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Nursing: Life Cycle Change Theory


The radically changing environment in the field of nursing calls for urgent solutions to challenges that nurses come across as they perform their responsibilities. One of the problems that have been prevalent is the shortage of nurses in hospitals. Unfortunately, studies postulate that this shortage is likely to exacerbate and the conventional strategies to counter the same will have little or no success. Solving this problem requires a clear strategic plan by utilizing the most pertinent leadership plan. This paper discusses the nursing shortage plague and ways of to resolving it through situational leadership model. Moreover, in discussing the proposed changes, the paper will utilize a life cycle change theory to help in evaluating the impact of change.

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Application of Situational Leadership and Life Cycle Model

Situational leadership asserts that every situation is unique and thus it should be handled differently. This model is a good representation of how every responsible leader should respond to every issue with fresh observation of the visions, their staff, and what is needed to achieve such aims. Situational leadership encourages nurse managers to utilize certain leadership techniques when responding to various situations (Ladd, 2009). For instance, if the staff is oblivious of the proposed, the leaders must educate the nurses until they understand the necessity of the changes. However, if nurses are more conversant, then leaders should participatory style whereby the staff is included in decision-making (Ladd, 2009).

The flexibility of situational leadership model makes it pertinent for application in a hospital environment. Situational leadership also agrees with the fact that there are certain factors that make people to adopt a character distinct from the past for example, change in environment (Grossman & Valiga, 2009). Since nurse shortage is a chronic problem, it would be prudent to use situational leadership concept to map out ideas to alleviate it.

The changes proposed in this paper will apply a life cycle change model, which postulates that change occurs because of leaders attempt to shape a person’s natural growth. The benefit of this concept is that it results to transformation of the organization’s identity, which may restore the workers confidence on the institution (Kezar, 2011).

Changes Proposed

Resolving the problem of nurse shortage will be of great importance because it will simplify the delivery of services, which will in turn reduce the mortality rate in hospitals. The strategy to solving this impediment often falls into short-term and long-term solutions (Zinn, 2012). This paper discusses the applicable changes in both long-term and interim basis. These changes include temporary staff, reward system, and nurses’ work environment. Since the nursing shortage will presumably persist even in the future, it is essential to underpin these changes on a long-term perspective.

Major Goals Presented

This strategy plan intends to accomplish several goals. The solutions seek to sustain high levels of professional practice. The strategy plan also aims at enlightening the professionals as well as edifying the public. This move will help nurses to comprehend clearly factors that may trigger problems in the field and channels that they can use to tackle such issues. Another goal for proposing these solutions is to tackle nurses’ working hours as well as structures in the workplace.

Strategies for Change

Temporary staff

Under this strategy, health centers utilize per diem or external-agency caretakers that agree to sign interim contracts to perform nursing responsibilities and interim staffing requirements that emerge because of staff holidays and medical vacations. Another technique of hiring temporary staff is through internal-agency caretakers (Egenes, 2012). This technique helps the institution to minimize expenditure because such nurses are paid amount less than per diem nurses. Furthermore, nurses hired through internal-agency are more effective because they include caretakers who already form part of the institution, but would aspire to work overtime. Nonetheless, health centers can hire temporary external nurses but require them to have a certain degree of experience or training (Langan et al., 2009).

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The problem of applying this technique of hiring temporary staff is that it is expensive if practiced over a stretched term. Nurses hired from external-agency may be also ineffective and consequently cause more problems for the institution (Egenes, 2012). In a bid to avoid the challenge of hiring incompetent nurses, the institution should mutually formulate policies that restraint unskilled nurses from being hired. Furthermore, nurses hired through external-agency on a temporary basis should receive full contracts if they are proficient. This strategy is essential in alleviating the long-term effect of hiring temporary nurses, which leads to loss of money (Zinn, 2012). The hospital should give a top priority to staff nurses when it comes to hiring temporary nurses. However, nurses who agree to work extra hours should earn competitive salaries as a way of inspiring them to work unreservedly (Egenes, 2012).

Reward System

Rewards and incentives have a central role in any organization considering how they manipulate several work-affiliated behavior and rousing personnel. Most institutions use rewards to guide workers’ demeanor and commitment in an effort to search and preserve the most skilled workers by keeping them contented and inspired. This move results to direct increase in input, which is eventually reflected by the augmented revenue that the organization gets. Health institutions are not precluded from this practice considering the influence of nurses on the image of hospitals. Moreover, since rewards could be used to motivate workers, it acts as a good tool to inspire nurses to work for extra hours (Langan et al., 2009).

