Effective Approaches in Leadership and Management

Nursing Shortage and Nurse Turnover

Over the last decade, the U.S. healthcare environment has experienced dramatic changes, affecting the models of patient care delivery and the nursing workforce. As a result, the changes have seen increased nursing shortages, staff retention, and turnover, which is a prime concern in a majority of health care organizations. The deficit correlates with the U.S. Bureau of statistics prediction that projected that the demand for Registered Nurses would grow by at least 3.2 million increase by 2018 (Robert Wood Johnson Foundation, 2010). Ideally, without the sufficient number of nurses, nurses are more likely to be overwhelmed, distressed, and dissatisfied, a factor that may compromise patient care and safety. At the center of this, nurse leaders and managers have a responsibility to examine the contributing factors of the current nursing shortage, familiarize themselves with the situation, and come up with strategies for improvement. In essence, nurse leaders and managers need to understand the severity and implications of the nursing shortage and low nurse turnover, establish the contributing factors, and come up with solutions for successful recruitment and retention.

Nurse Manager Approach in Addressing Nursing Shortage and Nurse Turnover

Within the clinical settings, the nurse managers’ roles involve overseeing the daily operations of the health facility and hold the hospital together. As Armstrong, Rispel, & Penn-Kekana (2015) notes the managers are accountable for the management aspect within a nursing unit. Part of their greatest responsibility is to promote a positive attitude among the staff, increase job satisfaction, and reduce job-related stress. In particular, nurse managers have a critical role in providing support and fostering a positive working environment. In the same demeanor, nurse managers have a role in addressing nurse shortage and nurse turnover. Ideally, nurse turnover is a recurring problem in numerous health care organizations and has been strongly associated with nurse shortages within specific clinical settings that experience high turnover rates. Similarly, Flinkman, Isopahkala-Bouret, & Salanterä (2013) notes, it is also important to understand that it is hard to address nursing turnover through a single intervention because there are several reasons that lead nurses to quit their job. Nonetheless, although factors contributing to nursing turnover are considerably complex, a high number of solutions if well understood. The solutions range from addressing the entire nursing profession lifecycle to having an applicant pool ready to discuss retirement of elderly nurses. In light of this, nurse managers have a role in retaining nurses. This can be achieved by ensuring that nurses feel valued in their work environment, recognize their efforts, and give meaningful feedback. In essence, nurse managers are expected to encourage positive motivation among nurses. Similarly, in order to ensure positive performance, nurse managers can try formulating the human resource policies to support flexible scheduling and job sharing, as well as address wages, and benefits as part of the incentives projected to motivate nurses. In addition to the above, nurse managers should only hire qualified nurse professionals. Ultimately, as (Currie & Carr (2012) note, one of the reasons why nursing turnover is prevalent is hiring candidates who are not sure of their job description or what is expected of them. For instance, when screening prospective candidates, it is important to give the candidates of a comprehensive preview of what is expected of them. Otherwise, nurse managers may end up hiring nurses expecting them to work on weekends only to realize the candidate is unwilling to work on Sundays. Thus, realistic job previews should be put in place to provide clear job descriptions to nurse candidates to reduce nursing turnover associated poor fit job characteristics such as tasks, schedules, and pay rates.

Nurse Leader Approach in Addressing Nursing Shortage and Nurse Turnover

In contrast to nurse managers, nurse leaders are individuals who use their interpersonal skills to influence others in accomplishing specific goals within the clinical setting. According to Sullivan (2013), the role of a nurse leader is to forge links and create connections among members in order to promote high performance and quality outcomes. Due to the nature of their responsibilities, nurse leaders have a major contribution in nurse job retention and satisfaction. Essentially, it is common knowledge that nurses want to work in an environment where they feel appreciated. They should be able to express their opinions, communicate, and feel encouraged among other things. Nurse leaders are skilled in empowering others by creating a meaningful learning environment, developing knowledge, enhancing communication, solving problems, and collaborating with others for effective delivery of care. In particular, nurse leaders are known to pay attention to context and recognize each situation and the specific skills that should be applied. By doing this, nurse leaders are able to inspire, motivate, and orient staff to create a positive working environment for the nurses, which is a major determinant of staff retention and turnover rates.

Personal Reflection of Leadership Style

The desire to help people through nursing is a calling, and it is in the same context that I chose nursing as my professional career. As part of my philosophy, I feel that nurses have a responsibility towards patients to provide a safe and patient-oriented care. I also understand that achieving my responsibilities towards my patients is not possible without the collaboration of my colleagues. Alongside this comes together with the philosophy of encouraging staff, setting goals, and encouraging professional growth and self-esteem among staff members. Thus, as conceptualized along this continuum, the approach that fits my leadership style is transformational leadership, which seeks to inspire and motivate others. Ideally, transformational leadership does not focus on the status quo; rather it seeks to revolutionize change in organizations (Sullivan, 2013). While traditional leadership emphasizes the different between leaders and employees, transformational leadership aims at merging the goals, desires, and values of leaders and followers into one cause. By choosing this approach, I believe it will enable me to work together as a team while allowing others to explore their innovativeness at work. Precisely, by applying transformational leadership, nurse leaders can encourage others to exercise leadership. Similarly, because this approach enables me to appeal to other people, I believe I will be able to quickly identify conflicts and barriers and solve problems amicably whenever they arise. As a leader, I understand that I am part of the team and my role is to spearhead the vision and sharing of responsibilities to achieve our preset goals. In addition to the above, by using this approach, I believe that I will be able to instill respect, self-value, ethical practice principles and transmit the same to members of the team while maintaining the focus on the future of the organization. More importantly, by practicing this kind of leadership I believe I will be able to address burnout and work related stress and in return improve staff retention and reduced nurse turnover.


Armstrong, S. J., Rispel, L. C., & Penn-Kekana, L. (2015). The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?. Global Health Action, 8(26243), 1-9.

Currie, E. J., & Carr, H. R. A. (2012). What are the reasons for high turnover in nursing? A discussion of presumed causal factors and remedies. International Journal of Nursing Studies, 49(9), 1180-1189.

Flinkman, M., Isopahkala-Bouret, U., & Salanterä, S. (2013). Young Registered Nurses’ Intention to Leave the Profession and Professional Turnover in Early Career: A Qualitative Case Study. Isrn Nursing, 2013(3), 1-12.

Robert Wood Johnson Foundation. (2010). Nursing Projected to Lead Employment Growth over Next Decade. Retrieved from: http://www.rwjf.org/en/library/articles-and-news/2010/01/nursing-projected-to-lead-employment-growth-over-next-decade.html

Sullivan, E. J. (2013). Effective leadership and management in nursing. New York: Pearson. 

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