How are nurses in the workplace improving the quality of care and driving down costs? According to a new policy brief from the Robert Wood Johnson Foundation (RWJF), momentum is building for an array of worksite-based care delivery and preventive health approaches that could produce such benefits and more, with nurses taking a leading role.

The Value of Nursing in Building a Culture of Health (Part 2): Helping Employers Create Safe and Productive Workplaces, the latest in RWJF’s Charting Nursing’s Future series of policy briefs, describes a number of nurse-designed initiatives now underway at workplaces across the nation. They include:

  • Evaluating and changing the workplace environment to minimize workplace hazards;
  • Implementing programs to address job and life risks in tandem and to bolster worker resilience;
  • Increasing access to evidence-based primary care through worksite clinics that provide convenient, low-cost, and efficient care;
  • Rebooting workplace culture through healthy menu choices, walking meetings, and fitness;
  • Redesigning benefits to reward prevention and wellness;
  • Measuring the impact of workplace health initiatives; and
  • Building the business case for investing in the health of communities at large.

“From an employer’s perspective, it’s just good business to keep workers healthy and on the job,” says Maryjoan Ladden, PhD, RN, FAAN, RWJF senior program officer, and executive editor of Charting Nursing’s Future. “Nurses bring a professional perspective and clinical expertise that makes them the perfect partners for such initiatives, and employers and employees are turning to them with increasing frequency. It’s appropriate to note the work nurses are doing to build a Culture of Health in the workplace.”
The brief highlights several ongoing programs, including:

  • Johnson & Johnson’s Live for Life teams, which offer employees health education and coaching, risk assessment, and clinical interventions at on-site clinics;
  • The National Institute for Occupational Safety and Health’s (NIOSH) Total Worker Health® program, which melds workplace safety and health promotion;
  • HeartMath® Institute’s The Resilience Advantage program, a stress-resilience initiative recently pilot-tested with the Milwaukee, Wisc., police department;
  • The UnitedHealth Group’s Moment Health program, which offers mindfulness programs to employees of its Optum™ division and its customers;
  • A health care center created by SAS, a North Carolina-based software company, which provides on-site care to employees, including such services as primary care, physical therapy, counseling, pharmacy, nutrition, biofeedback, and breastfeeding support;
  • Baltimore’s Johns Hopkins Hospital’s on-site clinic for its employees, which reduced the number and frequency of employee emergency department visits and saved both employees and the employer money; and
  • Aurora Health Care’s Live Well program in Milwaukee, which uses financial incentives to engage employees in wellness programs focused on weight, tobacco cessation, preventive screening, flu vaccination, and behavioral health.

The brief also shines a spotlight on nurse leaders conducting research and education on work-related health problems, including:

  • Claire Caruso, PhD, RN, FAAN, a National Institute for Occupational Safety and Health researcher who has spent two decades researching the health effects of night-shift work.
  • Carolyn Sheridan, RN, clinical director and founder of the AgriSafe Network, who has worked to provide care to farmers and training to other clinicians focused on farming-related occupational illnesses.
  • Sandra Ramey, PhD, RN, who trains police officers in how to manage their responses to stress.

Finally, the brief addresses ongoing debates over workplace-based wellness programs, which typically assess individual employees’ health risks. Nurses are often called on to administer key aspects of such programs, conducting biometric screenings, coaching employees to help them reach wellness goals, and sometimes managing the care of individuals with chronic diseases. Various studies have produced conflicting results about the financial return on investment these programs produce for employers,   while the incentives used to encourage employee participation have generated controversy.
This brief is the second of two focused on nurses’ contributions to building a Culture of Health. The first focuses on nurses’ work where people live, learn, and play. Also available online is a complete archive of the Charting Nursing’s Future series.

For 10 years, Charting Nursing’s Future has assembled research and expert opinion to inform readers about policies and best practices that are transforming nursing, health care, and public health. It is currently produced for the Robert Wood Johnson Foundation by Propensity LLC.
About the Robert Wood Johnson Foundation

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit Follow the Foundation on Twitter at or on Facebook at