Nursing Shortage and Nurse Turnover: Effective Leadership and Management Interventions

This essay discusses the causes and effects of nursing shortage and nurse turnover in healthcare organizations. It emphasizes the importance of effective leadership and management interventions in overcoming the issue. The essay also suggests transformational leadership as a solution to the problem.

Running head: NURSING SHORTAGE AND NURSE TURNOVER
NURSING SHORTAGE AND NURSE TURNOVER
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Nursing shortage can be defined as the situation where the healthcare industry lacks
adequate amount of skilled nurses required for providing quality care to the patients. The needs
and requirements of the patients cannot be met successfully as the number of nurses required to
provide them efficient and sufficient care are quite less than required (Buerhaus et al., 2017).
Nurse patient ratio can be explained as the number of nurses allocated to the number of patients
for providing effective care. When the number of nurses is low and the numbers of patients are
higher, adequate quality and safe care cannot be provided to patients. These results in patient
dissatisfaction, unsafe services to patients, preventable errors, missed interventions, omissions
and many others. These can affect the health of the patients (Fischer, 2016). Therefore, the essay
will focus on how effective leadership and management interventions can help in overcoming the
nursing shortage and reduce nursing turnovers in the healthcare organizations. This assignment
will mainly show how effective leadership and management can handle the situation successfully
helping the healthcare industry to fight the issue.
One of the main causes that lead to nursing shortage is short staffing. The higher
authorities are seen to recruit less number of nurses with an expectation that such low nurses will
handle more patients and thereby try to save resources and increase the profit margin. However,
they remain ignorant about the risks and harms that might take place when there is less number
of nurses but more number of patients (Wu et al., 2016). When low number of nurses is expected
to care for more patients, they are burned out physically making them suffer from fatigue,
headache, backache, spondylitis, and metabolic disorders. They are drained out mentally and
emotionally that create stress in their lives. They also fail to meet appropriate work-life balance.
All these contribute to nurse turnovers making them leave their professions. Hence, the nursing

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leaders and managers need to lead and manage the present number of nurses in ways by which
they feel motivated and guide them to handle the stress effectively.
Often poor working conditions also leads to nursing turnovers thereby reducing the
number of nurses working for any organization. Lack of support from seniors and colleagues,
poor organizational culture, lack of proper resources and many others might contribute to poor
working conditions of the nurses (Snavely, 2016). This affects the morale of the nurses.
Therefore, leaders and managers need to develop effective strategies by which the working
conditions of the nurses in healthcare organizations can be developed. These would help to
retain the nurses reducing chances of nursing shortage.
One of another cause for nursing shortage is the lack of proper opportunities and
adequate resources for nursing research and education. Therefore, individual students do not
try to enter into the profession due to lack of promotion of the glorious features of the profession.
Moreover, individuals who have already become nurses might also become frustrated and leave
their professions if they do not get adequate opportunities in their career to enjoy growth.
Another cause is the aging nursing workforce. The rate at which the present nursing workforce
is ageing and retired is not running parallel with the number of students entering into the nursing
profession. Therefore, it is the duty of the nursing managers and the leaders to advocate the
issues to the higher authorities of the organizations as well as to the government. These would
help the government to realize how nursing shortage might affect the healthcare industry and
accordingly the life of the citizens in the nation (Twigg et al., 2014).
The main form of leadership that can help in overcoming the situation is transformational
leadership. Transformational leadership can be defined as the leadership approach that helps in

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modifying traits in the individuals and social systems as whole. One of the most important traits
of this leadership that would be useful in overcoming nursing shortage is inspirational
motivation. Often nurses are seen to fail in managing the stress and fatigue that occur from
handling more number of patients that they can handle successfully (Richardson et al., 2018).
The nursing leaders would be able to articulate a vision to the nurses that would be appealing as
well as inspiring to the nurses. Leaders can challenge the nurses with high standards,
communicate optimism about the future goals, and provide meanings for the task. These would
help the followers to work beyond their potential helping the organization to meet its visions.
Managers on the other hand can take the initiative of consulting with human resource
department and recruit more nurses so that the nurse-patient ratio remains stable. They can also
arrange for fun sessions so that nurses can also participate in games and outings and overcome
mental and physical fatigues.
Another important trait of this form of leadership is the individualized consideration.
Nursing leaders attends the needs of each of the followers, act as mentors or coaches to the
followers and listen to each of the concerns and needs of the professionals. The leaders will
ensure empathy and support and keep communications open. This trait would be helpful to
understand the issues that nurses have with their working conditions. The nurses would be
revealing about the lack of support they get, poor organizational climate, blame games, power
struggles, ego clashes among the team members and any other issues they face. The leaders will
help in solving each of the concerns faced by every nurses and this will help in development of
the working conditions. Managers need to allocate the resources in the organization by which
each of the problems can be solved. Feedback sessions would be promoted by managers, surveys

