Identification of the issue
Many countries of the world are facing the problems of the nursing shortage and high nurse turnover in the healthcare set-ups. Many young nurses either change their place of employment or leave the nursing profession within one year of their professional careers. High nurse turnover is economically costly and is associated with negative patient outcomes. Several strategies have been adopted by the healthcare systems to reduce this shortfall. Two of the most significant of these strategies are attracting newcomers to the profession and improving staff retention.
A significant link exists between healthy work environments, job satisfaction and staff retention. Therefore, one of the critical factors affecting high staff retention and low turnover is the role of nurse leaders or managers (Duffield, Roche, Blay, & Stasa, 2011; Hayes, 2012).
Role of nurse leaders and managers to address the issue
There is role overlap between nurse managers and nurse leader to a certain degree. However, both nurse leaders and managers are necessary and have important roles to increase staff retention and decrease turnover. While clinical leaders focus on professional issues and quality of care, the nurse managers have more of managerial responsibilities and administrative issues to deal with.
Nurse leaders are expected to align the staff and motivate & inspire them. They are also expected to hold a ‘visionary position’ and anticipate as well as cope with the change in the system. Whereas, managers diffuse the interpersonal conflict between the nurses and may use the money or other tangible rewards as motivational factors (Stanley, 2006).
Leaders focus on people and have the passionate desire to infuse meaning into the work of staff nurses; however, managers maintain low levels of emotional involvement with nurses. Leaders are proactive, intuitive and empathetic; therefore, they understand the problems faced by young nurses and teach them the new, innovative and situation specific problem solving techniques. Overall, they inculcate confidence in the young nurses and increase job satisfaction.
Nurse managers are more involved with planning, budgeting, goal setting, staffing, etc., they may not interact in the one-to-one way with all the staff nurses. They focus on analysis, problem solving and planning; so, they tend to reduce workplace friction and stress. Nurse managers have more authority than the leaders and depend on their title and hierarchical status. While nurse leaders promote staff retention through communication and collaboration and have a strong influence on group’s achievement of the goals. Nurse managers who consult with staff, provide praise and recognition and promote communication decrease the staff turnover (Hayes et al., 2012; Stanley, 2006).
More often nurse leaders have transformational leadership and nurse managers have transactional leadership qualities. Transformational leadership involves emotions, ethics and long term goals, and it aims at transforming the nurses to best fit the hospital set-ups. On the other hand, transactional leadership or transactional management is based on the relationship of exchange between the nurse managers and staff nurses (followers) (Stanley, 2006).
Approach best fitting in my personal and professional philosophy of nursing
Transformational leadership style of nurse leaders and managers demonstrates inspirational motivation, individualized consideration, intellectual stimulation and charismatic influence. It is often associated with higher levels of achievement in the staff nurses. It leads to low turnover, high morale and enthusiastic approach to patient care, and a higher level of achievement and belonging. I find this approach rewarding and encouraging because the transformational leaders continuously stimulate the staff nurses to communicate patient care outcomes validating the meaning of their work at the bedside. They encourage the nurses to implement new and innovative solutions to existing problems and thereby, contribute to the smooth functioning of the system. This approach significantly reduces work-place stress and, therefore, leads to staff retention. Good transformational leaders create opportunities for learning and professional growth of the nurses. The staff nurses are free to learn and grow as per their abilities and desires & may also avail the mentoring and coaching sessions. Hence, they experience professional enhancement leading to job satisfaction (Raup, 2008).
The transformational leadership of nurse managers or leaders instills pride in the nurses for being associated with him/her. The charisma of the leader leads the nurses to have a strong sense of purpose, and individualized consideration helps the nurses to learn more. The nurse managers who motivate the staff and stimulate them intellectually are effective and admired. On the other hand, transactional and passive-avoidant leadership styles of the nurse managers lead to staff dissatisfaction and higher turnover (Raup, 2008; Hayes et al., 2012).
I feel that transformational leadership style is the best approach to influence the staff work behavior as a good leader or manager demonstrates doing the right thing in the adverse circumstances. It promotes ethical and moral behavior of the staff and maintains trust. Transformational leadership increases the job satisfaction directly as well as indirectly, and it is a vital component in resolving the issues of nurse turnover and shortages. The approach of contingent award (a category of transactional leadership) by the nurse managers or leaders may also contribute to job satisfaction for staff nurses. Therefore, transformational leadership styles along with some other approaches to enhance job satisfaction may decrease the nurse turnover and motivate the youngsters to choose nursing as a career (Raup, 2008).
References
Duffield, C. M., Roche, M. A., Blay, N., & Stasa, H. (2011). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20(1‐2), 23-33.
Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., & North, N. (2012). Nurse turnover: a literature review: An update. International Journal of Nursing Studies, 49(7), 887-905.
Raup, G. H. (2008). The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals. Journal of Emergency Nursing, 34(5), 403-409.
Stanley, D. (2006). Role conflict: Leaders and managers. Nursing Management, 13(5), 31-37.
