Nursing Shortage and Approaches to the Employee Turnover

The primary goal of any healthcare system is to offer the best possible treatment for its patients. Highly qualified healthcare specialists constitute the foundation of that system, yet at the moment, skilled nurses are in the highest demand in the United States. A lack of educational opportunities and stressful working conditions has led to an acute nursing shortage and high rates of nurse turnover. This paper examines the most common factors that cause distress in medical institutions and focuses on leadership techniques that could be implemented to improve the working environment and solve the problem of understaffing.

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Shortage and Turnover Issues

Today, healthcare services in the United States are facing a number of challenges including a significant shortage of nurses and high rates of turnover. Nurses comprise the majority of all medical workers at various types of healthcare facilities, and a stable, skilled nurse population is critical for providing the best healthcare services around the country. Indeed, a sufficient number of qualified nurses in the workforce is essential for the wellbeing of the entire nation.

Over the last decade, the popularity of nursing as an occupation has increased considerably, yet because of a lack of available educational opportunities, the problem of understaffing is far from solved. Medical schools and colleges offer limited places and often have to turn away thousands of qualified candidates from their educational programs due to economic considerations and a lack of teaching staff (Cherry & Jacob, 2015). Because professors earn considerably less than practitioners on average, the majority of postgraduate students prefer to work in the private sector after finishing their studies.

The U.S. government has implemented a number of policies in order to improve the accessibility of education and manage the nursing shortage in hospitals nationwide. Currently, more prospective students have a chance to receive grants or win scholarships for professional training. In addition, foreign specialists are encouraged to come and build a nursing career in the United States. However, according to recent statistics, the nursing shortage is being reduced very slowly due to the high turnover rate of the employees.

Due to the stressful nature of the job, the irregular working hours, a sometimes unbearable working environment, and relatively low wages, many competent nurses leave their jobs after just a few years of working. The commitment of the staff depends greatly on their levels of job satisfaction and the existence of a comfortable working environment. According to researchers, the primary factors that create a difficult working environment for nurses are improper leadership and poor organizational management (Mosadeghrad, 2013). The failure of institutional administration to develop an efficient working process and build a strong team results in poor performance and, as a consequence, a low quality of patient care and healthcare services.

Many nurses complain that their employers do not give explicit instructions or descriptions of their duties and responsibilities, which in turn prevents the nurses from fulfilling their professional goals and often leads to professional miscommunications (Mosadeghrad, 2013). Especially in a healthcare environment, it is critical to organize the working process in such a way that staff is motivated for constant improvement and has opportunities to use their knowledge and competencies. Another stressful aspect for nurses is the unfairness of the treatment of various staff members. It is crucial for management to provide feedback and show that all nurses are equally praised and respected. Oftentimes, healthcare personnel find the working conditions uncomfortable and inefficient if they are not involved in the decision-making processes.

The impossibility of professional growth and the absence of training opportunities are common reasons for nurses to quit their jobs and seek placements in other institutions. Creating a comfortable working environment and reducing stress factors are two fundamental ways to build an efficient team of qualified workers and make the best use of each team member’s knowledge and skills.

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Leadership and Management in Nursing

In order to provide healthy working conditions for nurses and encourage them to maintain a long-term commitment, the organization must reconsider and improve its leadership frameworks. Leadership entails the ongoing growth of the professional competence of the team as well as the ability to motivate workers, define their mission, and lead them towards common goals. However, it is important to distinguish the roles of a leader and manager. According to Curtis, de Vries, and Sheerin (2011), managers should be in charge of fulfilling administrative duties, continuing existing procedures, and maintaining standards (p. 307).

They control overall performance and focus on current problems. The key duty of a manager is to build a strong team (Huber, 2013). The manager knows the competencies of all staff members and is able to structure the team accordingly. Moreover, the manager ensures that all team members learn to cooperate with each other and develop trust and mutual respect. It is important for a manager to organize regular team meetings and discuss concerns, conflicts, expectations, experiences, and ideas. Emotional intelligence has been scientifically proven to be vital for any successful team, especially in a stressful environment like healthcare.

Unlike a manager, the duties of a leader are to bring innovations, develop original ideas, challenge and inspire the team, and be able to see future prospects (Curtis, de Vries, & Sheerin, 2011, p. 307). The leader should possess excellent people skills and be open-minded and approachable. He or she encourages the team members to take initiatives and share their vision and ideas with the rest of the staff.

As mentioned above, many nurses feel uncomfortable if they cannot participate in important processes and have an impact on decisions concerning their work. Although the model of shared governance is widely implemented around the country, not all hospitals or other healthcare facilities fully understand the importance of such an innovation (Cherry & Jacob, 2015, p.68). Putting this model into practice should be a primary concern of every facility. Nurses constitute the majority of the entire healthcare workforce. Apart from their theoretical knowledge and practical skills, they constantly communicate with patients and their families. Thus, they are able to view the situation in the hospital from a wider perspective than other healthcare specialists. Nurses are able to notice problems with patient care on different levels, and their judgments should be taken into consideration during the decision-making process. By participating in important organizational processes, nurses will become more satisfied with their jobs, improve their performance, and provide a high quality of patient care.

Employees who receive clear information about their duties have a chance to impact workplace decisions and are not distracted by competitiveness, miscommunication, or interpersonal conflict. As a result, these employees can direct their energy and skills towards better patient care and constant personal and professional development.


Proper nursing leadership is critical for every healthcare facility that aims at ongoing quality improvement of patient services. Creating a positive working environment and adequate schedules for nurses results in higher levels of efficiency and a deeper commitment to the job. While the manager’s duty is to form an effective team and keep track of its performance, the team leader is responsible for providing constant professional development, increasing team members’ motivation, and offering them greater involvement in making decisions. Nurses who know that their opinions can impact the administrative procedures experience less distress and contribute to the positive development of the healthcare system.


Cherry, B., & Jacob, S. R. (2015). Contemporary nursing: Issues, trends, & management. Amsterdam, Netherlands: Elsevier Health Sciences.

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Curtis, E. A., de Vries, J., & Sheerin, F. K. (2011). Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), 306.

Huber, D. (2013). Leadership and nursing care management. Amsterdam, Netherlands: Elsevier Health Sciences.

Mosadeghrad, A. M. (2013). Occupational stress and turnover intention: implications for nursing management. International journal of health policy and management, 1(2), 169-176.

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