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would be conducted and many others by which they can identify the issues and accordingly
allocate resources for managing the problems (Lasala, 2017).
Another important trait is intellectual stimulation which shows the degree to which the
leaders challenges assumptions, takes risks and solicit the ideas of the followers. Leaders will
encourage creativity among the nurses. They need to advocate the issues of restricted career
opportunities of the nurses to the higher authorities so that opportunities of growth can be
provided to the nurses. This would make them satisfied and turnover would reduce. Another
trait is the idealized influence where they themselves act as role models and provide examples
to followers about how they should act and perform tasks to achieve success and meet goals. The
leaders would work along with the nurses and provide them with examples about stress should
be handled, how continuous professional development can be assured and how taking risks can
help in becoming an expert nurse in the future (Tabloski, 2016). Therefore, this trait would help
the nurses to follow the leader and overcome different barriers that come in their ways.
Managers will conduct sessions along with HR department and discuss the career opportunities
available. Accordingly, they will examine the performance of nurses and provide them with the
opportunities that would benefit them. They would also arrange training sessions for the nurses
for their continuous professional developments. When nurses see that organization is dedicated
for their growth, nursing turnovers would reduce.
Health Resources & Services Administration also called the HRSA had already been
seen to award about $ 94 million for strengthening and growth of the healthcare workforce in the
year 2015 (Hrsa.gov, 2015). Similarly, the nursing leaders need to advocate about the issues of
nursing shortage and nursing turnovers that the healthcare industry is facing again. They should
be requested to provide effective funding for promotion of the nursing profession so that it

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encourages more young adults to accept nursing as profession. Secondly, they should be also
requested to allocate sufficient funds to the organizations so that they can recruit more nurses
and can pay them sufficiently. Third, they also need to allocate funds for advanced nursing
education programs. This would help nurse to develop their skills and nurses can expect further
growth in their careers with rewarding remuneration.
From the above discussion, it becomes clear that nursing shortage and turnover is a
leading concern in healthcare industry as it can compromise quality of care to the patients.
Burning outs, poor working conditions, lack of career opportunities, aging workforce and many
others are some of the reasons. Therefore, leaders and managers can undertake transformational
leadership style to help the healthcare industry overcome the issues. HRSA would be requested
to allocate funds so that the leading concern of nurse turnover can be handled efficiently.

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References:
Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing
the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.
Fischer, K. M. (2016). How the educational funding provisions of the Patient Protection and
Affordable Care Act will affect the nursing shortage in the United States. Nw. JL & Soc.
Pol'y, 11, 54.
Hrsa.gov (2015). HRSA awards more than $94 million to strengthen and grow the health care
workforce, Hrsa News Room [online] retrieved from:
https://www.hrsa.gov/about/news/press-releases/2015-07-14-health-workforce.html
[accessed on: 25th October 2018]
Lasala, K. (2017). Nursing workforce issues in rural and urban settings: Looking at the
difference in recruitment, retention and distribution. Online Journal of Rural Nursing and
Health Care, 1(1), 8-24.
Richardson, K. (2018). The impact of retiring baby boomers on nursing shortage. The Journal of
Global Health Care System, 1(1).
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United
States. Nursing Economics, 34(2), 98.
Tabloski, P. A. (2016). Setting the stage for success: Mentoring and leadership
development. Journal of Professional Nursing, 32(5), S54-S58.

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Twigg, D., & McCullough, K. (2014). Nurse retention: a review of strategies to create and
enhance positive practice environments in clinical settings. International journal of
nursing studies, 51(1), 85-92.
Wu, S., Singh-Carlson, S., Odell, A., Reynolds, G., & Su, Y. (2016,). Compassion fatigue,
burnout, and compassion satisfaction among oncology nurses in the United States and
Canada. In Oncol Nurs Forum (Vol. 43, No. 4, pp. E161-E169).