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Addressing Nursing Shortage and Nurse Turnover


Nursing shortage is a major issue across the globe. In the United States of America, it is projected that the shortage of registered nurses (RNs) will intensify (Rosseter, 2012). This is due to increased need for health care catalyzed by the aging Baby Boomers. This is also influenced by the fact that nursing schools in the US have been struggling to expand their capacity to meet the required training needs. In addition to the training issues and the projected increase in health needs, nurse turnover has been a major issue affecting the nursing fraternity. According to Cox, Willis and Coustasse (2014), nurse turnover has been a recurring issue for health care organizations. The problem is caused by both economic and non-economic factors. The non-economic factors relate to the management of the nurses in terms of retaining the appropriate number, overburdening the nurses, poor work environments and lack of incentives to attracts quality nurse. This paper discusses how leaders and managers can approach the issue of the nursing shortage and turnover.

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Approaches to Nursing Turnover and Shortage

Nurses play a critical role in the health sector; they provide direct care in hospitals. However, the work environment has been a major issue that has resulted in high nurse turnover. The shortage of nurses has also been aggravated by the numbers of nurses who are retiring. Rosseter (2012) noted the number of nurses joining the profession from the nursing institutions is lower than those leaving. For example, the percentage of registered nursed below the age of 30 dropped drastically from 25% to 8% between 1980 and 2004. In order to overcome the challenges, leaders and managers should instigate strategies that respond to the needs of the nurses. For example, leaders and managers need to collaborate to transform the work environment of the nursing units.

In response to this aspect, the leaders can also apply Robert Wood Johnson Foundation’s (RWJF) approach. The approach recognizes that challenges faced by nurses are related to the work environment. The approach includes the dimensions of advanced leadership approach, transforming work processes, transforming physical design, and transforming hospital culture (Hassmiller & Cozine, 2006). Hence, it focuses on improving the hospital work environment in order to attract and retain nurses who are highly qualified. The main goal of the approach is to create a healing environment in hospitals and places where workers are supported in their jobs.

Managers are tasked with the role of ensuring that the daily operations of hospitals and nurse work units are appropriate (Huber, 2010). The managers should formulate human resource policies that uphold the welfare of the nurses. According to Huber (2010), nurse managers need to put in place strategies that streamline the hospital environment. For example, they can initiate recognition programs that make the nurses feel valuable and appreciated. In addition, there should be a good organizational culture that enhances the productivity of nurses and upholds their work conditions. Similarly, Cox et al. (2014) noted that one of the major issues that affect nurse turnover is the increased workload. Thus, the strategies should be based on a policy framework that addresses the issue and ensures that there are programs that support work-life balance for the nurses. The measures will ensure that the turnover rates are reduced.

On the other hand, the nurse leaders are tasked with inspiring and motivating nurses through a positive work environment. For example, they collaborate with the managers to ensure that work units are safe and hazard free. The nurse leaders provide support, motivation, and direction. The transformational leadership theory stipulates that work environments should encourage communication that takes place in all directions (Huber, 2010). Just like managers, nurse leaders can promote communication, recognition and the autonomy of the nurses. This will motivate the nurses and hence reduce the labor turnover. It will also increase the desire by other people to join the nursing profession. Thus, managers should collaborate with leaders to ensure that transformational leadership style is practiced in the nursing units. This approach focuses on the enhancing productivity and performance by motivating employees.

The key similarity between the transformative leadership approach and the RWJF is that the two approaches endeavor to promote the welfare of nurses. The main different is that RWJF approach incorporates the components of improving the work processes and the welfare of patients in order to promote a healing environment. This is unlike the transformational leadership that is centered on the motivating the employees only. In general, it is worth noting that vitality, culture and values of an organization affect its employees.

Approach that Fits my Philosophy

My personal and professional philosophy is that nursing is a noble profession that is based on the commitment to accountability, compassion, and professionalism for the people seeking health care. Based on the philosophy, there is the need for an approach that ensures that there is good work environment for nurses that promote their welfare of nurses, patients, and work process. Thus, the approach that fits my personal and professional philosophy is the RWJF approach. This approach best suits my leadership style because it incorporates the component for transformational leadership and goes further to initiate changes that improve the hospital environments by creating hospital healing environments.

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Cox, P., Willis, K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Insights to a Changing World Journal, 14(2). 1-4.

Hassmiller, S., & Cozine, M. (2006). Addressing the nurse shortage to improve the quality of patient care. Health Affairs, 25(1), 268-274.

Huber, D. (2010). Leadership and nursing care management. Philadelphia: Saunders Elsevier.

Rosseter, R. (2012). Nursing shortage fact sheet. Web.

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