward are more likely to stay motivated and committed. Facilities can:

• Leadership: Offer a “charge nurse residency” program for nurses who aspire to move into management but are unsure of where to begin.
• Continuing education units (CEUs): Host education courses or seminars within your facility from time to time, so nurses don’t have to spend extra money traveling.

Investing in nurses’ long-term growth not only benefits them but also builds organizational capability and loyalty.

6. Connect engagement to your mission

Every facility has a mission statement. When crafting it, make clinician engagement a part of its development.

Your mission statement should clearly articulate how nurses contribute to the facility’s vision of care. When nurses see their daily efforts tied to a larger purpose, engagement deepens. Invite nurses to help craft or refine the mission and integrate engagement language into it—such as commitments to empowerment, well-being, or shared success.

7. Review onboarding processes

Early experiences can shape long-term engagement. A structured onboarding program can help new hires feel confident and connected from day one. Effective onboarding practices include:

• Facilitating social introductions and unit tours to promote belonging.
• Scheduling check-ins at the 1-week, 30-day, and 90-day marks.
• Giving preceptors a reduced workload while onboarding a new member
• Helping new members with social integration

Related: 5 Tips for quickly onboarding PRN nurses

8. Address heavy workloads

How can you help your nurses during call outs?

Workload management is critical to sustaining engagement. During last-minute callouts or census surges, nurses shouldn’t be left scrambling. Facilities can reduce stress by:

• Using per diem staffing platforms like Nursa to fill shift gaps and maintain safe staffing ratios.
• Implementing real-time scheduling systems for better flexibility.
• Encouraging teamwork so nurses can support one another during high-demand periods.

Balanced workloads protect both engagement and patient safety.

9. Promote healthy work-life balances with facility policies

Sustainable engagement requires helping nurses recharge. Work-life balance policies demonstrate that leadership respects personal well-being. Consider implementing:

• Implement no-contact policies to ensure that nurses never get calls or texts during their days off.
• Convert an unused space into a wellness room or a room for resting.
• Mental health days or additional PTO for nurses under high stress.

These measures communicate genuine investment in staff well-being, which pays dividends in loyalty and performance.

10. Keep compensation competitive

Financial stability shouldn’t interfere with work. You can prevent excessive turnover by maintaining manageable workloads and keeping nurse compensation competitive:

• Keep benefits high for loyal nurses.
• Clearly list shift differentials (nights, weekends, or holidays) so that nurses feel that their time is appreciated.
• Offer commuter subsidies such as gas cards.

You can also stay up-to-date with staffing trends, allowing you to adapt your facility and implement innovative ideas to enhance nurse engagement.

Nurse engagement is a strategic priority

Engaged nurses are more likely to deliver higher-quality care, stay with their organization longer, and actively contribute to a positive workplace culture.

When nurses thrive, facilities thrive with them. By taking deliberate, data-driven steps to engage and support nursing professionals, healthcare leaders can create more resilient teams and stronger, safer care environments for everyone.

For facilities managing call outs and staffing volatility, flexible PRN staffing can help protect core teams. Nursa connects facilities with local, pre-vetted clinicians to support safer, more sustainable staffing.

Explore how Nursa can help facilities improve workforce management.

Sources:

• PRC: Trends and Implications with Nursing Engagement 
• The Atlanta Journal-Constitution: Nurse burnout study reveals that 41% of nurses feel ‘unengaged’PRC: Trends and Implications with Nursing Engagement
• PMC: Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors
• Loma Linda University Health: Nurse Leadership Residency