Nursing Shortages and Nurse Turn-Over: Effective Approaches in Leadership and Management
Nursing shortages and nurse turn-over is a growing issue among the nursing profession. The main reason for this growing problem seems to be dissatisfaction among nurses with some aspect of their job. Nursing leaders and managers play a vital role in job satisfaction and ultimately nurse retention. Through this paper, I will identify the roles of nursing leaders and managers and examine the different approaches that each take to ensure job satisfaction among their staff and co-workers, as well as how they manage nursing shortages and nurse turn-over.
Nursing Leadership
In today’s rapidly changing healthcare environment, it is important to develop strong, creative and effective nursing leaders. Leaders are those who possess certain characteristics such as motivation, commitment, autonomy, integrity, courage, initiative and the ability to handle stress (Huber, 2010). Good nursing leaders have the ability to encourage and inspire those around them to work as a team to achieve a common goal. Effective nursing leaders are respected and admired by their co-workers. They are able to think critically, set goals and have good communication skills which make those around them want to follow their lead. “Nursing leaders do more than just delegate, dictate and direct. Leaders help others achieve their highest potential” (ANA, 2014).
Nursing Management
Just like nursing leaders, nursing managers are equally as important to the nursing profession. The role of nursing managers is not only to promote and deliver safe, quality nursing care but also to facilitate and manage the environment of the health care setting. Nursing managers are responsible for the...
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Duffield , C., Roche, M., Blay, N., & Stasa, H. (2010). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20, 23-33. Retrieved from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com.library.gcu.edu:2048/login.aspx?direct=true&db=ccm&AN=2010882967&site=eds-live&scope=site
Huber, D. (2010). Leadership and nursing care management. (4th ed., pp. 2-298). Maryland Heights: Saunders Elsevier
Morgan, J., & Lynn, M. (2009). Satisfaction in nursing in the context of shortage. Journal of Nursing Management, 17, 401-410. Retrieved from http://library.gcu.edu:2048/login?url=http://search.ebscohost.com.library.gcu.edu:2048/login.aspx?direct=true&db=a9h&AN=37814776&site=eds-live&scope=site
As the forthcoming nursing shortage threatens the United States, organizations must be knowledgeable in the recruitment and retention of nurses. The challenge facing health care organizations will be to retain sufficient numbers of nurses to provide safe, efficient, quality care to patients. Organizations will look to recruit and attract quality nurses to fill vacancies. As turnover in nursing is a recurring problem, health care organizations will look for strategies to reduce turnover. The rate of turnover for bedside nurses in 2013 ranged from 4.4 to 44.6% (American Nurses Association, 2013). Nurse retention focuses on keeping nurses in the organization and preventing turnover. The purpose of this paper is to discuss the significance of recruitment and retention of nurses, review the literature, and explore how recruitment and retention apply to nursing.
Wieck, K. L., Dols, Jean, RN, PhD,N.E.A.-B.C., F.A.C.H.E., & Landrum, Peggy,R.N., PhD. (2010). Retention priorities for the intergenerational nurse workforce. Nursing Forum, 45(1), 7-17. Retrieved from http://search.proquest.com.library.capella.edu/docview/195019599?accountid=27965
Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2010). Essentials of nursing leadership and
There are several factors that are considered the causes of the nursing shortage. Literature suggests that the shortage is linked to factors related to current population trends and the nature of the health care e...
In most aspects of life the saying “less is always more” may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient’s quality of life as well as nurse’s satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low, conversely this is affecting all patients’ quality of care. As stated in the article Addressing The Nurse Shortage To Improve The Quality Of Patient Care “According to an Institute of Medicine report, Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff”.
Nevidjon, B., & Erickson, J. (31 January, 2001). The Nursing Shortage: Solutions for the Short
Marquis, B. L., & Huston, C. J. (2012). Leadership Roles and Management Functions in Nursing: Theory and Application. (7th ed.). Philadelphia: Lippincott, Williams & Wilkins.
