A Balancing Act: Managing Workload While Improving Nurse and Patient Satisfaction.

High workload and unpredictable shift end times can contribute to employee turnover, dissatisfaction, and low staff engagement. The aim of this project was to improve nurse and patient satisfaction within a hospital-based outpatient gastrointestinal endoscopy unit while moving from an existing three-shift procedure staffing model to a two-shift model with defined expectations and predictable shift end times. The shift modification led to an 82% decrease in nurse turnover rates after the first 6 months. There was a 12% decrease in the number of nurses calling in ill to work. Nurse satisfaction, compared to 2 years prior, demonstrated 21% improvement related to "having a sense of achievement"; 39% improvement with "being involved in work unit decisions"; 62% decrease in burnout; and 7% improvement in overall satisfaction. The number of nurses attending and presenting at national, regional, and local conferences increased. Furthermore, overall unit patient satisfaction improved by 1.94% (p = .063) between first-quarter 2014 preimplementation data (n = 183) and first-quarter 2015 postimplementation survey data (n = 140). The created shared governance environment supported nurses' involvement in decision-making and creating a new shift model that led to greater staff and patient satisfaction.