Nurse Turnover and Management Approaches

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Table of Contents

Turnover and the Provision of Care
Professional Standards and Turnover
Nurse Leaders and Managers
Strategies that Can Be Utilized
Leadership Style to Be Employed
Conclusion
References

Nurse turnover is one of the most burning issues to be addressed in the healthcare system. These healthcare professionals have to work in a challenging working environment characterized by considerable workload, high responsibility, low salaries, and limited promotional opportunities (Nei, Snyder, & Litwiller, 2015). Nurses have to work long hours and respond to numerous challenges daily, which tends to lead to a high level of burnout and job dissatisfaction. The way hospitals view the problem also contributes to the increase in turnover in American hospitals. Park and Boyle (2015) note that healthcare facilities find nurse turnover inevitable, so they often ignore a certain degree of turnover, especially when it comes to hospital departments. When the problem becomes alarming, managers try to address it but can do little to improve the situation. This paper includes a brief analysis of nurse turnover and methods employed by nurse leaders and managers to decrease its prevalence in healthcare facilities.

Turnover and the Provision of Care

It has been estimated that hospitals that are unable to ensure their nursing staff retention lose up to six percent of their annual budgets every year (Kurnat-Thoma, Ganger, Peterson, & Channell, 2017). Nurse turnover is associated with a direct effect on the quality of the provided care and patient outcomes. High turnover is related to the shortage of nursing at some points, which leads to overload and burnout. Medical errors become frequent, which has an adverse impact on patient safety. Nurses find it challenging to develop effective relationships with patients and their families as they concentrate on the implementation of specific clinical procedures. Patient satisfaction can hardly be achieved in such environments.

Besides, this phenomenon affects the development of relationships between healthcare practitioners, nursing professionals’ commitment, or rather insufficient commitment to organizational goals. Wei, Roberts, Strickler, and Corbett (2019) state that new nurses are specifically vulnerable, and the majority of nursing professionals leave within the first year of work at a specific hospital or unit. It is also found that proper relationships between nursing practitioners negatively correlate with nurse turnover.

Professional Standards and Turnover

Although the problem under analysis is complex and requires multiple steps and measures, one of the ways to reduce this phenomenon is to ensure compliance with standards linked to interprofessional relationships (Wei et al., 2019). Nurses should concentrate on the provision of high-quality care and patient safety, but adherence to these standards cannot reduce the associated burnout, fatigue, and job dissatisfaction. Clearly, healthcare professionals follow the existing guidelines when completing their daily routine, which enables them to avoid errors and manage their duties effectively. Professional standards regulating the relationships between nurses, interactions between nurses and nurse leaders and managers can be instrumental in addressing the problem (Nei et al., 2015). Mentorship and support provided to newcomers and programs aimed at creating a favorable working atmosphere have proved to be effective in making nurses less willing to quit.

Nurse Leaders and Managers

It has been found that managers play one of the central roles in the development of the working environment, which has an impact on nursing practitioners’ intention to leave. Managers arrange the work of the unit and ensure the provision of high-quality care to patients and their families (Duffield, Roche, Dimitrelis, & Frew, 2015). In simple terms, these healthcare practitioners manage various aspects, including but not confined to shifts, and address conflicts, if any. Managers are always in the position of power and enjoy the status of the formal leader. Nursing leaders perform another role as they provide mentorship, assist in setting goals, and developing relationships with patients or other healthcare professionals (Wei et al., 2019). These healthcare practitioners rarely have formal power, but they are often informal leaders who enjoy the trust of their colleagues. It is clear that the roles managers and leaders play are different and have specific effects. Nurse leaders are also in closer contact with nursing professionals, so they contribute to the development of the atmosphere in the unit.

Depending on their status, nurse managers and leaders use diverse techniques to address the problem of turnover. Managers tend to utilize authoritarian or transactional leadership styles as they concentrate on tasks and established goals. They often pay little attention to the needs of nursing professionals because they are more concerned about specific procedures to be performed. Nurse leaders utilize a transformational leadership style since they concentrate on relationships and collaboration (Wei et al., 2019). The differences between methods employed by managers and leaders influence these practitioners’ roles and impact on nurse turnover.

