Nurse Turnover: A Case Study

In today’s healthcare system, effective leadership is essential to improving and reaching organizational outcomes. A leader is someone with the ability to influence others but, an effective leader uses positive strategies to inspire employees to work towards the same goal. Leadership in nursing requires a constant effort to motivate others to become part of the organizational transformation. This can be achieved using a transformational leadership style with a focus on communication, motivation, and empowerment.

Nursing leaders are crucial to any nursing organization. They motivate, empower, influence, and communicate the organization’s vision to create change within the organization. Great nursing leadership depends on great nursing leaders. This paper will define nursing leadership and describe leadership characteristics. It will further depict the democratic style and transformational theory of nursing leadership. While exploring leadership in action, this paper will illustrate the aspects of nursing.

With the prevalence of nursing shortages, more specialty units are now hiring new graduate nurses in positions that were once reserved for experienced nurses (Maiocco, G., 2003).

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.

Reggan ended up with a traumatic brain injury and broken vertebrae. She is now unable to work or care for herself. She was tired from going to school the previous day, then working a sixteen hour shift. Hospitals and nursing facilities don't understand the effects mandated overtime has on someone untill it's to late. So I guess in the eyes of an employer, having a fatigued nurse at your bedside is better than none at all.

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

A positive force for change centers on the nurse’s strong desire to change current practices. The combination of the turnover rate, low morale, and higher percentage of new nurses, is the driving

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.

Leadership and management are essential to any health care organization, balancing patient care, employees, physicians, and the organization. Nursing is founded on interpersonal relationships. As a people-oriented profession, nursing leadership styles are influenced by humanism. The mission, attitude, and behaviors of a health care organization begins with its leadership, which creates the direction and purpose of the organization. The purpose of this paper is to differentiate between leadership and management, describe views of leadership, and explain the

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.

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,

One of the significant health issues which can affect patients, organizations and nurses in determining some outcomes especially with the employment stability, the lack of materials needed, as well as financially is when there is a turnover of nurses. negativeOne of the major health issues that can negatively affect patients, nurses and organizations outcomes, even the financial in-stability and material shortage is nursing turnover. According to Hayes, (2008) nursing turnover is specifically defined as “the process whereby nursing staff leave or travel within the hospital environment”. Turnover can be either internal or external – according to the position of the turnover relative to the main hospital or organization-; internal turnover usually

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

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.

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.