The shortage of nurses is a happening that keeps persisting in the modern healthcare and also could be observed in the healthcare history decades ago. Regardless of all the efforts the nursing leaders take to overcome this problem, it keeps reoccurring. Today, many specialists are involved in the process of predicting the pattern of the nursing shortage in order to be able to address it before it grows too large and begins to make a serious negative impact on the health care capacities. Compared to the shortage, nurse turnover is a problem with a narrower scope of factors that mainly comes from within the field (whereas the predictors of nursing shortage depend on social and even historical trends). Turnover, just like skills and human resources shortage among nurses, is a global problem. The solutions of both of these issues involve its economic aspects and employ leadership and change theories.
Factors that Cause Nursing Shortage and Turnover
As noticed by Keenan (2003), the nursing shortage has a cyclic nature; in other words, after a period of relief, it becomes more severe due to the social factors. For instance, the nearest increase in the nursing shortage is predicted to occur within the next decade due to the aging of Baby Boomers – a large generation that will require many nurses to help address their health problems (Keenan, 2003). Nurse turnover may be viewed as one of the direct outcomes of the nursing shortage because the workplaces that have an insufficient number of staff members create more pressure on their employees. As nursing is quite a challenging career based on the level of responsibilities, and the seriousness of choices the professionals are to make on the daily basis, the excessive workloads become one of the main determinants of job dissatisfaction, burnout and, as an outcome, higher rates of turnover (Tironi, Silva, Dellarosa, Haddad, & Vannuchi, 2014).
How the Issue Is Approached and Addressed
The United States today has a rather large number of registered nurses. Judging from the statistical data, the population of nurses in the USA has grown significantly over the last hundred years. For instance, the number of RNs in 1900 was about twelve thousand whereas that of the modern days has reached three million (Whelan 2014). That way, one may conclude that the problem of the shortage is not caused by the lack of supply of human resources. On the contrary, the factor that is growing is the demand. While earlier the primary measure employed to attract more people in this career field was the raise of salaries, today the shortage is addressed by means of an emphasis on the recruitment opportunities. However, the training of a qualified nurse takes a few years. The modern healthcare does not have time to wait and thus, a number of short-term training programs have been introduced in the USA. Logically, the brief courses prepare the specialists of a lower level which leads to the decrease of the quality of the provided services and patient outcomes.
Overall, two of the most common ways of attracting human resources in the field without losing in quality are based on motivators such as money and education. However, the RNs, who remain in the profession and need to be retained in order to prevent turnover, appreciate some other motivators such as professional growth and an ability to influence the policy-making process of their organizations. According to McClelland’s theory of motivation, these needs correspond with those for achievement and power. Power and influence theories are also extremely useful as the sources of solutions for nursing shortage and turnover as these problems are the signs of the depowerment of the personnel due to their forced assumption of diverse roles. Addressing the problems of turnover, the leaders are to research the needs of this group of employees and then delegate the fulfillment of these needs enabling the managers. In other words, responding to this issue, the leader would rely on their charisma and follow transformational style, whereas the managers’ roles would include actions that could be described within the transactional style (Coach 4 Growth, 2011).
The task of a leader is to develop a strategy and a plan to deal with turnover and shortage while the managers would participate mainly as the facilitators and maintainers of change (Murray, 2011). A change theory developed by Lewin could be rather suitable as a universally acceptable model for addressing the problem through unfreezing (developing a new staffing strategy), moving (hiring additional employees), and refreezing (putting into practice retention strategies and theories of motivation) (Bowers, 2011). That way, a leader and a manager would assume equally active roles; however, the former would focus on the interactions and inspiring while the latter would concentrate on the maintenance of the structure of the change plan.
Personal Philosophy and Approach
In my opinion, the situational leadership would be the most appropriate way of dealing with the issues of nursing shortage and turnover. Neither of these problems is recent, nor are they rare in the contemporary world known for its rapidly growing demand for the nursing professionals with a high level of qualification. To my mind, situational leadership is the most responsive and flexible type. Under the circumstances of the nursing shortage, a leader is to act immediately so that the lack of resources could not cause job dissatisfaction among the remaining workers and result in the nurse turnover.
That way, this twofold issue requires a two-layered action plan directed at both the attraction of the new nurses and the retention of the remaining ones. The attraction plan would be based on the research of the existing resource base – whether or not there are available professionals in the region, if the people from other regions could be hired (foreigners included), and whether the human resources available for hiring are highly qualified or require additional training. In the latter case, the experienced personnel would have to assume the roles of coaches which would require additional investment. Besides, both the new and the experienced staff would have to be motivated in order to continue operating under the new circumstances. Higher salaries, bonuses and perks, as well as learning and self-actualization opportunities, should be provided to the nurses.
Moreover, the leader would have to conduct a conversation with the experienced staff as to the changing working environment and duties, and discuss their perceptions and propositions as to the ways of the change facilitation. Taking into consideration the perspectives and suggestions of the experienced nurses, a leader and the managers would empower them as supervisors and curators of the new staff. Assigning monetary rewards, as well as providing verbal appreciation to the hardworking personnel, would also play an important role in the creation of harmonious and friendly atmosphere in the workplace.
References
Bowers, B. (2011). Managing change by empowering staff. Nursing Times, 107(32/33), 19-21.
Coach 4 Growth. (2011). Leadership vs. management: What are the characteristics of a leader and a manager? Web.
Keenan, P. (2003). The Nursing Workforce Shortage: Causes, Consequences, Proposed Solutions. Issue Brief 916, 1-8.
Tironi, N. M., Silva L. G. C., Dellaroza, M. S. G., Haddad, M. C. L., & Vannuchi, M. T. O. (2014). Management impact of staff turnover in the view of nurses: an exploratory study. Online Brazilian Journal of Nurses, 13(4), 549-558.
Whelan, J. (2014). “Where Did All the Nurses Go?”: Mid-Twentieth Century Nurse Shortages, Causes, Solutions, and Continuing Problems. Web.