Effective Leadership and Management Approaches
Introduction
Registered nurse (RN) turnover is a complex issue that continues to disturb nursing leaders and mangers across all healthcare settings. There is a myriad of inter-related factors that influence nurse turnover, and there is sufficient evidence of the adverse impacts this has on patients, nurses, and healthcare organizations (Black, 2019). In both private and public healthcare centers and hospitals, there has been an increased shortage of nurses. Hospital managers associate this nurse turnover with unfavorable working conditions, external attractions, and personals reasons. To improve hospital operations, nursing leaders and managers must thus address this issue. This paper seeks to describe the different approaches that healthcare managers and leaders can embrace to address the nurse turnover issue.
Nurse Turnover – Description
The impacts of nurse turnover have been felt in the healthcare industry for decades. On average, the RN annual turnover rate is 17.1 percent (Black, 2019). The problem remains harmful and costly to patient safety, quality of care, and the hospitals. With high nurse turnover, nurses feel stressed, overworked, and dissatisfied. As a result, their service delivery falls below the set standard, hence lowering the quality of care. Also, turnover regularly amounts to nursing staff shortage, which negatively affects patient satisfaction and outcomes. Due to the shortage of nurses, the healthcare workers work for long hours attending to very complex patient disorders; this results in fatigue and burnout. The outcome of having nurses fatigued and work under stressful conditions increases the risk of injury and harm to the patients. Studies by (Kovner, Brewer, Fatehi, & Jun, 2017) indicated that higher rates of healthcare workers turnover were directly associated with higher patient deaths. Besides, nurse turnover attracts patients’ concern, something which attracts fear, stress, anxiety, and hopelessness to them. Typically, nursing shortage affects the physical and psychological wellbeing of the patients, delaying their recovery. Nurses working in such stressful healthcare settings are more prone to making medical errors and other mistakes that endanger patient safety.
Demonstration of Professional Standards to Rectify the Nurse Turnover Issue
In the U.S., standards of professional nursing practice are developed by the American Nurses Association (ANA) (Maloney, 2016). Under the issue of nurse turnover, these professional standards have to be applied to improve quality care and patient safety. To RNs, they should demonstrate the quality of practice standard by systematically engaging with patient care quality improvement activities, such as being more accountable and responsible for the patient’s safety. Also, RNs need to collaborate with the patient, his/her family, and other reliable people when treating the patient to improve the quality of care and safety for the patient (Charlotte, 2014). In the hospital setting also, the available nurses should consider using all resources potent of creating safety effectiveness and lowering treatment costs when creating the treatment plan before providing the nursing service to the patient(s). Another nursing standard that needs to be embraced to rectify the nurse turnover issue is leadership. Nursing leaders should encourage teamwork, work to establish healthy working conditions, mentor new nurses, train nurses, be flexible, and coordinate all care operations to improve the quality of nursing care and improve patient safety (Maloney, 2016). To steer professional conduct, nursing leaders should integrate ethical provisions across all nursing practice areas.
Roles of Nursing Leaders and Nursing Managers in Solving Nurse Turnover
Creating healthy working conditions for nurses that enhance the quality of care and patient safety is a change that all healthcare leaders and managers must oversee. To combat the nurse turnover issue, nursing leaders and managers should embrace the strategic approach to help them promote quality care and patient safety (Cherry, 2020). Nursing leaders have a role in overseeing the integration of patient care, including the creation of treatment plans, management of nurses’ team attending to the patients, and evaluation of treatment outcomes. To achieve this role, nursing leaders need to be visionary. By embracing a top-down approach, nursing leaders should share this vision with the nurses’ team, and this turnover issue will be broken down into easily solvable ways hence improving nurse retention whose benefits are evident in patient safety and quality care (Charlotte, 2014).
