Introduction
Without a doubt, there is an increasing shortage of nursing professionals not only in the United States but also globally, with the trend anticipated to worsen in the coming years (Goodin, 2003; Zori, Nosek, & Musil, 2010). Nursing shortage and nurse turnover are fundamentally related to the concepts of leadership and management, as both are mirrored in organizational philosophies demonstrating ineffective management approaches, transactional and autocratic leadership styles, and the resulting disempowerment of staff (Kelly, 2011). Using the existing theories, principles, skills, and roles of nursing leadership and management, the present paper compares and contrasts how nursing leaders and managers can address this issue.
Leadership approaches/theories
When faced with the issue of the nursing shortage and/or turnover, the underlying concern for nursing leaders and managers should be to develop and implement strategies and approaches that attract and retain staff while ensuring that the turnover rate is kept at a minimum. Nursing leaders may employ capabilities such as idealized influence and inspirational motivation to influence and motivate junior nurses as well as align them with the goals and objectives of the organization. These skills are grounded in the transformational leadership theory (Blegen & Severinsson, 2011).), and imply that nursing leaders should demonstrate relation-oriented moral responsibility towards staff, motivate and energize them using open and mutually fulfilling relationships, as well as encourage and challenge value orientation (Blegen & Severinsson, 2011). Extant literature demonstrates that a motivated workforce is likely to register high job satisfaction rates and therefore less likely to leave (Goodin, 2003). In contrast, nursing managers may deal with the situation by involving themselves with administrative duties, such as planning, budgeting, organizing, and staffing.
Management approaches
Because job satisfaction, organizational commitment, and intention to change professions have been demonstrated as significant variables in informing nurses’ turnover intentions (Parry, 2008), nursing leaders may employ such approaches as intellectual stimulation (appealing to the intellect using natural authority) and individualized consideration (availing individual support, acknowledgment, confirmation, recognition, acting as a coach), with the view to providing direction to junior staff and inspiring them to remain with the organization (Kelly, 2011). In contrast, a nursing manager may apply a reward system (pay, promotions, leave, allowances, etc) in an attempt to have a substantial amount of control over the nurses, especially in terms of increasing their job satisfaction and commitment levels. However, current research demonstrates that approaches that aim to exercise control and authority over nursing staff through the use of reward and punishment systems are not as effective as those that aim to inspire, influence, and motivate staff (Blegen & Severinsson, 2011).
In dealing with staff shortages, a nursing leader may take the informal role of empowering the available nursing professionals to work hard, with the view to ensuring that patient needs are successfully met and quality of care is not compromised (Stachowiak & Bugel, 2013). Empowerment can be achieved by using the principles of the transformational leadership style, which include visioning, planning, communication, and creative action intended to have a constructive unifying effect on other nurses within the department or organization (Blegen & Severinsson, 2011). In contrast, nursing managers may deal with the problem of staff shortage by coordinating the available resources, assessing and planning services in line with available staff, and also by making informed decisions on whether to request additional staff from relevant agencies or parties (Stachowiak & Bugel, 2013).
Lastly, it is important to note that nursing leaders employ different outcome measures in assessing a nursing issue, such as staff shortage and/or turnover (Stachowiak & Bugel, 2013). In this context, the outcome measures for nursing managers may include patient-nurse ratios, job satisfaction and commitment, service level, and nurse staffing levels. In contrast, the outcome measures related to the roles of nursing leaders in addressing the issue of staff shortage and/or turnover include the level of influence on others, level of nurse-to-nurse relationships, level of staff satisfaction, quality of care, and patient safety.
Personal Approach
The approach that best fits the personal and professional philosophy of nursing is transformational leadership, which consists of important leadership elements such as idealized influence (charismatic, establishing visions, role-modeling), inspirational motivation (providing challenges, goal sharing, going beyond self-interests), intellectual stimulation (facilitating creative problem solving, critical thinking, flexibility), and individualized consideration (encouragement and support, empowerment). This approach is suited to personal leadership style not only due to its capacity to influence and motivate other members of staff in practice settings, but also because it has the potential to convert other nursing professionals into an empowered workforce using minimal resources (Blegen & Severinsson, 2011). Such characteristics as idealized influence and inspirational motivation, in my view, are best suited in engaging other nursing professionals with the view to reinforcing commonly held beliefs and raising each other to high levels of motivation and morality.
Conclusion
Overall, this paper has compared and contrasted how nursing leaders and managers may address the issue of staff shortage and/or turnover through the adoption and implementation of a multiplicity of management and leadership approaches. In a way, the paper has served to demonstrate how nursing leadership approaches are essentially different from nursing management approaches, and also why transformational leadership is best suited in practice settings.
References
Blegen, N.E., & Severinsson, E. (2011). Leadership and management in mental health nursing. Journal of Nursing Management, 19(4), 487-497.
Goodin, H.J. (2003). The nursing shortage in the United States of America: An integrative review of the literature. Journal of Advanced Nursing, 43(4), 335-350.
Kelly, P. (2011). Nursing leadership and management (3rd ed.). New York, NY: Cengage Learning.
Parry, J. (2008). Intention to leave the profession: Antecedents and role in nurse turnover. Journal of Advanced Nursing, 64(2), 157-157.
Stachowiak, M.E., & Bugel, M.J. (2013). The clinical nurse leader and the case manager: Are both roles needed? American Journal of Nursing, 113(1), 59-63.
Zori, S., Nosek, L.J., & Musil, C.M. (2010). Critical thinking of nurse managers related to staff RN’s perceptions of the practice environment. Journal of Nursing Scholarship, 42(3), 305-313.