Most hospitals have opted to reward their nurses with gifts, certificates, or cash whenever they consent to work for extra hours. The impact of this idea has often been positive with most nurses willing to work extra hours just to get the additional pay especially during the Christmas season. However, since nurses represent the hugest number of workers in hospitals, monetary rewards for nurses may demand allocation of significant amount of the hospitals’ budget. Therefore, it is necessary for hospitals to adopt other forms of rewards, which are non-financial to eliminate the challenge of budget allocation. Hospitals should focus in issuing gifts and certificates as long as they can motivate nurses to work for extra time (Langan et al., 2009).

A recent research conducted in the United States revealed that there are many licensed nurses, but they prefer other occupations or are unemployed. Most of the unemployed nurses that were subjects of the studies stated that they preferred other occupations due to unpleasant working conditions in the nursing profession. The nurses admitted that they would be interested in returning to hospitals if the relevant authorities could provide incentives such as refresher courses accompanied with twelve-hour shifts and increased benefit packages. The number of licensed nurses who are not working in hospitals is large; hence, nurse policy-makers should take nurses’ grievances seriously by formulating proper evaluation program of the working environment as well as nurses’ career stress.

Nurses’ work environment

Adjusting the hospital working environment has also proved significant in employing and maintaining nurses (Egenes, 2012). Positive adjustment in the working environment can encourage nurses to utilize their expertise fully as they gain confidence of the hospital. The adjustments should mostly focus on the nurse staffing levels. The hospitals should focus in raising the staffing levels in a bid to enhance patient care whilst minimizing the tasks of nurses. However, this initiative does not improve care delivery. In order to enhance care delivery, hospitals should incorporate specific alterations in the nurses’ duties to augment care delivery as well as nurse contentment. Hospitals could decide to divide the nurse staff fraternity into various departments for instance, those who respond to urgent cases and those that handle patient’s personal demands (Langan et al., 2009).

It is essential for hospitals to retain elderly nurses because of the massive experience they possess. Nonetheless, as leaders advocate for nurses to remain in the institution, it is important to note that as individuals become old, their level of exhaustion rises. Hence, they may find it difficult to perform execute some responsibilities such as dressing patients. Furthermore, most of their senses become impaired, which may impede them from effectively dispensing their skills. Most elderly nurses are willing to continue providing their services, but they are discouraged by working environment. Thus, as hospital heads contemplate on how to retain elderly nurses, they consider factors that ease the dispensing of services, for instance through redesigning the building structures by avoiding long corridors (Langan et al., 2009).

Impact of Strategies on tackling Nurse Shortages

The application of these strategies will expectedly reduce nurse shortages after two years. The plan to train nurses will amplify their populace and consequently reduce cases of nurse scarcity. Hiring temporary staff is expected to be the immediate means through which hospitals will resolve any shortage that may arise in the future (Egenes, 2012). It also aims at solving the issue of the nurses’ working hours. Using the strategy of internal-agency, nurses have the liberty to pick the amount of extra time they wish to work. The application of modern technology will probably simplify workload in the nursing department, and thus minimize the number of nurses required in various departments.

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Although these strategies are anticipated to have a positive impact on the hospital by reducing the effect of the nursing shortage, studies still indicate that, the future is desolate (Egenes, 2012). Studies predict a prevalent shortage of nurses in the future and the current strategies will be inadequate in solving such shortages. This postulation hinges on the increasing number of hospitals in several markets that will demand more nurses.


Situational leadership is an effective model of making a decision in an organization because of its flexibility. Nursing shortage is prevalent in the medical profession and it can only be solved if leaders use distinct ideas to solve various issues. Hiring temporary staff, introducing a reward system, and changing the nursing working environment will surely contribute to reduce the current shortage. Nonetheless, by utilizing the life cycle theory in applying the proposed changes, leaders should recognize that they play a crucial role in ensuring that organizations adopt new identities.


Egenes, K., J. (2012). The nursing shortage in the U.S: A historical perspective. Chart, 110(4), 18-22.

Grossman, C., & Valiga, M. (2009). New leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia: F. A. Davis.

Kezar, A., J. (2011). Theories and Models of Organizational Change. Understanding and Facilitating Organizational Change in the 21st Century, 28(4), 25-56.

Ladd, J. (2009). School Nurses: Positive Deviant Leaders in the School Setting. The Journal of School Nursing, 25(6), 6-14.

Langan, J., Tadych, R., Kao, C., & Israel, H. (2009). Registered nurse incentives to return to practice in the United States. International Journal of Nursing Practice, 15(5), 359-367.

Zinn, L. (2012). Addressing the nursing shortage: The need for nurse residency programs. AORN Journal, 96(6), 652-657.

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