Nursing Shortage and Nurse Turnover: Causes and Solutions
This paper examines the persistent problem of nursing shortage and high nurse turnover in the healthcare industry, drawing on research from multiple countries to identify its causes and consequences. It distinguishes between the roles of nurse managers and nurse leaders, highlighting how effective leadership can mitigate workforce instability. The paper outlines several strategies for reducing turnover—including wage increases, nurse unionization, fair wage-setting practices, appropriate staffing ratios, and ongoing research and education. It concludes with a professional philosophy favoring competitive pay and democratic leadership as the most effective approaches to retaining nursing staff and sustaining quality patient care.
- Introduction: The Nursing Shortage Crisis: Causes and consequences of nursing turnover worldwide
- Role of Nurse Manager vs. Nurse Leader in a Healthcare Unit: Distinguishing leadership from management in nursing
- Methods for Reducing the Level and Cost of Nursing Turnover: Five strategies to reduce turnover and improve retention
- Approach That Best Fits a Professional Philosophy of Nursing: Advocating for fair pay and democratic leadership
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What makes this paper effective
- It grounds its claims in multiple peer-reviewed citations, lending credibility to assertions about the causes and consequences of nursing turnover across different national contexts.
- It clearly distinguishes between nurse managers and nurse leaders, offering a practical and conceptually useful contrast that informs the paper's applied recommendations.
- The section on reduction methods is well-organized into discrete, actionable strategies, making the argument easy to follow and apply in a professional setting.
Key academic technique demonstrated
The paper demonstrates effective use of evidence synthesis: rather than relying on a single source, the author weaves together multiple citations (Aiken et al., 2001; Gray & Phillips, 1996; Tai et al., 1998) to build a cumulative argument about the scope and causes of nursing turnover. This technique strengthens the paper's authority and shows awareness of the broader research landscape.
Structure breakdown
The paper follows a clear four-part structure: (1) an introduction establishing the problem and its consequences; (2) a conceptual section distinguishing nurse managers from nurse leaders; (3) a practical section presenting five strategies for reducing turnover; and (4) a concluding section offering the author's professional philosophy, integrating wage reform and democratic leadership as preferred solutions.
Introduction: The Nursing Shortage Crisis
Nursing shortage and high nurse turnover are very common issues faced in the healthcare industry. This instability of the workforce in many countries is raising questions about the performance of nurses and the quality of patient care.
Gray and Phillips (1996) pointed out that nursing turnover has a negative impact on an organization's ability to meet patients' needs and provide quality care. Tai et al. (1998) also identified nursing shortage and turnover as an important factor responsible for poor performance in healthcare centers. This is because high turnover affects the morale and productivity of the nurses who remain, as they must care for patients while the healthcare unit recruits new staff members (Sofer, 1995; Cavanagh and Coffin, 1992; Shields and Ward, 2001).
Aiken et al. (2001) pointed out that the common reasons behind nurse turnover in Canada, America, Germany, and Scotland included problems in work design and emotional exhaustion. Other contributing factors include the availability of alternative career options, low wages, departure from the profession altogether, and the increasing average age of the nursing workforce.
Nursing shortage and turnover affect not only performance but also the profitability of healthcare units. Patients prefer healthcare facilities with stable, well-trained, and active nursing staff who provide high-quality care. Constant nurse turnover distracts staff, forces them to take on extra work, causes frustration, and results in lower-quality patient care. Losing a single nurse carries a financial cost estimated at roughly double that nurse's annual salary. Beyond this direct cost, healthcare units experience a range of additional consequences: declining quality of care, a reduction in patient volume, increased absenteeism, a rise in workplace accidents, higher rates of medical staff turnover, and increased expenditure on temporary and contingent staff.
References
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H., Giovannetti, P., Hunt, J., Rafferty, A. M., and Shamian, J. (2001). Nurses' reports on hospital care in five countries. Health Affairs, 20(3), 43–53.
Cavanagh, S. J., and Coffin, D. A. (1992). Staff turnover among hospital nurses. Journal of Advanced Nursing, 17(11), 1369–1376.
Gray, A. M., and Phillips, V. L. (1996). Labor turnover in the British National Health Service: A local labor market analysis. Health Policy, 36(3), 273–289.
Shields, M. A., and Ward, M. (2001). Improving nurse retention in the National Health Service in England: The impact of job satisfaction on intentions to quit. Journal of Health Economics, 20(5), 677–701.
Sofer, S. (1995). Determinants of nursing turnover (Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol. 55, No. 9-B). University Microfilm International.
Tai, T. W. C., Bame, S. I., and Robinson, C. D. (1998). Review of nursing turnover research, 1977–1996. Social Science and Medicine, 47(12), 1905–1924.
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