Nurse Turnover, Leadership and Management

Introduction

The modern health care sector is focused on the delivery of high-quality care to patients and guaranteeing a high level of their safety. For this reason, there are multiple efforts to create an environment characterized by the increased effectiveness of specialists and improved outcomes that are achieved due to aligned cooperation. However, the high level of stress that comes from the responsibility and the necessity to perform multiple functions results in the growing levels of tiredness, exhaustion, and inability to perform functions vital for the achievement of improved outcomes. Moreover, it preconditions the appearance and the development of the problem of turnover, which is critical for healthcare. For this reason, the improved management of this problem is one of the major tasks today.

Definition

The scope of the problem mentioned above presupposes the existence of different definitions and perspectives on it. One of the generalized ones states that nursing turnover is a process of nurses leaving organizations because of a set of reasons (Antwi & Bowblis, 2018). It might also include voluntary and involuntary decisions to stop working in a particular healthcare facility. The growing demands of the quality precondition a significant increase in turnover; statistics show that its rate comprises about 17% every year (Antwi & Bowblis, 2018). It evidences the need for immediate actions aimed at the improvement of the situation in the sphere and the creation of an environment beneficial for nurses.

The burden for the Healthcare Sector

Turnover also becomes a serious burden for the healthcare sector as it preconditions the negative changes in the functioning of units. There is a direct correlation between the low rates of nurses’ leaving and results demonstrated by the hospital (Kurnat-Thoma et al., 2017). Additionally, accepting the fact that rehiring, retraining, and preparation of new workers require extra resources and time, the overall spending related to turnover and all associated processes estimate about $5 million per year (Chesak et al., 2019). Unfortunately, the financial aspect is not the only issue that arises because of the discussed problem. Investigators admit the increased number of errors caused by human factors or cases of maltreatment in units characterized by a high turnover rate (Wendsche et al., 2017). Under these conditions, it is critical to introduce effective measures to attain improved outcomes.

Patient Safety

Finally, speaking about the problem of turnover, it is vital to mention the aspect of patient safety as one of the basic concerns of modern healthcare. It is defined as the absence of harm to a patient during the process of care delivery and reduction of risks that might emerge in the healthcare setting (Chesak et al., 2019). The modern approach presupposes the collective effort and cooperation between all members of a team to guarantee the achievement of the acceptable minimum important for the recovery of patients (Antwi & Bowblis, 2018). It means, if one of the specialists quits, the effectiveness of the whole unit reduces because of the lack of experience peculiar to a new team member. Under these conditions, the resolution of the problem of turnover becomes vital for the achievement of higher levels of patient safety.

Professional Standards

One of the possible ways to reduce the issue is the strict adherence to the professional standards that exist today. They emphasize the critical importance of the appropriate care delivery and describe the competent level of care peculiar to every phase of the nursing process (Antwi & Bowblis, 2018). Because all health workers should possess an improved understanding of these standards, the continuity of care can be established by observing the code and avoiding actions that contradict it (Antwi & Bowblis, 2018). New specialists should also be aware of these regulations, which means that they should be able to prevent the harm that can be done to patients or deteriorate their outcomes (Antwi & Bowblis, 2018). Comparing the actual performance of a nurse to the existing standards, it is possible to determine the problem areas and eliminate them.

Leadership and Management

At the same time, the problem of nursing turnover can be handled with the help of leadership and management approaches. Investigations show that overworking, high levels of stress, and dissatisfaction remain the central causes of nurses leaving healthcare facilities (Kurnat-Thoma et al., 2017). For this reason, leaders and managers, as individuals responsible for organizing the work of a unit, can contribute to the reduction of the turnover rate. Thus, in accordance with the accepted theoretical framework, the climate within a collective, which includes stress management, can be aligned by creating effective communication patterns and delegating tasks effectively (Kurnat-Thoma et al., 2017). It will also guarantee that specialists will not overwork and experience professional burnout (Chesak et al., 2019). Additionally, managers can introduce appropriate changes in the schedule to provide rest to nurses who need it and avoid a significant reduction in their effectiveness.

Additionally, managers and leaders can initiate additional training or evaluation of specialists’ skills to ensure that they can meet diverse clients’ demands and perform their functions at a sufficient level. The given check is needed to guarantee that all workers possess an improved understanding of their current tasks and are ready to engage in teamwork. Moreover, newly hired employees might demand some time to adapt to new conditions, and this training will be vital for better integration. Both leaders and managers possess the resources needed to introduce the given measurements and ensure that the improved outcomes will be achieved.

The investigation of the turnover rate also outlines the existence of the dependence between the employed leadership style and final rates. For instance, autocratic leadership can be associated with the decreased level of satisfaction among nurses, and, as a result, their desire to leave a unit and find another place (Chesak et al., 2019). It means that there is a need for approaches that will cultivate trustful and positive relations between employees. Under these conditions, transformational leadership presupposing enhanced teamwork to determine change and create a vision to achieve it together becomes a preferable option regarding the high turnover rate (Antwi & Bowblis, 2018). Leaders of this cohort might inspire nurses to work in tandem and guide all followers to achieve better results together, which is critical for patient safety and recovery.

Conclusion

Altogether, the high turnover rate remains a significant problem for the modern healthcare sector. First, this problem contributes to the increased costs needed to support the effective work of units. Second, it preconditions the deterioration of patient safety and the appearance of multiple concerns regarding the quality of care delivery. For this reason, there is a critical need for a practical solution that will help to improve the situation and reduce the turnover rate. Leaders and managers can contribute to the creation of the positive climate needed to avoid overworking, high-stress levels, and growing dissatisfaction among nurses. The employment of transformational leadership, along with the introduction of additional training and assessments, might help to reduce the number of nurses who want to leave and attain better outcomes.

References

Antwi, Y., & Bowblis, J. (2018). The impact of nurse turnover on quality of care and mortality in nursing homes: Evidence from the great recession. American Journal of Health Economics, 4(2). 131–163. Web.

Chesak, S. S., Cutshall, S. M., Bowe, C. L., Montanari, K. M., & Bhagra, A. (2019). Stress management interventions for nurses: Critical literature review. Journal of Holistic Nursing, 37(3), 288–295.

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—A 10-element onboarding program intervention. SAGE Open Nursing, 3.

Wendsche, J., Hacker, W., & Wegge, J. (2017). Understaffing and registered nurses’ turnover: The moderating role of regular rest breaks. German Journal of Human Resource Management, 31(3), 238–259.

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