Strategies that Can Be Utilized

As mentioned above, effective collaboration and interaction with other healthcare professionals can help nurses to adjust to the challenging working environment and gain the necessary resilience. Wei et al. (2019) identify seven strategies to build nurse resilience that include such significant aspects as the promotion of positivity, facilitation of social connections, concentration on nursing professionals’ strengths, encouragement of their growth. At the same time, it can be necessary to implement research to identify the extent to which specific measures can be utilized. Park and Boyle (2015) emphasize that the understanding of the degree of nurse turnover in a department or unit can shed light on the exact challenges nurses face.

Kurnat-Thoma et al. (2017) developed a ten-element program that can reduce nurse turnover. The primary components of this initiative are the focus on communication and collaboration between different healthcare professionals operating at different levels. The focus is on the support given to new nurses who are introduced to existing standards and practices. Nurse leaders and managers should collaborate when interacting with nurses, especially when it comes to those who have been working for up to a year. It is also essential to ensure adherence to the corresponding professional standards that are instrumental in developing suitable working environments. Compliance with these standards can also help in creating or maintaining the organizational culture that will be based on the principles of support, empathy, and collaboration.

Leadership Style to Be Employed

Transformational leadership is often regarded as the most effective style to be utilized in the modern world. Recent research shows the benefits of the use of this framework in the clinical setting (Wei et al., 2019). Transformational leaders create a favorable working environment and assist employees in understanding their roles and value. Although transactional leadership may be the most suitable in the healthcare context, it seems to be somewhat outdated. Wei et al. (2019) note that nurses place a greater value on relationships rather than material awards. The increase in salaries can have a short-term effect as the workload and other challenges will make nurses reconsider their life priorities.

Therefore, the use of the punishment and award approach is becoming less effective. It is vital to empower nurses, making them prepared to address numerous issues that they have to encounter in their practice. Park and Boyle (2015) suggest that the resources allocated to motivate nurses financially should be accompanied and, in some cases, replaced by initiatives aimed at the development of proper interactions between healthcare practitioners. It is essential to create a system where all nurses understand their roles, interact with their colleagues freely, and receive support from nurse leaders and managers.

Conclusion

In conclusion, it is necessary to state that nurse turnover is a serious issue that has to be addressed within a short period of time. The shortage of nursing practitioners is likely to persist, so it is critical to help nurses adapt to the challenging working environment. The medical staff’s intention to leave is often associated with workload, burnout, lack of appreciation, and ineffective communication at different levels. Nurse managers and leaders should play a central role in addressing the problem as they can help nursing professionals complete tasks and maintain a positive attitude towards the profession. Transformational leadership is the instrument to be employed as interactions between people should be the foremost priority when addressing nurse turnover. Clearly, it is also essential to ensure proper nurse staffing and appropriate funding. The provision of training to nursing managers and leaders may also be needed. Hospitals must allocate sufficient resources to make nurse managers and leaders able to provide support and guidance. However, relationships and communication should be an indispensable part of initiatives aimed at the reduction of turnover.

References

Duffield, C., Roche, M. A., Dimitrelis, S., & Frew, B. (2015). Leadership skills for nursing unit managers to decrease intention to leave. Nursing: Research and Reviews, 57-64. Web.

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—a 10-element onboarding program intervention. SAGE Open Nursing, 3, 1-13. Web.

Nei, D., Snyder, L. A., & Litwiller, B. J. (2015). Promoting retention of nurses. Health Care Management Review, 40(3), 237-253. Web.

Park, S. H., & Boyle, D. K. (2015). How hospitals view unit-level nurse turnover data collection. JONA: The Journal of Nursing Administration, 45(2), 100-106. Web.

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2019). Nurse leaders’ strategies to foster nurse resilience. Journal of Nursing Management, 27(4), 681-687. Web.

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