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Leadership and Nursing Management


Leadershipand Nursing Management

Thenursing shortage and nurse turnover is a critical concern affectingthe functioning of healthcare industry in the entire globe. In case,no measures are taken to get rid of this issue, there is a likelihoodof this issue worsening (Hart, 2003). Every hospital has its ownleadership that ensures successful approaches are considered for aproper functioning of the hospitals. Therefore, success of hospitalsin the future will highly depend on the long term strategies thatbecome implemented by leaders. This means that there is a need ofensuring that leaders and managers that become appointed in thehealth care industry musts have the required skills in order toensure successful approaches of dealing with the issue of nursingshortage and nurse turnover (Hart, 2003). This paper will have an aimof discussing the causes of nursing shortage and nurse turnover,approaches that leaders and managers can use in resolving this issue,and personal and professional philosophy of nursing concerning theissue.

Nursingshortage emerges as one of the principal issues affecting the healthcare industry. This is a critical issue as it results to poor patientsatisfaction and decreased patient outcome. One of the prime groundsthat lead to the nursing shortage entails aging work force. In thehealth care industry, most of the nurses are nearing retirement age,which creates an impression that nurses in the health care industryare likely to be few, creating a shortage. In the United States, thenursing profession emerged as an exceedingly popular professionduring the 60’s and 70’s however, the popularity of theprofession has decreased, especially to women who are currentlyengaging in other different career opportunities. This has anunpleasant effect on the healthcare industry since few individualsare engaged in the profession. Another reason leading to the nursingshortage is a lack of nursing school faculties. Although there arevarious nursing faculties, most of them lack proper clinical sites,preceptors, and classrooms. Since nursing is an exceedingly toughjob, both mentally and physically, individuals feel that nursing is astressful job due to its environment. This makes most individuals notidentify with the profession this definitely leads to the nursingshortage since only a few individuals identify with the profession.

Nursingturnover emerges as a significant concern affecting the profitabilityand performance of health care settings. Healthcare entities usuallyneed a steady, fully engaged and highly skilled nursing personnel inproviding effective patient care. However, the mounting shortage ofcompetent nurses has caused a firm augment in the turnover rate amidnurses. The rate is likely to worsen in the future as the expansionof the healthcare industry is continuing to surpass the existingsupply of nurses. Indeed, it has been projected that there is likelyto be a nurse shortage of approximately one million nurses by 2020,in the U.S. (Health Resources &amp Services Administration, 2006).

Consequencesof Nurse Turnover

Nursingturnover is likely to have negative consequences on the healthcareorganizations. One of the consequences of nursing turnover isdecreased patient care quality. Nurse shortages that are aconsequence of nursing turnover are usually associated with vastdeclines in the patient care quality. Nursing turnover leads to lossof patients entities have reported to turn patients away to otherhealth care facilities because of a lack of personnel due to highnursing turnover. This emerges as a noteworthy concern for healthcareentities operating in countries, which mandate the least nurse topatient enrollment ratios. Besides, nurse turnover develops personnelshortages, which increase the job demands that is placed on the leftnurses. This increases the risk of the left nurses to quit because ofthe extra workload. Alternatively, there is a likelihood of augmentedstaffing cost. Substantial resources are usually needed inrecruiting, hiring and training nurses that substitute nurses thatquit. Healthcare entities, which suffer from elevated nurse turnover,are likely to find it cumbersome to recruit fresh nursing personnel.

Causesof Nurse Turnover

Twoapproaches are used in diagnosing the reasons for nursing turnover.One approach entails identifying why nurses make a choice of workingin different jobs and then determining if the needs are being met.The other approach entails identifying things, which occur afternurses become hired that make them quit jobs, although the jobs maymeet their initial job expectations.

WhyNurses Prefer Working for an Organization

Studiessuggest that the key issues, which determine the nurses’ option ofemployers, entail career expansion opportunities that exist,commuting distance, and work schedules. Nevertheless, thesignificance of these issues varies amid nurses. Nursing professiondraws individuals having an exceedingly broad array of career goalsand interests. Some nurses look for jobs, which give themopportunities of developing professional capabilities and skills,while others leave a quality on job schedules, which do not impedetheir pledges outside of work.

WhyNurses Give Up Their Jobs

Thereare various issues that make nurses give up their jobs these factorsvary from those that make them accept jobs. Some of these factorsinclude feeling overworked, lack of role clarity, not feeling valuedand respected, poor communication for critical issues with themanagement, lack of effective collaboration and trust with coworkers,and work being too physically demanding among others.

Leadersand Managers Approach to Reducing Nursing Turnover

Leadersand managers have the role of managing the staff, which implies thatthey have a duty in maintaining the right number of nurses topatients ratio. Leaders of healthcare can collaborate with thehealthcare organizations and other institutions in ensuring thatthere are sufficient nurses in the provision of healthcare services.Therefore, they can use different approaches in an attempt to reducenursing turnover. One of the approaches that leaders ad managers canuse entails augmenting the number of trained nursing candidates.Nursing turnover is very prevalent because of scarcity of competentnursing candidates existing in the labor market (Hunt, 2007). Thenumber of competent nursing candidates can be increased in the labormarket through establishing community outreach programs that targetstudents. This encourages students to engage in nursing careers.Qualified nursing candidates can also be increased by providingeducational scholarships to the nursing students.

Anotherapproach entails making jobs more attractive to nursing candidates(Hunt, 2007). This can be done through changing the schedule designand pay structure. Besides, nursing turnover can be reduced through job screens, where candidates that do not fit become wiped out.Hiring candidates with blurred expectations concerning requirements,duties and job benefits is a leading factor to increased turnover.Statistical tools can be used in screening candidates in order tomitigate the turnover resulting from poor job fit(PriceWaterhouseCoopers, 2007).

Byconsidering these approaches that can work in reducing the nurseturnover, I feel that the best approach that best identifies withpersonal and professional nursing philosophy entails augmenting thenumber of qualified nursing entrants that exist in the labor market.This approach is beneficial since it will address the significantissues, which make nurse turnover exceedingly costly (Anderson et al,2004). Although this approach requires a lot of time and resources,it can be successful where the government provides sufficient supportto the healthcare industry.


Anderson,R.A., Corazzini, K.N., &amp McDaniel, R.R. (2004). Complexityscience and the dynamics of climate and communication: reducingnursing home turnover.Gerontologist, 44, 378-388.

Hart,P. (2003). Patientto nurse staffing ratios: perspective from hospital nurses.AFT Healthcare.

HealthResources &amp Services Administration (2006). Whatis Behind HRSA`s Projected Supply, Demand, and Shortage of RegisteredNurses?United States Government Department of Health and Human Services.

Hunt,S.T. (2007). HiringSuccess: the art and science of staffing assessment and employeeselection.Wiley: San Francisco, CA.

PriceWaterhouseCoopers(2007). Whatworks: healing the healthcare staffing shortage.PriceWaterhouseCoopers, LLP.