Nursing Shortage and Nurse Turn-Over

Nursing shortage explains a case where the demand for professional nursing practitioners such as the registered nurses exceeds the supply of the caregivers. On the other hand, nurse turnover explains the tendency of nursing employees to leave their jobs both voluntarily and involuntarily (Cox, Willis, & Coustasse, 2014). It is worth noting that the nurse shortage and turnover have critical and undesirable outcomes in the nursing profession. Particularly, the healthcare employers realize the great loss through the disruptions and poor quality patient care resulting from the shortage and the turnover (Cox, Willis & Coustasse, 2014). Evidently, the nurse shortage and turnover present a critical issue to both the nursing leaders and nursing managers. Therefore, a comparative analysis of the approaches that would be embraced by the nurse leaders and managers in the management of the issue of nursing shortage and nurse turnover would be critical in the current discussion.

It is worth appreciating that nurse turnover can be a ‘good’ or a ‘bad’ thing, especially to any organization. In fact, the good turnover occurs when the employee gets fired by the management while the bad turnover ensues when a well behaved and desirable nurse opts to resign from his/her position. Consequently, the nurse turnover issue has direct impacts on the performance and profitability of the healthcare organizations. To start with, although the terms “leadership” and “management” are often used interchangeably, the names carry different meanings as applied to the nursing profession. Huber avers that not every nurse manager portrays traits of an effective nurse leader, and the nursing leaders are not necessarily good managers (2013). Notably, a nurse manager has an assigned role in the organizational hierarchy and participates actively in the decision-making processes. In contrast, a leader may not have any recognized roles or powers within the organization (Huber, 2013). In fact, a leader is often defined by the power of the individual to influence others through interpersonal skills and communication. Accordingly, nurses demonstrate leadership skills at all levels of experience and stages of career development.

Furthermore, to improve the nurse turnover and shortage, the leaders should develop an effective understanding of the work environment within which the nurses operate (Butts, Bandhauer, & Rich, 2013). Through the understanding, the leaders should find out the issues affecting the nursing practitioners, including the high rates of turnover or the shortage. Therefore, a frontrunner would be expected to communicate with any particular nurse before making the decision to leave. In addition, the mentorship skills acquired will position a nurse leader strategically to share insights and knowledge that would be valuable to fellow nurses; hence, lowering the rate of nurse turnover. Besides, the leaders are known to rely on critical thinking as well as the ability to envision a positive future (Butts, Bandhauer, & Rich, 2013). Accordingly, the mentors also employ the principles of inspiring, motivating, and empowering others to influence their decisions.

Similarly, the nurse managers have critical roles in handling the issue of nurse turnover and the nursing shortage because they possess the power to influence decisions and organizational processes; hence, the responsibility of addressing the issue. Moreover, just as the leaders, managers also rely on critical thinking and the ability to visualize a positive future while addressing the issue of the nursing shortage and nurse turnover (Butts, Bandhauer, & Rich, 2013). Again, the effective nurse managers are empowered through skills to coordinate resources in the form of personnel and finances to meet the goals and objectives of the organization. Indeed, control as a key element in the role of the nurse manager enables him/her to employ reward and punishment effectively in tackling the issue of the nursing shortage and nurse turnover.

Notably, there are various principles that guide the roles of the nursing management. First, the evidence-based management practices are critical doctrines that guide decision-making. Accordingly, the manager would employ research in improving the working environment to overcome the challenges of the nursing shortage and the turn-over rates. Therefore, the nursing managers are expected to improve the healthcare working environment for the nurses through the following ways. Firstly, the managers should balance the tension between effectiveness and efficiency. Secondly, the managers have the power to create and enforce trust among the working nurses. Thirdly, the managers are obliged to handle the process of change in the organization. More practically, the managers should create a learning organization and involve the other nursing personnel in work design and decision-making processes (Butts, Bandhauer, & Rich, 2013). Therefore, these ways are considered critical and effective in addressing the concerns of nursing shortage and nurse turnover. As a principle, the managers are expected to merge the disciplines of labor relations, human relations, and personnel management for effective administration of nursing shortage or nurse turnover. Besides, managers would have to harness such critical skills as communication, motivation, and leadership if they were to address the healthcare issues effectively (Butts, Bandhauer, & Rich, 2013). Finally, the recruitment and hiring process would require that the manager ensures that the organization acquires sufficient and motivated nursing workforce as a measure to counter high rates of turnover and shortages of the nursing personnel.

According to the “Novice to expert theory,” leaders in the nursing field would appreciate the gradual process of learning and the five critical competencies of the nursing practitioners (Butts, Bandhauer, & Rich, 2013). In fact, the skills of a novice, advanced, beginner, proficient, competent, and expert are developed through the time. Accordingly, the leaders would approach the issue of the nursing shortage and turnover for the nurses from the five levels to develop an accommodating system for the practitioners. Besides, the leader would utilize the independence in decision-making, skills in solving problems, as well as critical thinking to influence change within the organization as guided by the novice to expert theory.

Finally, leaders would approach the issue of nursing shortage and nurse turnover through the diversity in leadership styles. For instance, to counter the challenge of shortage of increased turn-over, transactional leaders would use rewards to attract and retain the nurses (Giltinane, 2013). Likewise, for the transformational leaders, identifying the strengths of the nurses and building on the self-esteem aspects would work to overcome the challenge in the nursing discussion. As such, particular situations would also be best handled by the leaders exhibiting the situational leadership traits (Giltinane, 2013). For instance, with the rampant loss of employees, the situational leaders would address the issue through contingent measures as influenced by the prevailing circumstances.

From a subjective position, any person at the management level would need to exhibit definite leadership traits. Through such personalities, the manager, just like the leader should address the issue of the nursing shortage and the high rates of nurse turnover with understanding as guided by theory. Therefore, the philosophy of everyone being a leader at a personal level would guide the above argument. Accordingly, instead of a practicing nurse leaving the current occupation because of manageable issues, then one would employ the skills learned in the developmental stages outlined by the novice to expert theory and understand that all matters arising would always have a solution. In essence, the high rates of nurse turnover and the overall nursing shortage would be overcome through improved interpersonal relations and the personalized approach by the nursing practitioners to improve the nursing discipline.

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