Nursing Turnover and Leadership

Effective Approaches in Leadership and Management Nursing turnover is one of the most important issues facing the health care industry today. Turnover rates increase costs for health care facilities and decrease the quality of care for patients, as new nurses constantly need to be trained and a lack of experience throughout the department can mean that patients suffer ultimately from a continuous rotation of novices (Twibell, 2012).

Han, Trinkoff and Geiger-Brown (2014) have shown that various factors can impact turnover rates: nurses can be burned out by working too many shifts or consecutive hours; they can feel overburdened and unsupported; they can feel that they are not empowered to actually care for the patients they way they were taught they should. All of this can contribute to high turnover rates in nursing.

This paper will discuss the ways leaders/managers can address the problem, the approach that I would personally prefer, and a possible funding source to address this issue. As Huber (2014) notes, there are many differences between the concept of leadership and the concept of management in health care. For the problem of nursing turnover, both leadership and management skills are required.

Leadership focuses on interpersonal relationships, motivation, inspiration, vision, and effecting a real change within the organization by forging a new path and getting everyone to “buy in” to it. Managing focuses on scheduling, controlling, directing, marshaling resources, organizing, and communicating the day-to-day affairs. Leaders take a big picture approach that lets them then focus on the individuals under their care. Managers take a micro perspective that allows them to set personal feelings aside and arrange those under their care in the most effective ways possible.

I would expect nursing leaders and managers to approach the issue of turnover differently. Leaders should approach it by getting to understand directly from the nurses what the problems leading to their desire to quit are and what could be done to help them want to stay. The leader would be required to read the research (there is a ton on this issue), and that should go into the process of formulating a response.

The leader would have to use skills like emotional and social intelligence to get to the heart of the matter by asking questions such as: Are the nurses being overworked? Are they not getting enough emotional support? What is the major issue? Servant leadership could be very effective here but so too could be innovative leadership. The manager, on the other hand, would have to be focused on making sure nurses are being scheduled properly, are getting enough breaks, and are not too fatigued while on the job.

The manager should be looking at the daily operations to ensure that everything is running smoothly and implementing the vision of change supplied by the leader. In any case, a leader and manager can be the same person or they can work together to bring about a practical, workable solution. The nursing leader would operate on the principle that to be successful, a strong organizational culture must exist.

The leader, therefore, would know that to retain nurses, the facility must have an attractive, supportive and helpful workplace culture of which the nurses actually want to be a part. The manager, on the other hand, will operate on the principle that to be successful, one must be logistically minded and create an atmosphere in which nurses are made aware of organizational objectives.

The manager would have to maneuver nurses in a way that keeps them all focused on the main goal of the facility, which is to provide quality care to the patients. The approach that best fits my personality and professional philosophy of nursing is to get to know directly from the nurses why they want to get out of the field or leave the facility.

I would want to conduct personal interviews with the staff routinely to see how everyone is feeling, whether they are positive or negative about the workplace.

I would want to conduct exit interviews to see why a nurse is leaving, and I would want to stay on top of the situation and create a culture in the workplace that is more accommodative and in line with the vision of nursing that the nurses had when they were in school—as a job that is based on giving quality care to every patient. The approach is suited to my personal leadership style of servant leadership because it puts the needs of the nurses first.

I want to create both a culture that supports the nurses and makes them feel appreciated and empowered to do their jobs to show each patient enough time and care that the patient feels grateful and satisfied. As a manager, I would want to make sure enough nurses are scheduled for every shift so that they can take their time with patients and make sure they are giving quality care to all.

The key here is that the nurses need to feel supported rather than overburdened, and that is both a leadership and managerial issue—and my style of servant leadership would be very effective in addressing the issue. A possible funding source that I would take advantage of is the free educational seminars offered by Health Resources and Services Administration (HRSA).

The Nurse Education, Practice, Quality and Retention (NEPQR) Veteran Nurses in Primary Care (VNPC) Technical Assistance Call (a webinar through HRSA) is one example that can help provide training for improving retention rates. HRSA offers a variety of funding opportunities via programs such as Nurse Education, Practice, Quality and Retention courses, which can be used to train nurses and get everyone to “buy in” to the vision of reducing turnover through positive changes in the workplace culture and through new, innovative managerial solutions.

According to HRSA (2018), the programs are helpful in supporting “projects that will build upon the unique leadership skills, abilities, and training that military veterans possess in order to reduce the burden of transitioning into professional nursing careers.” This is the type of grant that could be very supportive in making sure we obtained the funding required for.