Staff Shortage Prevention by Developing a Shared Vision


Staff shortage and turnover rates are some of the greatest challenges that many hospitals around the world have to face. According to Hall, Johnson, Watt, Tsipa, and O’Connor (2016), staff shortage is connected with poor patient outcomes, medical mistakes, failures to rescue, and other negative effects. In many cases, staff shortage is interconnected with burnout and poor job satisfaction, which results in high turnover rates.

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The average turnover rates vary from one country to another but remain significantly higher than in most other industries. In the US, the average hospital turnover rate stands at 26.8% (Duffield, Roche, Homer, Buchan, & Dimitrelis, 2014). The four major causes of nurse shortage and turnover rates include interpersonal behaviors, high workloads, and relationships with colleagues and supervisors. The purpose of this proposal is to outline the issues the hospital is facing because of these factors, evaluate the impact of this issues on the department, and provide academic solutions to the problem with the emphasis on communication and collaboration.

Present Issues

Nurse turnover stands for the rate at which workers leave the workforce and need to be replaced. A higher turnover rate is associated with increased expenses associated with the necessity to find and train new staff. Shortage rates stand for the number of positions that need to be filled for an organization to operate at optimal capacity. As it stands, our hospital has a 28.3% annual turnover rate, which is 1.5% higher than the national average. Nurse understaffing rates are at 31.1%. The average nurse-to-patient ratio is at 0.3, which is below the national average of 0.34. In the ICU unit, the nurse-to-patient ratio is 0.56. In the neonatal care unit, the nurse-to-patient ratio is at 0.25.

The Impact of Turnover, Job Dissatisfaction, and Understaffing

The effects of turnover and understaffing are felt across all departments. According to Hall et al. (2016), patient mortality rates increase per every percent of nurse understaffing. This is especially true for the neonatal care unit and the ICU, where chances of medical error during a critical situation and failures to rescue show a distinct association with a lack of nurses to attend to patients in a timely manner.

In long-term care departments, understaffing is associated with increased workloads, job dissatisfaction, medical errors, and increased hospitalization rates. All these statements are true for our hospital as well, as our current readmission rates are at 21%, with the majority of them associated with heart diseases. According to the economic department, the average costs of hiring and training a new physician or nurse vary between 22,500 to 40,000 USD (Hall et al., 2016). To summarize, turnover and understaffing issues endanger patients, decrease the effectiveness of care, and cause additional expenses in order to hire and train new staff.

Communication and Collaboration in Reducing Turnover and Understaffing Rates

Duffield et al. (2014) stress out the importance of communication and collaboration strategies in reducing turnover rates and increasing job satisfaction. As conflicts between coworkers and supervisors constitute a large portion of dismissals, it is important to implement evidence-based strategies to deal with them in an effective and proper manner. Adoption of servant and transitional leadership techniques by overseers would help improve the overall satisfaction and personal growth rates among nurses, while at the same time reducing the number of conflict situations associated with protocol and change acceptance.

As a result, understaffing ought to decrease, as in many situations; the large numbers of vacancies are caused by failures in retaining employees. Collaboration strategies should be aimed at increasing nurse involvement in all aspects of decision-making. Opening channels to receive feedback from the lowest levels of practice and all the way to the top ought to ensure communication and understanding, as well as help, improve the standards of practice (Duffield et al., 2014).

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Useful Literature

Vermeir et al. (2017) provide useful insights into factors behind nurse turnover in relation to the intention of leaving the profession, which is directly connected to nurse understaffing. According to the research, some of the highest factors of communication and collaboration with peers and managers revolve around leadership styles, the frequency of communication, fairness, recognition, and routinization.

Therefore, emphasizing these factors in personal communication with peers, patients, and managers ought to increase job satisfaction. Aside from that, Vermeir et al. (2017) pointed out the correlation between nurse understaffing and increased levels of stress that makes the issue escalate in mid-term and long-term perspectives.

Galletta, Portoghese, Battistelli, and Leiter (2013) have evaluated the relationship between variables at the group and individual level in relation to nurses’ intention to leave. This source is useful, as it describes the mechanisms of nurse-supervisor and nurse-group interactions and provides ways of increasing job satisfaction and reducing turnover rates, which would reduce nurse understaffing and increase employee retention. According to Galletta et al. (2013), individual commitment towards the unit was associated with decreased intentions to leave. Communication and collaboration strategies aimed at improving employee retention should be aimed to foster that quality among the nursing staff.


Understaffing and high turnover rates are a symptom of a larger problem within American healthcare. In order to protect the patients and ensure a high quality of service, it is paramount for every hospital to find methods of reducing it domestically. Communication and collaboration strategies have the potential of reducing understaffing and improving job satisfaction without increasing the costs of provided care.


Duffield, C. M., Roche, M. A., Homer, C., Buchan, J., & Dimitrelis, S. (2014). A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing, 70(12), 2703-2712.

Galletta, M., Portoghese, I., Battistelli, A., & Leiter, M. P. (2013). The roles of unit leadership and nurse–physician collaboration on nursing turnover intention. Journal of Advanced Nursing, 69(8), 1771-1784.

Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: A systematic review. PLoS ONE, 11(7), 1-12.

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Vermeir, P., Degroote, S., Vandijck, D., Mariman, A., Deveugele, M., Peleman, R., … Vogelaers, D. (2017). Job satisfaction in relation to communication in health care among nurses: A narrative review and practical recommendations. SAGE Open, 2017, 1-11.

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