Effective Approaches in Leadership and Management
The issue of nursing shortage and nurse turnover is an all too familiar challenge hospital administrators, directors and managers deal with on an everyday basis. The number of nurses enrolled in nursing programs can’t keep up with the demand and the need of health care organizations for highly trained and competent professional nurses (Purnell, Horner, Gonzalez, & Westman, 2001). Insufficient staffing leads to distressed and overworked nurses, impacting their job satisfaction. Consequently, despondent nurses are leaving the profession altogether once they become disengaged and frustrated. Managers and leaders need to be innovative and adaptive in employing leadership skills to address this
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The nursing shortage and high nurse turnover rates can be attributed to various factors, including low job satisfaction, concerns with on the job injuries and work environment, retention issues and limited number of nursing faculty to prepare prospective nurses. According to JCAHO (n.d.), 41 percent of registered nurses expressed dissatisfaction with their current roles and an alarming statistic of 55 percent conveyed that they would not encourage a career in nursing due to their dismay on the profession. Certainly, there are a number of reasons why nurses are dissatisfied, but all lead to frequent turnover and decreased retention of qualified nurses. With added duties due to staffing issues, disheartened nurses complain that time to care for patients is significantly diminished. On the other hand, administrators and managers grumble that fewer nurses are competent enough to handle patients who are acutely ill in a complex and rapidly changing health care field (Purnell et al., 2001).
Given this nursing shortage and associated challenges, managers and leaders need to search for a unified vision, present ideas and turn these into strategies to help alleviate this health care issue. A manager and a leader, terms that are often used interchangeably, need to be unified in their actions while carrying out their specific roles and duties. A manager concerns himself/herself with managing resources and structure while a
The current and growing shortage of nurses is posing a real threat to the ability of hospitals, long-term care facilities, and others to provide timely access to quality care. Nurse staffing shortages and nurse turn-over contributes to the growing reduction in the number of staffed patient beds available for services, increasing costs, and rising concerns about the quality of care. Health care organizations highly depend on nurse managers and leaders to reverse this trend. This paper discusses the reasons for nursing shortage and turn-over, different approaches to solve this issue, and my personal philosophy about this issue.
Current internal and external hospital stressors are impacting NCs nursing shortage. With the release of many reports from different sources suggesting a change is needed. Most have been accurate in their projections; however, the struggle continues. Strong implications for the direction the crisis is heading, from campaign research to thesis and dissertations, written by professional groups and organizations add credibility to the cause; however, the shortage remains. Although some would argue that job satisfaction has no bearing on the nursing shortage and more pressing problems are prevalent; for example, the ageing population, undereducated nurses, patient safety and more positive patient outcomes; therefore, this paper highlights suggestions for change, with a concentration on nursing dissatisfaction and the nursing shortage.
There are many challenges facing today’s nursing leaders and managers. From staffing and scheduling, to budget cuts and reduced reimbursements, today’s nursing leaders must evolve to meet the ever changing health care environment. Constance Schmidt, Chief Nursing Officer at Cheyenne Regional Medical Center (CRMC), identified retaining experienced registered nurses (RN) as one of the biggest problems she faces as a nursing leader. She went on to state “Nationally, most hospitals have more than 60% of their nurses with at least 5 years of experience. At CRMC, it’s the reverse. We have more than 60% of our nurses with less than 5 years of experience” (personal communication, March 28, 2014). The two largest factors affecting those numbers are the nursing shortage and nursing retention. The first, the nursing shortage, was identified years ago and has been researched countless times. Some projections indicate the number representing the gap between available registered nurses, and the positions needing to be filled, could be over a million before the end of the current decade. The latter, retention of nurses, is a problem in every health care facility in the nation. Nursing turnover results in both a significant financial cost to hospitals, and a significant impact on the community through its effects on patient outcome.
In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also
Many healthcare organizations worldwide are striving to achieve magnet designation. Having the magnet title is essential because it recognizes healthcare organizations that act as a “magnet” for excellence by establishing a work environment that identifies, rewards, and promotes professional nursing (ANCC Magnet Designation, 2012). A magnet hospital is considered to be one where nursing provides excellent patient care, where nurses have a high level of job satisfaction, and where there is a low staff
A leader can help the staffing ratio issue by creating a vision. With this vision, they are able to create a plan that incorporates new ideas to find solutions. Leaders are risk takers and like to challenge others to formulate ways of doing things better. Leaders like to build relationships and promote those around them and help them develop so they as well as the company can grow. (Coonan 2007) Since leaders are not always in manager roles, they often are the ones who are working at the bedside and can help staffing ratios because they can base them on the individual needs while taking into account the training and experience of the nurse taking care of those patients. They are trying to look out for the best solution for everyone involved. Leaders act as guides to those around them rather than try and control others. Leaders are the ones who stand up for others. These kinds of leaders are able to inspire and motivate people to achieve solutions to problems.
