NRS 451 Benchmark Effective Approaches in Leadership and Management

Sample Answer

Nurse leaders and nurse managers encounter various issues in nursing practice that implores them to develop innovative solutions and approaches to tackle them. Nurse turnover, nurse staffing shortage, and lateral violence or bullying are some of the issues that affect nursing practice and implore leaders and managers to seek solutions to ensure patient safety, accessibility and quality of care (Dewanto & Wardhani, 2018).

The purpose of this paper is to discuss the issue of nurse turnover, its effects on quality of care and patient safety as well as effective nurse leadership and management approaches in addressing it in settings where it happens.

Description of Nurse Turnover Effects on Quality of Care and Patient Safety

Nurses are a critical part of the healthcare system and comprise of the largest part of the health profession. However, nurse turnover remains a core issues that impacts the profession and threatens to reduce the gains made through healthcare reforms. Recent reports and studies show that the rate of nurse turnover is between 8.8% to 37%, depending on region and nursing specialty.

However, the national average of nurse turnover for registered nurses (RNs) is about 17% annually. The implication is that healthcare leaders continue to struggle to maintain sufficient staffing ratios. While the Bureau of Labor Statistics projects the RNs as among the top occupations to grow in terms of jobs, more and more organizations face nurse turnover due to a host of reasons.

The rise in the demand for RNs alone is expected to hit 438,000 new nurses or about 15% of the current levels. In its recent (2021) report, the NSI Nursing Solutions, Inc. asserts that the turnover rate for staff RN rose by 8.4% and this resulted in a national average of 37.1%. Further, the cost of turnover for a staff RN is about $46,000 with hospitals having to spend close to $262,300 per years for every percent change in RN turnover.

The report notes that causes of the turnover include nurse shortage that leads to more workload and long working hours, lateral violence that discourages new nurses, change of careers and ineffective leadership and management that does not heed nurses’ concerns. Nurse turnover has serious effects on quality of care and patient safety in the settings that it occurs.

Nurse turnover leads to increased workload for nurses who may suffer from burnout and fatigue. Studies and evidence show that fatigue and burnout increase one’s susceptibility to medication errors and continuity of care (Antwi & Bowblis, 2018). Nurse turnover affects quality of care due to the inability of the facilities to attain required or mandated as well as industry’s best practice standards in care provision.

Nurse turnover affects quality of care because it affected the overall efficiency and effectiveness of new workers who may not be acquainted with the operations of the new organization. Nurse turnover also affects the operational costs of a facility and lead to poor service delivery due to resource limitation and expert care provision.

Professional Standards of Practice to Maintain Professional Conduct

Developed by the American Nurses Association (ANA), the standards of practice comprise of the scope of practice and eighteen standards that RNs must comply with in providing holistic care to diverse patient populations. The standards offer authoritative statements on action and behaviors that RNs are expected to competently execute, irrespective of their role, population, specialty and setting.

These include assessment, diagnosis, identification of outcomes, planning and implementation of their plans of care, evaluation of patient’s progress and ethical practice (Kaddourah et al., 2018). Nurses are also expected to patient advocates, carry out respectful and equitable practice, nurture effective communication protocols, collaborate with other healthcare providers and professionals, be leaders by demonstrating skills in their profession, seek ways to acquire and grow their knowledge and skills as well as competence to reflect the current nursing practice and innovative ways of care provision, and be contributors to quality practice through quality of care.

These standards implore on nurse leaders to develop effective ways to address the nurse turnover rates. Professional standards like quality practice, advocacy for patients and acquisition of knowledge as well as skills to improve competencies should be demonstrated to address the nurse turnover issue in any setting that it takes place. As patient advocates, they should seek ways to address the problems that may lead to their leaving organizations while nurse leaders and managers should focus on issues leading to the problem.

This implies that there must be effective collaborative leadership and approaches to ensure that there is respectful practice, increased chances of career development and research for better interventions to improve quality of care and practice.

Differing Roles of Nursing Leaders and Nursing Manager & Different Approaches

Nursing leaders and nursing managers have different roles and even approaches to addressing the issue of nurse turnover. The ANA standards of practice implores nurses to be leaders and focus on quality of care and practice. While nurse leaders and nurse managers are all nurses, their differing roles mean that they will also have different approaches to solving the nurse turnover problem.

