Effective Approaches in Leadership and Management

Nursing Shortage and Nurse Turnover

An essential component of achieving quality health care for all in any given medical set up is a sufficient workforce.  The human resource department of the health care system should always be well stocked to meet the health care needs of the health customer. Worth noting is the fact that nurses form a significant chunk of the health care workforce. Without an adequate number of nurses in the healthcare system, the entire set up could cripple(Raup, 2008). Despite these glaring consequences the health care system has continued to be faced with multiple issues concerning worker shortages and turnover. This paper will specifically discuss the issue of nurse’s shortage and turnover. The paper will analyze the approaches a nurse manager would take in trying to sort out the problem of nurse shortage and turnover.

There are different methods and strategies that nurse leaders and managers can make in trying to resolve the issue of Nurses shortage and nurses turnover. To begin with, we take a look at eh strategies that the nurse leaders would take to try and reduce this problem. In nursing leadership are individuals that head organizations and associations that nurse belong to. These organizations could be those that seek to stand for the betterment of the welfare of their members who in this case are nurses, for instance, The American Association of Nurses (AACN(Hayes et al., 2006). The other organizations that are led by the nurse leaders could be regulatory bodies for nurses in the country.

First and foremost the nurse leaders will try to change the difficult situation through legislation and regulation. The nurse leaders can advocate and lobby for the government to increase the number of nurses being trained by the state funding. The growth of the nursing students being educated could be under the Public Health Act(Raup, 2008). The nurse leaders could also advocate for more funding that would significantly improve the capacity and resources available for the education of a sufficient workforce(May, Bazzoli, & Gerland, 2006). The nurse leaders should also vouch for better identification of the registered nurse services inside the Medicaid and Medicare plus other systems of reimbursement.

Another avenue that the nurse leaders could take to help reduce the problem is in technological advancements, research and data collection. The leaders should encourage and promote the opportunities for the use of technological advancements to try and cover the gap and shortages in nursing. The improvements could boost the capacity of the reduced workforce to meet the health care needs of the health care customer. A focus on data collection by the nurse leaders will enable the primary employer of nurses who is the government to plan better(May, Bazzoli, & Gerland, 2006). Planning will be regarding the number to employ and the number to train to cover the shortages in the future generations.

The nurse leaders could use also strategies to reduce the high nurse turnover rate by fighting for the better pay and working environment for nurses in the setup. One of the main reason for the high turnover rate for a nurse is that nurses who are already employed move out of the system to seek better pay or because they have found better working environments(Hayes et al., 2006). The leader then should focus on improving the pay for the already employed nurse and creating a conducive working environment so as to retain the nurses who would want to move out.

The nurse managers also have a role in bettering the working circumstances of the already experienced nurses. The nurse managers’ approach to improving the working environment for their nurses could be through ensuring more flexible work environment structures and schedules. Flexibility in the work schedules will make sure that the nurses have ample time to develop take part in those activities that they want to engage in. Nurses leave the system in huge numbers for the purpose of increasing their level of education. The nurse managers could ensure they stick around by making their work scheduled flexible enough to take evening classes. Flexible scheduling by managers will keep nurses working(May, Bazzoli, & Gerland, 2006).

Managers could also create a healthy environment by the creation of a system that rewards experienced nurses who have served as preceptors or mentors for the newly registered nurses. The nurse manager could also ensure appropriate staffing to avoid stretching the available workforce(Raup, 2008). Finally, the nurse managers could ensure that the nurses available have sufficient autonomy over their practice at all times. The nurse managers can also achieve better retention by providing their nurses with autonomy at their place of work.

Nurse leaders have another role in solving the issue of nurse shortage in the health care set up. The characters fall in the sector of nursing education. Here, the nurse leaders in nursing education can ensure that the nursing students are taken through the graduate programs more rapidly. The nurse leaders in nursing education could also reach out to the youth via counselors, youth organizations, and schools(May, Bazzoli, & Gerland, 2006). Reaching out to the youth will ensure enrolment of a younger and more diverse population of nursing students.

Given these facts, I believe the roles of the nurse managers in creating a better working environment best suit the nursing philosophy. According to Mintzberg managerial positions, the nurse manager has an informational role, a decisional role and an interpersonal role. In their informational role, the managers can act as spokespersons for the nurses; they can fight for better pay, work environment and rewarding of exemplary nurses working under them. In their decisional and interpersonal role, the nurse managers can ensure the working schedule is flexible, and the nurses work with autonomy. The nurse manager living up to their role as disseminators of information can provide information for the nurses working under them on the way to better or upgrade their level of education(Hayes et al., 2006). Finally nurse managers as the resource allocators can ensure the work environment is well equipped to avoid nurses moving out because of poor working conditions.

In conclusion, it is important to note that nurse shortage and turnover is a real issue that is threatening to cripple the health care set up. Without enough nurses, the government cannot live up to its promises of providing quality and affordable healthcare to all its citizens. This paper has thus looked at how the nurse managers and leaders can improve the situation. The leader has seemed to be better equipped to make the changes by advocating for better pay, shorter education programs and enrollment of more youth for nursing education. The leaders could also ensure better working environment. The nurse managers also have roles that I view as better to help in cutting the shortage. Their roles have majorly fallen under the creation of a better work environment for the experienced nurses to reduce the high turnover rates.




Hayes, L., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., & Hughes, F. et al. (2006). Nurse turnover: A literature review. International Journal Of Nursing Studies, 43(2), 237-263. http://dx.doi.org/10.1016/j.ijnurstu.2005.02.007

May, J., Bazzoli, G., & Gerland, A. (2006). Hospitals’ Responses To Nurse Staffing Shortages. Health Affairs, 25(4), W316-W323. http://dx.doi.org/10.1377/hlthaff.25.w316

Raup, G. (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. http://dx.doi.org/10.1016/j.jen.2007.08.020


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