Belongingness Belongs in Nursing

Attention! Nerd alert!

I am about to geek out on one of my very most favorite topics. …

Belongingness

?“Why belongingness and why now?”

Because a profound sense of disconnect has grievously wounded our profession and the people working in it, and belongingness has incredible healing power.

Read on for how a culture of belongingness can turn even the most troubled organization around.

Before diving into the concept itself and the evidence supporting its impact on organizational culture, I will share a bit about why it is particularly meaningful to me.

I have been a nurse for over 40 years, and the profession has been a source of joy and meaning in my life.

This is largely due to the sense of belongingness I have experienced throughout my career.

As a nurse, I felt a deep connection to myself, able to express who I am in my relationships with patients, colleagues, students, research participants, and my community.

This sense of belonging extended beyond personal connections, as I also felt part of something greater than myself, a collective that transcends individual experiences.

Early on I understood that it is all about relationships; meaning that relationships are the lifeblood of any person-centered practice, service-oriented team or mission-driven organization.

Why?

Because relationships (person-Self, provider-patient, educator-learner, team member-colleagues, leader-team members, organization-community), are the metaphorical vessels in which healing, learning, transformation and growth take place.

And those intentional, purpose-driven relationships require among other things, a sense of belongingness.

And while I was a latecomer to academia (my first faculty position was more than 30 years post-BSN), my teaching philosophy and approach aligned with my overall professional approach.

Again, it was all about relationships. I was patient-centered in clinical practice, participant/population-centered in research and learner-centered in the classroom.

I knew that to create an inclusive learning environment, one in which every student thrived, I would need to incorporate pedagogical strategies designed to promote a sense of belongingness at the individual student level and at the community level.

Having no experience in curriculum development or teaching, I was scared. However, I had a vision. I wanted to be instrumental in socializing and welcoming the students into the nursing profession.

I dove into pedagogical evidence, participated in a Course Design workshop and partnered with the Center for Teaching Excellence.

And you know what?

It was freaking magic! I worked with an amazing group of colleagues and a very supportive leadership. I was inspired, motivated, and energized by the sense of belongingness I felt.

I received funding to examine the impact of the strategies I was implementing in the classroom, on student outcomes in the clinical and academic settings.

I also wanted to see if students from historically underrepresented groups in nursing experienced the classroom milieu differently from their majority peers.

Nearly all the 4th year students participated in the study which involved analyzing data collected over the academic year (surveys, course evaluations, academic markers such as grades, exam scores, clinical experience etc., and focus groups).

The results confirmed my experience in the classroom and what I knew in my heart.

All students benefit from an inclusive learning environment, but students from UG especially benefit because they are more likely to experience what I call breaches in inclusivity.

When students experience a true sense of belonging, they are able to redirect their energy from self-protection to achievement.

They understand that the classroom is a proxy for the clinical setting and the educator-learner relationship a proxy for the nurse-patient relationship.

Another key finding- the faculty is the leader in the classroom and is responsible for modeling expected behavior-having a growth mindset, treating others and self with compassion and respect, providing resources, addressing breaches in inclusivity and other barriers to belongingness.

And the best part? It was contagious!

Belongingness was integrated into all facets of my faculty role-in all the courses I taught, the PhD students I mentored, the students I advised, my collaborations in the clinical setting and with my research team.

During my time there I had hundreds of students to my home for dinner, brought research assistants to professional conferences, included RAs and other research team members as authors on papers and presentations, mentored future educators, invited clinical instructors and colleagues to present to students, and incorporated topics such as self-care, stress management, healthy work environment, compassion and communication into the curriculum.

I was electrifying! I was living my best life, fully engaged at work and at home, because my work energized me (as opposed to exhausting me).

Unfortunately, after a leadership change, the culture at the school changed and no longer belonged there.

I was forced out, in part because of my inclusive pedagogical research (and in part for having too short a funding runway-i.e. being too old).

And yes, I was heart-broken and traumatized by the subsequent bullying when I refused to go quietly. (They did manage to get rid of me, but they have not silenced me ;).

However, I was saved by my sense of belongingness.

I know who I am. I belong to myself first.

Perhaps you can understand why belongingness is so important to me.

It has been a healing force in my life, and I believe it will be a healing force for our profession.

Okay, time for a pivot…

?Some background on the concept of belongingness (I promise not to get too sciency)…

For the purposes of this article, belongingness is defined as a sense of connectedness by feeling accepted by others and being an integral part of the collective, as one’s true or authentic self.

Since Maslow’s hierarchy of needs (belonging being one), a sense of belonging has been considered an important psychological phenomenon that contributes to overall health and wellbeing across the lifespan.

Several nurse researchers (listed below)* have explored the concept of belongingness in nursing, including its impact on individual nurses, nursing students, teams, organizations, and the profession.

Evidence-Based Outcomes Associated with Belongingness

Individual nurse level outcomes include enhanced physical and mental wellbeing, increased motivation, engagement, job satisfaction, and greater empathy, compassion and professionalism.

Team level outcomes include greater team cohesion, enhanced teamwork and intra- and interprofessional collaboration.

Organization level outcomes include higher patient satisfaction scores, less absenteeism, and lower turnover/improved retention. Similarly, institutions known for cultivating a diverse and inclusive environment attract greater numbers of new nurses.

Education level outcomes include greater student retention/less drop-out, greater motivation and engagement, increased confidence, increased self-efficacy in the classroom and clinical setting, greater academic achievement.

In summary, the evidence strongly supports the idea that belongingness is integral to fostering a healthy, productive, and supportive environment for nurses.

It enhances job satisfaction, retention, and well-being, while also contributing to higher-quality patient care. For nursing organizations, institutions, and educators, prioritizing belongingness can lead to better outcomes both for nurses and the patients they serve.

When people experience belongingness in their relationships, they are empowered to show up authentically, consciously directing their energy toward growth/success.

As an epilogue to the story, I have not abandoned my profession. I am now a certified professional coach whose practice is informed by 40 years in nursing.

I empower service-oriented, purpose-driven healthcare providers, leaders and educators to inspire and motivate themselves and those around them to achieve success inside and outside of work without sacrificing their wellbeing.

Stay tuned tomorrow for ways you can foster a sense of belongingness in your work and in your life!

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