Nurse leaders are likely to develop a collaborative approach based on the application of leadership styles like transformational and servant leadership (Shaffer & Curtin, 2020). Nurse leaders may work collaboratively with nurses to fix schedules and encourage motivation and the need for increased focus on patient care. Through this approaches, nurse leaders may encourage nurses not to leave but suggest innovative ways like use of floating nurses on short term as they develop effective retention measures as a long-term solution to the problem.

Therefore, nurse leaders are more likely to engage diverse stakeholders to find a workable solution to the problem. Conversely, nurse managers have different roles and in most cases, they are formal roles and functions. These include planning, staff recruitment and development, organizational direction and ensuring effective and efficient operational environment. Therefore, nurse managers will want to maintain the status quo and offer solutions based on the transactional leadership model (Bruntt & Russell, 2022).

This implies that they are more likely to seek replacement of those leaving to ensure normal operations. As such, nurse managers focus on ascertaining that leaving nurses do not disrupt the delivery of care. However, it is essential for nurse managers to consider working collaboratively with all nurses and addressing issues that are causing the problem.

Additional Aspects for Managers and Leaders to Ensure Professionalism

Attaining professionalism during nurse turnover implores leaders and managers to implement additional measures. The ANA standard of practice require nurses as leaders to be at the frontline in patient advocacy and care provision, especially through quality care. In this regard, nurse managers and leaders should adopt an innovative approach to the issue and train nurses to enhance their overall competencies, especially in regards to the integration of technology and resource optimization (Bryant et al., 2018).

The nurse managers and leaders should work collaboratively with all nurses and implore them to generate and share ideas to enhance professional care delivery as nurse turnover is associated to negative outcomes like poor care quality due to a rise in the workload.

Leadership Style to Address Nurse Turnover

Leadership styles are approaches that nurse leaders and managers can deploy to help nurses offer quality patient care in diverse settings, especially in addressing issues like nurse turnover rates in healthcare settings. Transformational leadership style is the most effective approach to the issue of nurse turnover as it guaranteed staff motivation, ensure that leaders listen to nurses and leads to the development of a conducive work environment (Reinhardt et al., 2018). Therefore, nurse managers and leaders can leverage this style to nurse turnovers in the settings.

Conclusion

The rising levels of nursing turnover is a threat to every healthcare organization. Nurse turnover has negative effects to the care standards offered by nurses in diverse healthcare organizations. Addressing nurse turnover requires leaders and nurses to develop better approaches to care provision. Nurse leaders and nurse managers must address the issue of nurse turnover through effective approaches and leadership styles like transformational and servant leadership styles.

References

• Antwi, Y. A., & Bowblis, J. R. (2018). The impact of nurse turnover on quality of care and mortality in nursing homes Evidence from the great recession. American Journal of Health Economics, 4(2), 131-163. https //research.upjohn.org/cgi/viewcontent.cgi?article=1267&context=up_workingpapers
• Bryant, K., Aebersold, M. L., Jeffries, P. R., & Kardong-Edgren, S. (2020). Innovations in simulation Nursing leaders’ exchange of best practices. Clinical Simulation in Nursing, 41, 33-40. https //doi.org/10.1016/j.ecns.2019.09.002.
• Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences a preliminary study at private hospitals in Indonesia. BMC nursing, 17(2), 1-7.
  DOI https //doi.org/10.1186/s12912-018-0317-8
• Kaddourah, B., Abu-Shaheen, A. K., & Al-Tannir, M. (2018). Quality of nursing work life and turnover intention among nurses of tertiary care hospitals in Riyadh a cross-sectional survey. BMC nursing, 17(1), 1-7. DOI https //doi.org/10.1186/s12912-018-0312-0
• Reinhardt, A. C., Leon, T. G., & Summers, L. O. (2022). The Transformational Leader in Nursing Practice–an approach to retain nursing staff. Administrative Issues Journal Connecting Education, Practice, and Research, 12(1), 1-12. DOI 10.5929/2022.12.1.1
• Shaffer, F. & Curtin, L. (2020). Nurse turnover Understand it, reduce it. What can employers do to increase nurse retention? American Nurse Journal, 15(8) 57-59. https //www.myamericannurse.com/wp-content/uploads/2020/08/an8-Turnover-728.pdf
• NSI Nursing Solutions, Inc. (2022). 2022 NSI National Health Care Retention & RN Staffing Report. https //www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
• Bruntt, B. A. & Russell, J. (2022). Nursing Professional Development Standards. StatPearls
  [Internet]. https //www.ncbi.nlm.nih.gov/books/NBK534784/