Benchmark – Applying Leadership and Management Principles
Nurses play a crucial role in the promotion of optimum health and outcomes for the diverse populations that they serve. Nurses’ roles in healthcare include offering patient care, keeping up with evidence-based practices, and reassuring families and patients about the care that they receive. The diverse roles place nurses under immense pressure, which increases their turnover rates. Turnover among nurses is currently an issue in not only the United States, but also in most of the advanced nations, which threatens the delivery of high-quality, safe, and efficient care to all. Therefore, this essay describes the issue of turnover among nurses, its impacts, a possible solution, and leadership styles and theories that can be adopted to address it. It also explores nurses’ roles in addressing the issue of turnover among nurses.
Issue Description and Its Impacts
Nursing turnover occurs when nurses leave their profession or their jobs. Nursing turnover is a crucial concern for the healthcare industry as it threatens the safety, quality, and efficiency of healthcare delivery systems. Most countries, including the United States, are experiencing shortages of qualified nurses because of a high turnover rate among them. According to statistics, the hospital turnover rates in the United States from 2016-2020 increased by 2.8%, leading to an 18.7% turnover rate in 2020 (An et al., 2022). During the COVID-19 period, the nurse turnover rate in the United States reached 27.65%, the highest rate ever reported in history (Bae, 2023). Nurses who have worked for less than a year have the highest rate of turnover rate compared to those with more than five years of experience (Bae, 2022). Factors such as high workload, violence, and family demands contribute to the high rate of turnover among nurses.
Nurse turnover has detrimental effects on the quality of care in healthcare settings. An increase in the turnover rates among registered nurses leads to a high workload for the remaining nursing staff. High workload predisposes the remaining staff to adverse outcomes such as burnout, job dissatisfaction, and intention to leave their workplaces. A high nurse turnover rate also results in decreased patient outcomes. This can be seen from the increased rate of medical errors and delayed delivery of care services due to the high workload for the few staff. Studies have also linked occurrences such as pressure ulcers and hospital-acquired infections to increased turnover rates among registered nurses. Hospitals incur significant costs in hiring, training, and retaining new staff due to high turnover rates among registered nurses (An et al., 2022; Bae, 2022, 2023). Therefore, nurse turnover affects adversely patient, provider, and organizational outcomes.
One Possible Solution
An effective solution that hospitals can implement to prevent and reduce turnover among registered nurses is providing favorable working conditions for nurses. Most nurses who leave their jobs and profession attribute their decisions to poor or harsh working conditions. They report issues such as poor pay, violence, and limited autonomy as the factors that contribute to their decisions to leave their jobs and professions. Health organizations can retain their nursing staff by transforming their workplace environments. This can be achieved by ensuring that nurses get good pay, and flexibility in their work, be treated with respect, and ensure their autonomy is maintained (Lockhart, 2020). Paying nurses well will contribute to their job satisfaction, which lowers their intention to leave.
Providing nurses with flexible work arrangements will reduce their perceived workload, hence, lowering their intention to leave their employers. In addition, nurses should be treated as valuable members of the organization. Strategies such as valuing their contributions to the organizational success and being treated with respect by other healthcare providers minimize turnover rates among nurses. Nurses’ autonomy should be respected by ensuring that they practice as per their standards of practice. Creating a favorable environment has cost implications for health organizations (Perkins, 2021). For example, paying nurses well would mean that health organizations incur high operational costs to ensure increased workforce retention and the delivery of high-quality care that promotes sustainable outcomes.
Leadership Style to Address the Issue
A democratic leadership style would be best to address the issue of turnover among registered nurses. Democratic leaders encourage and prioritize the input and communication from their followers. They value relationships and strive to ensure that their followers are willing and comfortable to express their concerns, ideas, and opinions on how to address the nursing turnover problem in their organizations. These leaders also utilize a two-way communication model to enhance transparency, honesty, and trust among followers and the leaders (Hakim & Wirajaya, 2021). As a result, organizations benefit from increased staff motivation and the implementation of strategies that align with the prioritized needs of the nursing workforce.
Comparison of the Leadership Style with My Leadership Style
Democratic leadership style aligns with my leadership style. I consider myself to be a democratic leader. I value the creation of positive relationships in my workplace. I encourage open communication among the staff on issues that affect them. I also encourage them to be actively involved in exploring the strategies that should be adopted in the organization to enhance outcomes and performance. I also advocate for the creation of open channels of communication. I believe that a two-way communication channel makes employees feel valued and increases their overall satisfaction and job retention rates.
