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New Report shows that organizations must address relationships between nurses and key stakeholders for them to thrive and stay in the profession


New research from R3: the Renewal, Resilience, and Retention of Maryland Nurses Initiative at the Johns Hopkins School of Nursing revealed that organizations must address relationship dynamics between nurses and key stakeholders including leadership, peers, patients and themselves for nurses to thrive in the profession.

“This report shines a light on the critical role of relationships in addressing the nursing workforce crisis. Our responses as a health care community are too often transactional,” says Cynda Rushton, PhD, RN, FAAN, who leads the initiative. Dr. Rushton is a professor and the Anne and George L. Bunting Professor of Clinical Ethics at the Johns Hopkins School of Nursing and the Johns Hopkins Berman Institute of Bioethics.

The initiative engaged nursing students, practicing nurses, and nurse educators from 20 health systems and nursing schools across Maryland to identify the big narratives in the nursing profession—from what nurses are saying in the break room to portrayals of nurses in the media. R3 partnered with Slow Talk to facilitate the conversation and analysis.

Maryland nurses value compensation, improved staffing schedules, professional development opportunities, and other benefits (defined as transactional interventions). But when asked what is missing from public understanding, 63 percent of comments focused on relationship dynamics between nurses and key stakeholders like patients and hospital administrators. Existing research on the link between job satisfaction, retention, and performance, and employees feeling heard, supported, and in alignment with organizational values supports these findings.

Other notable themes emerged from this research. For one thing, generational differences loomed large among participants. Then, participants had substantial pride—and broad trust—in nurses’ ability to be drivers of change. “Relationships Matter: Beyond a Transactional Approach to the Nursing Workforce Crisis” will be released May 2, 2024 at the R3 state-wide conference with complete findings including the conversations, analysis, and recommendations. Dr. Rushton and Slow Talk will also launch a new initiative to engage nurse leaders in response to the report on May 2. The project will use Slow Talk to facilitate confidential discussions of the R3 findings and related dynamics, ultimately providing a safe space to build a deeper understanding of multiple perspectives.

R3: Resilient Nurses Initiative of Maryland was funded through a Nurse Support Program II grant. Slow Talk facilitated the conversation and analysis; through the platform, trained human facilitators and analysts use the latest AI tools to encourage rich, constructive conversations with results that shed light on new, important topics.

“One of the most rewarding aspects of doing this research was how the conversations not only surfaced insights, but also acted as catalysts to nurture relationships among nurses and foster a deeper sense of belonging to the profession,” says Dr. Rushton.

At the end of R3 Slow Talk, 76 percent of participants agreed or strongly agreed that “This conversation has helped me feel a stronger sense of belonging in the nursing profession.”


Located in Baltimore, the Johns Hopkins School of Nursing is a globally-recognized leader in nursing education, research, and practice. In U.S. News & World Report rankings, the school is No. 1 nationally for its DNP program and No. 1 (tied) for its master’s. In addition, JHSON is ranked as the No. 3 nursing school in the world by QS World University. The school is a five-time recipient of the INSIGHT Into Diversity Health Professions Higher Education Excellence in Diversity (HEED) Award and a four-time Best School for Men in Nursing award recipient. For more information, visit www.nursing.jhu.edu.


Sydnee Logan
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