Nurse Succession Planning Case Study

Nurse mangers is the leader of a specific department or unit of a healthcare facility. The nurse manager is responsible for recruitment and retention of the nursing staff, collaborating with other health care providers on patient care, and assisting patients and their families when needed. The nurse manager works with administration communicating and interpreting the facility’s policies and procedures to the staff. Usually with other departments in the facility, the nurse managers develop quality improvement measures tracking the patient services and care. According to Espinoza et al (2009), the nurse manager plays a pivotal role in

“Nursing is informed caring for the well-being of others” (Swanson, 1993, p. 352). Kristen Swanson’s relationship-based caring theory encompasses maintaining belief, knowing, being with, doing for, and enabling. Nursing is a profession with vast opportunities for growth and development. Each nurse has his or her individual passions; mine reside within obstetrics, women’s health, and nursing leadership. Nurse leaders play an integral role in the success of healthcare organizations. Nurse leaders shape the roles of nurses within their organizations. Nurse leaders seek methods to improve patient care. They also use innovation to gain efficiencies in care delivery and decrease healthcare cost. Many nurse leaders have an ultimate goal to aspire to be a chief nursing officer in a healthcare

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.

Slide 1: The expectations of nurses today are higher than ever with goals such as achieving top percentiles in nursing and patient satisfaction, to being among the top leaders in quality outcomes, and to build productive work relationships and environments. Nursing leaders serve as the primary link between staff, physicians, and the community. They are expected to be innovative, highly skilled, possess a certain degree of nursing knowledge, and produce qualified individuals to care for the growing population. According to Lorber, Treven, and Mumel (2016) “nursing leadership is pivotal because nurses represent the most extensive discipline in health care”. Because of this growing need for diversity in leadership and my background in the military, I decided to focus on the MSN Executive Track at Chamberlain College of Nursing.

Nurse leaders are the background to the nursing care. Effective nurse leaders can promote a positive workforce and a healthy work place for other nurses. Workplace dynamics is an essential part of how each nurse functions. Nurses, being mentally and physically stressed, need to have support and guidance from a nurse leader to feel confident about performance. The impact of nursing leaders can be a positive and guiding force for the younger or more inexperienced nurse. Having strong relationships with solid leaders can instill values in the beginning stages of a newer nurses’ career. Gaining insight and core concepts from a more experienced leader can make a world of difference in the way a new nurse performs, provides patient care, and sets future goals for themselves. A newer nurse with a positive role model and nurse leader can model themselves to become a leader for future nurses.

As the charge nurse of the acute care, the nurse interviewed is in charge of 6 employees in that specific department, but on the weekend she leads the entire hospital. Although being a nurse leader has its challenges, it’s great when everyone works together to achieve their goals and it becomes very fun. In regards to a budget, she has to conduct one for her responsibilities in infection control. This comes with many obstacles as it is hard to predict the budget for the entire year, and this was never taught to nurses in school or as part of job training (R. H., personal communication, November 12, 2016).

As a nurse administrator, I have a distinct role to play in the healthcare sector. Preparation for this position commences at the graduate level; either masters or doctoral level. Prospective students at graduate level are expected to indicate a variety of roles across healthcare sector as stipulated in the legislative law. Factors such as the nature of the organization and its system of leadership provide credible knowledge that is critical for nursing management roles. As opposed to Gerontology Nurse Practitioners who are expected to have a wide array of technical and hands-on skills

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

McGuire, E., & Kennerly, S. (2006). Nurse managers as transformational and transactional leaders. Nursing Economic$

Leadership traits associated with nurse executives are honesty, credibility, supportiveness, visibility, and flexibility. Nurse executives analyze nursing functions and empower nurses through participatory decision making, shared governance, and employee involvement. Nurse executives share the vision and goals of the hospital and promote application of a nursing theory into the nursing care delivery system. They anticipate the future of health care and nursing and serve as monitor, role model, and preceptor to lower level management (Upeniecks, 2003). Nurse executives in the Magnet program are required to have advance practice degrees with certification in their specialty (ANCC). Understanding evidence-based management and enabling the use of evidence-based knowledge provides the nurse executive with the tools to improve patient outcomes. The transformational leader will remove barriers to improvement and encourage outcome based thinking. While nurse leaders are charged with questioning the status quo, nurse managers in the transformational approach to leadership are charged with maintaining the status quo.

The global nursing shortage has prompted health care systems to seek new strategies to attract and retain nurses. The growing evidence points to the shared governance model of management are as a possible strategy to improve productivity, nurse job satisfaction and nurse retention. There are different models of shared governance, but a clear relationship exists between nurse practice environment and higher retention rates. Research found long hours, and unsupportive practice

Despite these suggestions, as many as 70% of hospitals still actively lack succession planning initiatives and over a third of existing nurse succession plans primarily focus on top-level management positions (Titzer, Shirley & Hauck, 2014). With more than 44% of nurses in management positions reported to be over the age of 55 and the cost of replacing nurse managers climbing to 75-125% of typical annual salaries, organization's need to turn increasing attention to proactive succession planning in order to remain viable in the healthcare industry (Sverdlik, 2012; Titzer et al., 2013). Increasing pressures to fill vacancies is resulting in clinically skilled but often underprepared nurses being selected for nursing leadership positions (Titzer & Shirley, 2013). Lack of formal preparation renders many aspiring nurse managers ineffective which has been associated with negative implications such as role transition stress, poor work environment, and increased turnover (Titzer & Shirley, 2013). This is further complicated by a lack of interest among younger novice nurses in leadership and management roles (Titzer et al., 2013). As such, the proposed succession planning program will utilize a multilayered approach to encompass all

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

Succession planning is a new process within the nursing practice and a recent asset to healthcare organizations. It is a program aiming to build up a leadership bank to secure continuation of governance. It encompasses selecting and preparing the best candidates from within the organization, also including exceptional programs that allow focusing all available resources on the talent development process allowing a greater return on the investment. This process involves senior leaders responsible for growing leaders, and employees who are committed to their self-development. Senior leaders should partner with the human resources department while addressing diversity, recruitment and retention which makes the succession process successful. In

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.