The role of a nurse has evolved from assisting the doctor to making important decisions regarding patient treatment methods. Nurses have also assumed a crucial, decisive role in hospital administration, which has tremendous influence on how treatment is provided to the patients. As such, they perform leadership functions, including planning, leading, and organizing the patients’ activities, apart from providing medical care and assistance to patient needs. In recent years, the nursing profession has been facing a lot of serious issues due to shortage of nurses and high turnover percentages. Despite the apparent high demand for nurses, the industry is not able to meet the current demand for nursing professionals. These problems have once again put the profession in the limelight as nursing management and leadership styles become issues in the healthcare industry. Due to the alarming situation, it is slowly affecting the quality of healthcare service as it leads to the slow deterioration of health professionals. Leadership and management styles are vital to address the problems of nurse shortage and high turnover due to heavy workloads, rotating work schedules, low professional status, and the assortment of risks that comes with the job, which all affect the well-being and motivation of nurses.
Nursing shortage and turnover arise from nurses’ dissatisfaction at work as many of them are overwhelmed and distressed over the high patient-to-nurse ratios, which lead to frustration and job burnout. In return, higher turnover results leading to understaffed workforce. This further increases the concerns about turnover. Jones and Gates (2007) assert that these concerns are caused by “non-economic and economic sources”. The non-economic reasons include how to keep an adequate number of nurses to ensure that patients are well taken care of, preventing over-burdening nurses with work, and hiring quality nurses. On the other hand, Jones and Gates (2007) also concede that higher turnover could become costly for the health facility as the quality of medical services could suffer upon losing the well-trained nursing staff. Hunt (2009) offers other reasons why nurses quit their jobs, such as lack of clear career opportunities or career ladder to follow, under appreciation at work, no recognition in terms of work output, miscommunication with administration and management regarding job expectations, physically demanding work responsibilities, lack of role clarity, and no control over job performance (p. 5), among others.
This is where leadership and management in the nursing profession come in handy. A popular belief is that, “employees don’t quit companies, they quit managers” (Jones and Gates, 2007, p. 5). Nurse managers who have been in service longer have more experience managing new staff and have well-developed techniques when it comes to defining job descriptions, managing nurses’ job expectations, providing a clear view of nurses’ possible workloads, and providing positive and developmental feedback for nurses that would help them (nurses) achieve their goals. In addition, they are the ones who have defined recognition and rewards system for nurses who have done exceptionally during the evaluation period (Jones and Gates, 2007, p. 5).
Leadership and management are terms that are often confused with each another. While they may be similar in some aspects, they are not the same, but are linked with one another. Leaders are people who focus on achieving tasks by ensuring that the employees are motivated, inspired, and have a strong sense of empowerment. They provide the group’s goals and visions and are usually the groups’ source of inspiration. They provide coaching and mentoring opportunities and focus on relationship building strategies. This type of leadership is called transformational leadership (“Leadership vs. Management”).
On the other hand, managers are those who focus more on tasks and ensuring that tasks are done on time and according to instructions. They are more concerned about money and equipment, thus, among the qualities that make them effective as managers include planning, coordinating, time management, organizing, and problem solving. To further differentiate a leader from a manager, leaders have followers, managers have subordinates (“Leadership vs. Management”).
In nursing management, a nurse manager’s leadership method determines the employees’ attitude towards work. It could also establish how productive the team is, including the “quality of patient care” (Williams). Several leadership methods can be employed, including democratic style, which engages nurses in the decision-making process and allow them to carry out their work independently. Authoritarian leadership provides instructions to subordinates without looking for inputs and supervises the nurses in a close manner. Transformational leadership encourages teamwork, participation in discussions and decision-making, and push employees to think about the “hows” and “whys” in hospital procedures (Williams).
Regardless of the leadership method employed, leaders and managers must always consider what drives nurses to do their work, such as job fit, realistic job expectations, compensation and benefits, flexible schedules, career development plans, and performance recognition (Hunt, 2009, p. 6), among others.
Among the types of leadership styles, the one that best fits my personal and professional nursing philosophy is transformational leadership because by empowering employees to think, an individual’s self-esteem increases, thus, the more the employees will become participative in their approach to nursing care. In addition, I believe that for leaders to empathize with their employees, they gain a clear insight about the issues that nurses have at work. As a result, there will be lower nurse turnovers occurring at work. By being transformational leaders, managers will also be able to understand what motivates nurses to work in certain healthcare facilities, thus, giving them a clearer view on how to resolve shortage and turnover issues. When individuals are recognized for their efforts and contributions, the more they become inspired and motivated to work, even if their salaries are not as high as in other medical facilities. As employees become more cooperative and participative, the quality of care and services increase. In the same manner, as the nurses feel important at work, the more they become inspired to do their best.
Nursing shortage and turnover are problems that the United States faces now despite the influx of foreign nurses in the country. While nurses play a huge role in helping a medical facility achieve its financial goals, many organizations still find themselves challenged when it comes to retaining their trusted and well-trained nurses. Therefore, to help minimize the decline in numbers of nurses in medical facilities, those in leadership roles may opt to change their leadership style according to the demands of the situation. Hospitals, leaders, and managers are also advised to invest in talent management and invest more in people, in nurses in particular, as management begins to understand the career plans and expectations of nurses in their chosen profession.
References
Hunt, S. T. (2009). Nursing turnover: Costs, causes, & solutions. Success Factors for Healthcare. Retrieved from http://www.uexcel.com/resources/articles/NursingTurnover.pdf
Jones, C.B., & Gates, M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. The Online Journal of Issues in Nursing, 12(3). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NurseRetention.aspx
“Leadership vs. Management.” (n.d.). Retrieved from http://msucares.com/forum/class0809/session1/barefield_leadership_vs_management.pdf
Williams, E. (n.d.). Leadership styles in nursing management. Chron. Retrieved from http://work.chron.com/leadership-styles-nursing-management-16070.html