Comparison of Two Different Leadership Theories
Transformational and transactional leadership theories might be applied to address the nursing turnover problem. Transformational leadership theory asserts the need for leaders to create an inspiring vision for their teams to influence the desired behavioral changes. The inspirational vision acts as a catalyst that drives employee behaviors to meet the set goals and objectives (Labrague et al., 2020). On the other hand, transactional leadership theory asserts the need for leaders to be focused on understanding the extrinsic motivators that influence employees to achieve the set goals and objectives. Unlike transformational leadership, which emphasizes the vision, transactional leadership theory aims at goals. Transformational leaders would be proactive in addressing nursing turnover while transactional leaders would be reactive (Wei et al., 2020). Transformational leadership theory would be effective in influencing nurses’ attitudes by inspiring innovation acceptance by developing trust, openness, and enthusiasm while transactional leadership theory would be effective by using rewards and reinforcement to address nurse turnover issues.
Nurses’ Role
Nurses play several roles in an interdisciplinary team in promoting patient quality and safety while fostering professionalism to address turnover among them. One of the roles is encouraging open communication. Nurses champion open communication among interprofessional teams to ensure the delivery of high-quality care to their patients. Nurses also promote respect among interprofessional teams. They ensure that each member’s contribution to care is valued. They also advocate the adoption of policies that promote their safety by addressing vices such as workplace violence (Majeed & Jamshed, 2021). Nurses also advocate the adoption of organizational policies that safeguard their interests such as ensuring flexible working conditions and favorable pay that meets their needs.
Conclusion
In summary, nursing turnover is a crucial issue affecting the healthcare industry in the United States. Nursing turnover affects care outcomes and the performance of health organizations. Creating favorable working conditions is an effective solution that health organizations can adopt to address nursing turnover. Democratic leadership, transactional leadership theory, and transformational leadership theory can be applied to address nursing turnover. Nurses play crucial roles in embracing interventions that would address nursing turnover in their profession and practice.
References
An, M., Heo, S., Hwang, Y. Y., Kim, J., & Lee, Y. (2022). Factors affecting turnover intention among new graduate nurses: Focusing on job stress and sleep disturbance. Healthcare, 10(6), 1122. https://doi.org/10.3390/healthcare10061122
Bae, S.-H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: a systematic review. International Nursing Review, 69(3), 392–404. https://doi.org/10.1111/inr.12769
Bae, S.-H. (2023). Comprehensive assessment of factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals: a systematic review. BMC Nursing, 22, 31. https://doi.org/10.1186/s12912-023-01190-3
Hakim, N. R., & Wirajaya, I. G. (2021). Influence of autocratic, democratic and laissez-faire leadership styles towards nurse’s job satisfaction in inpatient room of RSU Bhakti Rahayu Tabanan. STRADA Jurnal Ilmiah Kesehatan, 10(1), 1017–1023. https://doi.org/10.30994/sjik.v10i1.770
Labrague, L. J., Nwafor, C. E., & Tsaras, K. (2020). Influence of toxic and transformational leadership practices on nurses’ job satisfaction, job stress, absenteeism and turnover intention: a cross-sectional study. Journal of Nursing Management, 28(5), 1104–1113. https://doi.org/10.1111/jonm.13053
Lockhart, L. (2020). Strategies to reduce nursing turnover. Nursing Made Incredibly Easy, 18(2), 56. https://doi.org/10.1097/01.NME.0000653196.16629.2e
Majeed, N., & Jamshed, S. (2021). Nursing turnover intentions: the role of leader emotional intelligence and team culture. Journal of Nursing Management, 29(2), 229–239. https://doi.org/10.1111/jonm.13144
Perkins, A. (2021). Nursing shortage: Consequences and solutions. Nursing Made Incredibly Easy, 19(5), 49. https://doi.org/10.1097/01.NME.0000767268.61806.d9
Wei, H., King, A., Jiang, Y., Sewell, K. A., & Lake, D. M. (2020). The impact of nurse leadership styles on nurse burnout: a systematic literature review. Nurse Leader, 18(5), 439–450. https://doi.org/10.1016/j.mnl.2020.04.002
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Select an issue from the following list: workplace violence, workplace injury, unit restructuring, floating, nurse turnover, nurse staffing ratios, or use of contract employees (i.e., registry and travel nurses).
In a 1,000-1,250-word paper, discuss the following:
- Describe the issue you selected. Provide data to support how this issue impacts the quality of care in the setting in which it occurs.
- Using research evidence for support, present one possible solution that could be implemented to address the issue. In your discussion, be sure to include financial considerations as they relate to implementation of the solution.
- Describe a leadership style that would best address the issue.
- Discuss how this leadership style compares to your personal leadership style.
- Compare two different leadership theories that could be applied to resolution of the issue. Explain how each theory would be effective in addressing the issue.
- Discuss the nurse’s role within an interdisciplinary team in promoting patient quality and safety while fostering professionalism to address this issue.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.