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Nursing Turnover Management Approaches


Nursing shortage and turnover is a significant problem that has to be addressed and eliminated. There are several reasons associated with the issue that include the lack of caregivers’ education and dedication, as well as the increase in their age. To approach the problem, it is necessary to implement leadership and management techniques. This paper discusses the statistical data related to the issue and methods that can be used to decrease the number of shortages and the turnover rate. It concludes that communication between nurses, their patients, and leaders or hospitals’ authorities is crucial to eliminate the problem.

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Significance of the Problem

The problem of a nursing shortage and turnover has become more acute over the past decades. Cox, Willis, and Coustasse (2014) note that one of the reasons for this is the inability of medical organizations to establish caregivers’ dedication to their work. Some of the other preventable causes of the turnover and shortages include the lack of professional skills, the increase in nurses’ age, and demographic changes in patients (Cox et al., 2014).

The data provided by Blegen, Spector, Lynn, Barnsteiner, and Ulrich (2017) reveals that the problem is acute not only among older caregivers that enter retirement. The study performed in 34 states showed that 15% of newly licensed registered nurses leave their job within the first year of work (Blegen et al. 2017). This data suggests that it is necessary to address the problem and discuss the methods of its management.

Leadership and Management Techniques

Since leaders are responsible for ensuring the high quality of care, it is necessary for them to work on the elimination of high turnover and shortage rates. It is essential to distinguish between the roles of nursing leaders and managers in the maintenance of the problem. Leaders’ role is to motivate nurses to achieve their professional goals (Huber, 2017). Leadership encompasses administrative, financial, and operational capacities to address the problem; it is associated with innovation, change, and risks.

A leader should be able to examine an issue, adapt the situation to workers’ needs, and communicate with caregivers to reach an understanding of the problem. At the same time, the purpose of management is to control the issue and utilize the already existing strategies for improvement. Managers assign tasks and direct individuals while leaders convey their ideas but do not create a plan for their implementation.

To approach the issue, it is necessary to study the reasons for its occurrence within each particular medical institution. For example, if a problem is associated with a lack of education or professional skills, it is necessary to provide training for nurses or improve existing educational programs. Leaders and managers should communicate with caregivers to learn about their concerns related to work. It is necessary to reassure nurses that the measures of improvement will be taken.

However, it is also crucial to encourage them to reflect on their tasks and skills to identify challenging aspects. The American Association of Post-Acute Care Nursing (2014) presents several strategies of leadership and management that can eliminate the problem. For example, the servant leadership style considers individuals’ needs and the development of their skills. A democratic approach encourages open communication and involves the personnel in the decision-making process. Halter et al. (2017) suggest another management technique, such as creating support programs that assist nurses during the process of transition, development, as well as early clinical experience. A combination of these approaches can be an effective strategy for improvement.

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Personal Philosophy

The approach that best fits my personal and professional philosophy of nursing is creating a safe and positive environment for both patients and caregivers. Many hospitals tend to ignore the needs of their personnel which results in individuals working long hours, experiencing burnout, and being unable to rest. Nurses may not be seen as people that need care too, which often is associated with high turnover rates.

To improve the situation, a leader should consider the factors that create a negative working environment for the staff and discuss them both with nurses and administrative personnel. I believe that good working conditions may contribute to caregivers’ job satisfaction and commitment. It is necessary to mention that the elimination of the problem may improve the quality of care as well because nurses will be more motivated to show dedication to their work.

My philosophy of nursing also considers the importance of communication between all individuals involved in care. It is necessary for medical professionals, their patients, and hospitals’ authorities to express their perspectives on health and treatment, and consider each other’s goals and needs. To implement this vision into a strategy of the problem elimination, it is crucial to establish a dialog between these parties.

For example, sometimes the expectations novice nurses have about their practice do not correspond with the reality, where they encounter challenges and difficult situations while providing care. Consequently, they may decide to leave their job to avoid stressful situations. In this case, leaders should approach caregivers to discuss their concerns and offer possible solutions. Hospitals’ authorities should also consider the problem and implement discussion sessions or training during which they can address the challenging issues associated with nurses’ practice. Such an approach may change caregivers’ perspectives on their tasks and responsibilities, improve their work dedication, and decrease the turnover rate.

Funding Sources

In the US, many initiatives consider the problem of nursing shortages and serve as funding sources. For example, the Health Resources & Services Administration (HRSA) (2018) provides funding for advanced nursing education programs and traineeships for registered nurses. Moreover, the organization supports individuals of disadvantaged backgrounds providing them with opportunities to improve their professional skills.

The grants provided through HRSA may decrease the number of shortages and the turnover rate associated with a low level of training and education. It is crucial to mention that many state initiatives consider the problem as well. The American Association of Colleges of Nursing (2017) reports that the University of Wisconsin, the University of Minnesota, and other educational institutions provide fellowships, loans, and grants to improve nurses’ professional skills. They also offer training programs and aim to maximize caregivers’ clinical capacities.


The problem of high turnover rates and nursing shortages has become acute in recent years. To approach the problem correctly, it is necessary to implement management and leadership strategies including communication and training sessions. The concepts of the servant and democratic leadership styles can also be utilized to eliminate the issue. In the US, this problem is addressed by several governmental and local initiatives, including the ones created by HRSA and educational institutions.

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American Association of Post-Acute Care Nursing (2014). Nursing leadership. Management & leadership styles. Web.

American Association of Colleges of Nursing (2017). Nursing shortage. Web.

Blegen, M. A., Spector, N., Lynn, M. R., Barnsteiner, J., & Ulrich, B. T. (2017). Newly licensed RN retention: Hospital and nurse characteristics. Journal of Nursing Administration, 47(10), 508-514.

Cox, P., Willis, W. K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Web.

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J.,… & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123.

Health Resources & Services Administration (2018). Nursing. Web.

Huber, D. (2017). Leadership and nursing care management (6th ed.). Philadelphia, PA: Saunders.

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