High rates of nurse turnover currently persist all around the world. The issue of the nursing skills shortage in various medical organizations and facilities is a known concern. Nurse turnover may occur due to the influence of many different factors or their combinations. The professionals and leaders all around the world are working on the strategies and ways to prevent nurse turnover and address when it is already in process. The solution of the turnover problem assumes that the enforcement of change that can be done in a variety of ways based on different leadership and change theories.
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Currently, the discussed Medical Center is experiencing problems with nurse turnover due to the excessive workloads and lack of patient care technicians that result in the patients’ dissatisfaction and the unhealthy work environments. The leadership of the Center attempts to empower the nurses providing them with self-improvement and learning opportunities, and meeting with them for the discussion of the problems at the workplace. It looks like currently the organization demonstrates power and influence theories (looking to empower the nurses by giving them the ability to speak their concerns) as well as contingency leadership theories (preparing the nurses for various situations by means of coaching). The latter theory is employed by the service directors while the former is used by the senior leadership of the Medical Center.
Power and influence theories are highly useful in this situation as the nurse turnover is the sign of the personnel depowerment due to their assumption of diverse roles. In addition to all the extra tasks, under the circumstances of high turnover rates, the remaining personnel is to train the new workers which is another source of overload (Tironi, Silva, Dellarosa, Haddad, & Vannuchi, 2014). The current use of power and influence of the leaders is insufficient and needs to be altered to serve as a source of the future change strategies. Moreover, behavioral leadership theories need to be applied to the situation in the Medical Center to help the leaders apply democratic leadership style and achieve congruence with the nurses. The lack of agreement between the leadership and the nurses about the goals and objectives of work leads to the increasing turnover (Hunt, 2014). Finally, contingence theories are required as the leaders are to act based on the situations specific to this particular organization and their contribution to the turnover (Brewer, Kovner, Greene, Tukov-Shuser & Djukic, 2012; Duffield, Roche, Homer, Buchan & Dimitrelis, 2014).
One of the strategies for the application of the new leadership approach is to research the needs of nurses in the Medical Center by means of questionnaires or discussions and identify a list of the most significant issues. It is possible that some policies may be created to address the excessive workloads of the nurses and increase retention as this measure would be much more cost-effective than hiring new employees all the time (Jones & Gates, 2007). Secondly, the leaders are to empower their workers using democratic style and allowing the nurses to alter the existing policies according to their needs. In other words, the leaders could use their power to provide the nurses with more influence in the organization (this would definitely make them feel more valuable and facilitate the retention).
As outlined by Mitchell (2013), the change theory of Kurt Lewin works through three stages – unfreezing, moving, and refreezing. The Medical Center’s policy targeting the current hiring and firing policies needs to undergo changes. First of all, the current policy that led to the reduction of the number of patient care technicians. The administration needs to reconsider this policy and hire some technicians or assign their duties to other professionals without overloading the nurses. Another solution could be to accept more nursing students or nurses with lower qualification so that the ones that remain could delegate some of their duties.
The proposed strategies are likely to improve the relationships between the nurses and the administration of the Medical Center empowering the nurses to facilitate the change in the form they need it. For the solutions to be put into practice, the leaders of the Center need to shift their leadership style and approach the problem democratically, allowing the workers guide the next steps of the organization.
Brewer C. S., Kovner, C. T., Greene, W., Tukov-Shuser, M. & Djukic, M. (2012). Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals. Journal of Advanced Nursing, 68(3), 521–538.
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Duffield, C. M., Roche. M. A., Homer, C., Buchan, J. & Dimitrelis, S. (2014). A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing, 70(12), 2703–2712.
Jones, C., & Gates, M., (2007). The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention. OJIN, 12(3), 4.
Hunt, D. (2014). Does value congruence between nurses and supervisors effect job satisfaction and turnover? Journal of Nursing Management, 22, 572–582.
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37.
Tironi, N. M., Silva L. G. C., Dellaroza, M. S. G., Haddad, M. C. L., & Vannuchi, M. T. O. (2014). Management impact of staff turnover in the view of nurses: an exploratory study. Online Brazilian Journal of Nurses, 13(4), 549-558.