Healthcare facilities are integrated environments where multiple factors can influence the quality of care provided to patients. However, without the availability of a necessary number of nurses in healthcare facilities, practice settings will be unable to function the way they should. Because of this, it was chosen to focus on the problem of nursing shortages and turnover since they have a negative impact on staffing instability, thus adding to the poor quality of healthcare services.
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Leadership Versus Management: Nurses Turnover and Shortages
From the perspective of nursing leaders, nursing shortages and high rates of turnover are addressed through effective recruitment practices such as the American Nurses Association Nursing Agenda for the Future. The framework takes into account specific focus areas that require some improvements in the practices associated with updating the nursing profession and enhancing environments to make sure that practitioners are satisfied. Leaders, in contrast to nursing managers, are concerned with creating a beneficial setting in which nurses work as well as motivating and empowering them so that employees show high engagement and the interest to do their job well (Papathanasiou et al., 2014). The theory of psychological contracts aligns with the leadership approach toward nurse turnover and shortages because it implies both collaborative and transactional procedures for representing how different parties interact in order to ensure commitment and devotion to the practice.
Managers are less vision-driven because there is a list of tasks that they have to perform every day. They are not concerned with motivation and empowerment and dedicate their efforts to creating suitable schedules, managing the workload, and resolving interpersonal issues that occur within nursing teams (Ryan, 2016). From the perspective of theory, nursing managers have to possess a set of skills such as empathy, proactivity, respect, and the ability to manage staff from both micro and macro perspectives (Kodama & Fukahori, 2017). This means that managers are more likely to promote effective skills among nurses and engage them in the process of care to avoid turnover. Also, through the appropriate administration of the workload, managers have good chances of preventing understaffing. Nevertheless, leaders and managers should work cooperatively to address nurse turnover and facilitate retention because, without their collaboration, health care settings will lack structure when reaching the ultimate goal of providing patients with high-quality care.
In the discussion about effective nursing leadership styles that fit the majority of personal and philosophical guidelines, it is important to define good leadership and how it may impact the practice overall. With the abundance of research on this topic, it is surprising that there is little evidence to suggest that there is one good leadership approach that fits all healthcare organizations. Most of the narrative on nursing leadership revolves around gaining experience and wisdom (Maxwell, 2017). Nevertheless, transformational leadership has started gaining massive popularity due to its new way of thinking: it implies that nursing leadership requires “complex dynamic systems” (Maxwell, 2017, p. 18). Because of its innovative look at leadership and the management of relations between leaders and their followers, the transformational approach seems the most appealing.
In nursing, transformational leadership can provide multiple advantages because those who guide the practice of healthcare professionals have to be respectable, trustworthy, and dedicated to their followers in order to deal with the complexity of everyday operations. According to the study conducted by Lin, MacLennan, Hunt, and Cox (2015), subordinates reported positive attitudes toward transformational leadership not only in terms of practice but also in regards to their mental wellbeing. The psychological aspect is especially important because the way nurses feel can have a significant impact on retaining professionals in their positions. This hypothesis is also supported by Lin et al. (2015), who suggested that the overall work climate is the main contributor to the well-being of nurses. Therefore, there are strong links between maintaining positive nursing environments through transformational leadership and preserving the workforce in its entirety to avoid understaffing and high turnover rates.
The philosophy of keeping the working conditions of nurses on high levels aligns with my personal view on the nursing practice because, from experience, people tend to work much better when their environment enables their emotional wellbeing and enhances collaboration. Transformational leadership implies the mutual work between followers and their leaders to identify what changes are needed, create a vision to achieve change through inspiration and motivation, as well as to execute change by achieving commitment from all team members. In my personal view, it is the spirit of teamwork that can keep the nursing staff together and prevent turnover because when professionals care about each other the same way they care about patients, they will inevitably reach great outcomes within practice settings.
The Health Resources and Services Administration (HRSA) contributes to preventing nurses’ turnover and understaffing. For instance, in 2015, the organization announced the distribution of more than ninety-four million US dollars in awards to training new health care providers to enhance the delivery of care and strengthen the skills of the workforce. Importantly, Nurse Education Practice Quality and Retention received $11.9 million (twenty-six grants) for supporting “academic, service and continuing education projects designed to enhance nursing education, improve the quality of patient care, and increase nurse retention” (Health Resources and Services Administration, 2015, para. 6). Other initiatives for improving the practice of nursing professionals and offering them positive environments for work include Nursing Workforce Diversity, Advanced Nursing Education, Nurse Faculty Loan Program, and several others.
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It is important to consider HRSA a possible source of funding because the organization is already working on solving the identified problem as it has the knowledge and resources to prevent understaffing and high turnover rates of nurses in healthcare facilities. As a unique proposition to the organization, it can be beneficial to offer to improve the environments in which nurses work every day. For instance, investing in nursing coaches and psychologists will be a positive practice because of direct relations between nurses’ emotional wellbeing and their desire to remain in their positions and therefore prevent understaffing.
To conclude, nursing shortages and high rates of professionals’ turnover is an issue that managers and leaders need to solve. It has been shown that managers and leaders approach the issue differently, but it is their collaboration that can prevent the problem from occurring. When it comes to teamwork, the transformational approach to leadership was identified as beneficial for reducing the occurrence of staff shortages and turnover because it implies a close collaboration between leaders and their followers. Improving the work environments of nurses is of special importance because the way that professionals feel will inevitably lead to their decisions of either remaining in their positions or choosing a new career or a setting.
Health Resources and Services Administration. (2015). HRSA awards more than $94 million to strengthen and grow the health care workforce. Web.
Kodama, Y., & Fukahori, H. (2017). Nurse managers’ attributes to promote change in their wards: A qualitative study. Nursing Open, 4(4), 209-217.
Lin, P.-Y., MacLennan, S., Hunt, N., & Cox, T. (2015). The influences of nursing transformational leadership style on the quality of nurses’ working lives in Taiwan: a cross-sectional quantitative study. BMC Nursing, 14, 33.
Maxwell, R. (2017). Good leadership in nursing: What is the most effective approach? Nursing Times, 113(9), 18-21.
Papathanasiou, I. V., Fradelos, E. C., Kleisiaris, C. F., Tsaras, K., Kalota, M. A., & Kourkouta, L. (2014). Motivation, leadership, empowerment and confidence: Their relation with nurses’ burnout. Materia Socio-Medica, 26(6), 405-410.
Ryan, L. (2016). Management vs. leadership: Five ways they are different. Forbes. Web.