Introduction
Nurse turnover is a significant challenge in the healthcare and medical sector. Many healthcare leaders face the challenge of not knowing what causes nurse turnover and how it can be addressed. Under any circumstances, a nurse can choose to leave an organization, such as due to a change of organization or workplace, a change of profession, or retirement. They leave with a definite reason and must explain the reason to the organization.
The reasons might include working overtime without pay, straining from physical or mentally demanding labor, and feeling underappreciated. When there is nurse turnover, the organization is impacted negatively in many departments. The costs of replacing and having quality directly affect the organization.
An increase in nurse turnover, for whatever reason, is linked to the leadership and management of the organization. Management suffers in such situations, which may lead to a decrease in the quality of patient care and a challenging time managing turnover. In addition, patients and healthcare workers suffer due to loss of top care, trust, and effective communication.
Nurse Turnover’s Impacts Quality of Care and Patient Safety
Nursing turnover impacts patient safety and quality of care, as nurses who leave often exacerbate staff shortages. Accordingly, they will get overwhelmed by tasks that the nurses would rather carry out. They are expected to consider and attend to all patients and cater to their treatment needs; however, patients often lack the quality care they deserve, and nurses become overworked. Overworking nurses leads to burnout, which negatively impacts both the organization and its patients.
Moreover, increased nurse turnover affects the organization financially by requiring the replacement of nurses. New nurses must adapt to the practice and culture of the organization and adhere to ethical codes to deliver the quality of care patients require (Shaffer & Curtin, 2020). The patients are at the center of it all, and their safety is jeopardized. With new nurses, patient safety is also impacted during the orientation and adaptation period.
Effective communication among leaders or within the hierarchy is crucial for patient safety, and patients may be negatively impacted before it is implemented. Additionally, increased nursing turnover has a direct impact on nursing retention, and the ability to retain experienced and trained nurses decreases (Shaffer & Curtin, 2020). The management will struggle to address nurse retention and the nurse shortage, and create a balance between incoming and existing nurses.
Professional Standards of Practice in Nurse Turnover
The outcomes for patients, including patient safety and the quality of care they receive, are the nurses’ responsibility, as outlined in the Standards of Professional Practice. First, to help address nurse turnover, the employment and recruitment of nurses should be conducted in accordance with the established standards of practice (Barr & Dowding, 2022). Dealing with competent nurses who understand the level of a task in patient care helps address many of the problems they face. They can solve this by knowing how to communicate them to the management or the head of health units.
Notably, they can contribute to the decision-making process and give a lifeline to the challenges they face. The Standards of Professional Practice should understand the heftiness of healthcare work as nurses face issues of burnout, and mental issues like depression, and they need mentoring and counseling programs (Barr & Dowding, 2022). Addressing the issues professionally will help nurses improve their work and the workplace environment.
Both nurses and management should collaborate to address the factors contributing to the high nursing turnover rate. Culturally congruent practice is a standard that professionals should adopt. Different organizations have distinct work cultures, and developing a culture for an organization takes time (Helbig et al., 2018). Therefore, harmonizing it from the leadership and staff helps to inculcate and grow the desired culture. For instance, patient-centered care should be the goal that all staff aim to achieve at the end of their tasks.
Roles of Nursing Leaders and Nursing Managers
Leaders have a significant role in addressing patient issues amidst increased nurse turnover. Consequently, they should work to reduce or mitigate the issues leading to nurses leaving the organization. Nurse leaders can use motivational skills to avoid nurse turnover. Nurses’ tasks are overwhelming and need motivation, such as improving their careers, competence, and well-being. As they are sincere in helping others, when they receive help, they commit to providing more compassionate and caring services.
Transformational leadership theory can help encourage a reduction in nursing turnover and contribute to the organization’s overall success. Nurses can apply their problem-solving skills and encourage critical thinking. Transformational leaders help nurses have the drive and passion for their work. This approach is dynamic and powerful; nurses can understand the state of the organization and adapt to it, thereby discouraging turnover (Ferreira et al., 2020).
The delegation of tasks is a viable approach to help nurses grow as leaders within health institutions. The approach will help nurses feel that their contribution is needed and foster a sense of belonging within the organization. They can share the workload and appreciate the clinical environment by working together as a team.
Additional Aspects of Managers and Leaders in Nurse Turnover
Nursing turnover can happen in a diverse healthcare environment due to the same or additional factors. Thus, leaders and managers must add additional aspects to reduce nurse turnover and ensure patient safety. In a diverse team, upholding high professional standards of practice is essential (Barr & Dowding, 2022). Teams and leaders must respect each other. Registered nurses must work with various nursing assistants and newly enrolled nurses.
Nurse leaders should be able to address bullying, prejudice, and bias that negatively impact the quality of patient care by educating the diverse staff on health disparities (Shaffer & Curtin, 2020). Nurses can decide to leave an organization due to the failure of their culture being misunderstood and stereotypes making the environment unworkable. Leaders must help nurses understand different cultures, including those of patients, to avoid it becoming a barrier to quality patient care and safety (Barr & Dowding, 2022). Nurses can learn how to effectively interact with patients from diverse backgrounds and beliefs. Avoiding biases will enhance communication among nurses, patients, and nurse leaders, helping to improve effective communication that fosters an environment suitable for all and reduces nursing turnover.
Conclusion
In conclusion, the failure of nurse leaders to make the necessary changes in recruiting, communicating, and retaining nursing staff will continue to affect organizations, other staff, and patients, as well as nurse turnover. Addressing the Standards of Professional Nursing and effective leadership are critical factors in reducing nurse turnover. Leaders have the role of promoting patient safety and quality care by inculcating a culture that allows a free flow of communication to address the many challenges.
The decision-making process should involve most nurses and the board to make addressing nurse turnover issues easier. The reaction from staff can be shown through their level of engagement, collaboration, and commitment. Remarkably, working together with leaders will help improve the workplace and better address issues, allowing nurses to stay at the hospital and provide top-quality care and safety to patients.
References
Barr, J., & Dowding, L. (2022). Leadership in health care. Sage.
Ferreira, V. B., Amestoy, S. C., Silva, G. T. R. D., Trindade, L. D. L., Santos, I. A. R. D., & Varanda, P. A. G. (2020). Transformational leadership in nursing practice: Challenges and strategies. Revista Brasileira de Enfermagem, 73(6), 1-7. Web.
Helbig, J., Thomas, J. S., & Whitney, S. (2018). Nursing leadership & management. Grand Canyon University. Web.
Shaffer, F. A., & Curtin, L. (2020). Nurse turnover: Understand it, reduce it. My American Nurse, 15(8), 57-59. Web.