The number of patients assigned per nurse has been directly linked to nurse job satisfaction and patient outcomes; with a ratio of four patients to one nurse being the ideal ratio (7). Research has shown that the addition of just one patient per nurse has been associated with a higher risk of death for patients and an increase in nurse job dissatisfaction and burnout (2). This is significant because nurses wish to provide the best quality of care for patients and with increased patient to nurse ratios, nurses are unable to maintain their ideal quality of care; which leads to job dissatisfaction and nurse burnout. Originally, after the passage of the California nurse staffing act, which set mandated nurse-patient rations, overall job satisfaction appeared to increase (1). However, several longitudinal studies have suggested that direct care nurses are still dissatisfied despite increased nurse to patient ratios (1). From the results of these longitudinal studies, it has been found that there is still some shortcomings with staffing systems based solely on nurse-patient ratios. Therefore, even though the ratios staffing system accounts for appropriate patient care, it does not take into consideration different patient complexities and needs for nursing care (10). Staffing by acuity is the third and final staffing system that is considered when looking at nurse burnout and job
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
...elly, P., & Crawford, H. (2013). Nursing leadership & management. In Nursing leadership & management(2nd ed., pp. 168-177). Canada: Nelson Education.
Registered Nurse turnover is a continuous problem in the nursing profession. Turnover in this context is simply defined as “someone leaving a job” (Kovner, Brewer, Fatehi, & Jun, 2014). Some aspects of nurse turnover can be viewed as positive, however, most circumstances of turnover are seen negatively and can be referred to as functional versus dysfunctional. The difference between the two is a “functional turnover, a poorly functioning employee leaves, as opposed to a dysfunctional turnover, when well-performing employees leave” (“One in Five nurses leave First job within a year,” 2014). The nursing profession’s recommendation for improvement focuses on dysfunctional turnover of Registered Nurses. Nurses choose to leave their jobs to explore
Azaare, J., & Gross, J. (2011). The nature of leadership in nursing management. British Journal of Nursing, 20(11), 672-680. Retrieved from EBSCO host
Leadership is defined by Northouse (2013) as a transactional experience between persons whereby one individual influences a group of individuals who have a mutual goal. Leaders may hold authority attributed to them by the group, substantiated by how they are regarded, whether or not they have positional authority. In contrast to management, where the goal is to provide order through control, leadership is concerned with producing change through transformation and practical adjustments (Northouse, 2013). Because of the nature of nursing, its obligation to promoting health and healing of people, nursing leadership concentrates change efforts based on human needs and concurrently ponders the needs of administrations largely because they understand the interrelatedness of the two influences.
In today’s society, leadership is a common yet useful trait used in every aspect of life and how we use this trait depends on our role. What defines leadership is when someone has the capability to lead an organization or a group of people. There are many examples that display a great sense of leadership such being an educator in health, a parent to their child, or even a nurse. In the medical field, leadership is highly used among nurses, doctors, nurse managers, director of nursing, and even the vice president of patient care services. Among the many positions in the nursing field, one who is a nurse manager shows great leadership. The reason why nurse manager plays an important role in patient care is because it is known to be the most difficult position. As a nurse manager, one must deal with many patient care issues, relationships with medical staff, staff concerns, supplies, as well as maintaining work-life balance. Also, a nurse manager represents leadership by being accountable for the many responsibilities he or she holds. Furthermore, this position is a collaborative yet vital role because they provide the connection between nursing staff and higher level superiors, as well as giving direction and organization to accomplish tasks and goals. In addition, nurse managers provide nurse-patient ratios and the amount of workload nursing staff has. It is their responsibility to make sure that nursing staff is productive and well balanced between their work and personal lives.
...ransformation. However, the power to improve the current regulatory, business, and organizational conditions does not rest solely with nurses; government, businesses, health care organizations, professional associations, and the insurance industry all must play a role. Working together, these many diverse parties can help ensure that the health care system provides seamless, affordable, quality care that is accessible to all and leads to improved health outcomes. Also, the Nurse leader provides the link between management and the frontline staff who personally interact with the public and patients. They are the interface between management and care delivery, and can only be effective if they have the support, time, authority, and respect necessary to competently and visibly lead their teams on the delivery of high-quality care. (Dawes, M., Davies, P., T., 2006).