With the ongoing changes in the healthcare field, nursing workforce retention presents itself as one of the greatest challenges facing healthcare systems today. According to the American Nursing Association, nursing turnover is a multi-faceted issue which impacts the financial stability of the facility, the quality of patient care and has a direct affect on the other members of the nursing staff (ANA, 2014). The cost to replace a nurse in a healthcare facility ranges between $62,100 to $67,100 (ANA, 2014). The rising problem with nursing retention will intensify the nursing shortage, which has been projected to affect the entire nation, not just isolated areas of the country, gradually increasing in its scope from 2009 to 2030 (Rosseter,
The nursing shortage in healthcare has been a highlighted issue for many years. With the ever-growing health care system, hospitals and healthcare facilities often find themselves searching for ways to acquire new nurses and retain their very own. Throughout the years, the number one solution to this problem remains the same: decreasing nurse turnover, and increasing nurse retention. This paper discusses the causes of high nurse turnover rate, the negative effects on health care, and ways to improve the turnover rate.
Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover
In the healthcare field, nursing leaders and managers face consistent issues in their respective practices that force them to alter the way they work and the way they think. In taking on a role as a leader within the field, nursing leaders and managers also take on the role of ensuring that work within an organization runs smoothly regardless of new issues that may arise in the healthcare arena. For instance, in today's healthcare environment, the issues of nurse shortage and nurse turnover have the capacity to alter the healthcare field and many of its respective branches and organizations should these problems not be managed properly by the leaders in the field. In viewing the issue at hand and in discovering how nursing leaders and managers are expected to act, and do act, in order to approach this issues, along with pinpointing the best approach possible to aid this issue, one can better understand which leadership styles are necessary for leaders to function.
The healthcare industry has long emphasized that staffing issues are a constant concern. It is a worry that influences the safety of both the patient and the nurse. A study reveals that over seventeen percent of new graduate nurses leave their first nursing job within a year, and over thirty-three percent leave within two years (Christine T. Kovner, 2014). Nursing turnover in combination with other important factors will be discussed in greater detail in the following paragraphs.
hospitals of RN turnover and intention to quit have ranged from 17% to 36% (6,7), figures that compare to an overall turnover rate of 2.2% for those employed in health services and social services and 1.2% for those employed in educational services” (Stone, Clarke, Cimiotti, and Correa-de-Araujo, pg. 1). Personally, I can see the trend in high turnover rates in the area that I am currently working. I work on the Pediatric Hematology Oncology Unit, and the turnover rate for nurses in that unit is roughly around 27% yearly. The new Nurse Manager just had a meeting with all floor nurses, and spoke on how high those rates were, and that he is looking forward to hiring nurses that will stay, and find the goodness in our specific job. The working environment for nurses is so strenuous. After people attend nursing school, they realize that they no longer want to work in the area they originally thought they did because it is too stressful, both physically and emotionally. Data reveals that “the incidence rate of injuries and illnesses per 100 fulltime workers employed in nursing and personal care facilities is 13.5” (Stone, Clarke, Cimiotti, and Correa-de-Araujo, pg.
The general problem I am researching is that job discontent, burnout and workplace unfairness lead to high turnover among nurses globally. High turnover results in nursing shortage and lower productivity than in turn compromise patients’ perceptions of the quality of care they receive, and nurses’ job satisfaction, performance, and organizational commitment.
The ongoing instability evidenced from the high mobility of qualified nurses in the nursing workforce has raised many questions about the issue of nursing shortage and nurse turnover (Gates & Jones, 2007). The paper below discusses the issues of nursing shortage and nurse turnover. The paper also describes how leaders as well as managers in the nursing fraternity and other leaders can resolve those problems effectively and the different applicable principles, skills, roles of the leader, and theories of leadership and management.
The nursing shortage is no longer a projected problem in the healthcare industry in the United States, this problem is present and is not phasing out anytime soon. Addressing this challenge would improve job satisfaction, reduce burnout in the profession and ultimately improve retention.