In contrast, nursing managers tend to lack the nurse vision in their managerial approaches. Thus, they need to embrace a holistic approach to guide them in understanding the care that patients deserve from their nurses. To solve the nurse turnover issue, nursing managers have the role of supervising the nursing workers. Under this role, nursing managers should oversee patient care, set friendly work schedules for the nurses, coordinate meetings to collect nurses’ views, and make decisions that address the nursing staff’s welfare and wellbeing (Black, 2019). By this doing, quality care and patient safety will be promoted.
Additional Aspects Nursing Leaders and Managers should take to boost Nursing Professionalism
According to (Kovner, Brewer, Fatehi, & Jun, 2017), nurses complain lack of rewards and recognition for accomplishments. To stop the nurse turnover problem, nursing leaders and managers should embrace the concept of meaningful recognition. If nurses can adequately be recognized and rewarded, the issue of nurse turnover and shortages can be fixed. Another aspect that nursing leaders and managers would have to initiate to control nurse turnover is to offer nurses professional growth opportunities. In this initiative, nurses will maximize their patient care skills, be exposed to growth potential, and ensure their job retention (Charlotte, 2014). Also, nursing managers and leaders would need to embrace teamwork, collaboration, and trust amongst the nurses to improve healthcare work outcomes (Black, 2019). By trusting nurses, this would create meaningful relationships within the healthcare settings, encouraging collaboration, and hence quality care for the patients. In addition, healthcare managers and leaders need to incentivize performance to address underperformance issues and encourage quality patient care (Maloney, 2016). To keep nurses motivated and aligned; therefore, nursing managers and leaders need to touch on their career, performance, wellbeing, and psychosocial wellness.
Leadership Style to Address Nursing Turnover
Nurse turnover is linked with job dissatisfaction, devaluation, and lack of nurses’ recognition, and poor communication, among other reasons (Black, 2019). A healthcare leader has the mandate to design nursing strategies that address the wellness, welfare, and wellbeing of nurses. To achieve this agenda, nurses have to be consulted and involved in the process of policy formulation and decision making. Therefore, a democratic leadership style is the best approach to adopt in addressing the nurse turnover issue (Kovner, Brewer, Fatehi, & Jun, 2017). In this leadership style, the nursing team would participate by giving their suggestions, views, ideas, and opinions regarding the best policies which the leadership should implement to increase job satisfaction, communication effectiveness, welfare and wellbeing concerns, and other critical healthcare issues (Cherry, 2020). Also, a democratic leadership style will make the nurses feel more valued and engaged in the decision-making process. Besides, the democratic leadership approach will encourage employee creativity and ensure that excellent performance and recognized and rewarded (Cherry, 2020). As a result, the issue or nurse turnover in healthcare facilities will be resolved.
Conclusion
The nurse turnover issue has seen healthcare organizations continue spending more on rehiring, retraining, overtime, and many more. However, healthcare leaders and managers tend to ignore the psychological wellbeing of nurses. Due to job dissatisfaction, nurses become dissatisfied and stressed out, and this adversely impacts quality care and patient safety. To combat this turnover menace, nursing leaders and managers must initiate approaches that address concerns of both nurses and patients. This necessitates balancing the tension between reliability and efficiency. Implementing a suitable employee wellbeing program, therefore, would enable nurses to cope with on-the-job obstacles hence decompressing the nurse turnover issue across the healthcare centers.
References
Black, B. (2019). Professional nursing E-Book: Concepts & challenges. Boston: Elsevier Health Sciences.
Charlotte, D. (2014). The importance of professional standards. Nursing Made Incredibly Easy, 12(5), 4-7. doi:10.1097/01.NME.0000452691.04516.96
Cherry, K. (2020). The Democratic Style of Leadership. Verywellmind, 1-9.
Kovner, C. T., Brewer, C. S., Fatehi, F., & Jun, J. (2017). What does nurse turnover rate mean and what is the rate? Policy, Politics, & Nursing Practice, 18(4), 216-217. doi:10.1177/1527154414547953
Maloney, P. (2016). Nursing Professional Development: Standards of Professional Practice. Journal for Nurses in Professional Development, 32(6), 327-330.