The Case Study by Bally and Nemeck

As Finkelman (2006) stated, “Mentoring, and important career development to that can be used by nurses any type of set or specialty, can be used to develop the critical leadership skills needed by nurses. All successful leaders have had mentors are our mentors” (Finkelman,2006, p. 390).

“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

Staff nurses have great responsibilities in caring for patients. Often, these nurses experience heavy workload. Heavy patient load and stress contributes to burnout. Why is burnout important to discuss in relation to nurses? Burnout affects the performance of the nurse and the quality of care he or she provides to the patient. Therefore, it is imperative that staff nurses decrease the possibility of burnout and increase or maintain excitement and enjoyment in the field of nursing. If nurses do so, they will find joy in their work and quality of patient care will be increased. Contributors to burnout and

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

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.

The cost to train new nurses becomes so enormous for hospitals it would be much smarter to figure out why new nurses are leaving and provide tools to assist new nurses with their transition. Looking at reasons NGRN leave their new chosen profession seems simple enough find out what it is that decreases job satisfaction and fix it. One study looked at burnout in new nurses and possible causes, they looked at workplace environment, workplace incivility and empowerment.(Spence Laschinger et al., 2009) They found

"This example shaped me as a leader," she says, and her work with a professional career coach convinced her of the strength of her newfound career.

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

I agree that an organization’s structure plays an influential role in a nurse’s overall satisfaction. In fact, Buffington, Zwink, and Fink (2012) concur stating, “Creating an organizational culture committed to registered nurse (RN) retention is a strategy to reduce nurse turnover” (p. 273). Research reveals numerous hospitals today are restructuring their organizations to try and increase overall nurse satisfaction and retention. This “new recipe for healthcare leadership and organization is needed,” according to Miners, Hundert, and Lash (2015), not only to improve nurse satisfaction, but ultimately to improve quality of care and increase patient outcomes (p. 114).

The article by Bally Jill (2007) identifies that nursing leadership can use mentoring culture to achieve professional and career development in nursing, and increase the quality of care given, especially for acute care nurses. This is because the article finds that nurses often have low morale, heavy workloads, high patient acuity, apathy towards professional collegial support, and reduced resources. The article identifies that mentoring in

For nurses, the workload and patient assignments are the most significant factors in their perception of their ability to provide quality care to their patients. Of course, this is directly related to nursing job satisfaction. Nursing is a career in which patient satisfaction and caregiver satisfaction go hand in hand. When the nurse is happy, he or she provides high quality care to the patient, which in turn makes the patient happy. In addition, when the patient is pleased with the care they are receiving, this makes the nurse happy and improves nurse job satisfaction.

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.

Belizario, S. (2011, August). Inspiring change. Boosting patient satisfaction scores-and nurses’ morale. Nursing 2011, 41(8), 18-21. Retrieved from: http://dx.doi.org/doi:http://dx.doi.org.proxy.library.ohiou.edu/10.1097/01.NURSE.0000399591.81228.3e.

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.