Effective Approaches in Leadership and Management

In this assignment, you will be writing a 1,000-1,250-word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

Select an issue from the following list: bullying, unit closures and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.

  • Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
  • Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
  • Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
  • Discuss what additional aspects managers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
  • Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1:       Exemplify professionalism in diverse health care settings.

1.3:       Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.

3.4:       Demonstrate professional standards of practice.

Effective Approaches in Leadership and Management Sample Essay

Nurse Turnover

The healthcare system has been facing immense challenges in advancing the quality of care. For instance, unsafe staffing has been dominant in most states, adversely affecting patient and nurse satisfaction. Increased nurse turnover has become a significant health issue, with healthcare organizations struggling to retain their experienced workforce. The nursing leadership and management are left in a major crisis as they try to balance the available nursing resources and increasing demand for care services. This paper explores the different nursing leaders’ and managers’ approaches to addressing nurse turnover, expounding on additional aspects that may be essential to ensure professionalism in diverse healthcare settings.

Discussion of the Selected Issue

            Nurse turnover is any action that separates nurses from their job or organization. It may be due to retirement, a change of profession, or choosing to work for a different organization. Turnover may be voluntary or involuntary and may occur in the same organization in case of positional changes, and promotion, or externally (Bae, 2022). Nurse turnover may result from managerial style, personal destructors or stressors, and support factors. Violence, aggression, burnout, and a poor working environment also accelerate the nurse turnover rate.

Nurse turnover has a significant impact on patient safety and the quality of care. It increases staff workload forcing the available workforce to work for long shifts while caring for multiple patients. A high patient-nurse ratio significantly affects the mental health of the nurses, which increases their dissatisfaction with the provision of care (Bae, 2022). The nurses may even become detached from their work due to the overwhelming nature of their job. It also disrupts care continuity, thus compromising the quality and safety of care. Also, nurse turnover is associated with increased patient falls, healthcare-associated infections (HAIs), extended stays, and medical errors (Bae, 2022). It also leads to a poor nurse-patient relationship since the providers have very little time to interact with their clients due to the demanding nature of their job.

Professional Standards

            Effective professional standards are needed to address nurse turnover and reduce its adversities. One Professional standard that should be demonstrated in addressing nurse turnover is safe staffing, critical in facilitating quality and safe care. Nursing leaders and managers should ensure that the unit is adequately staffed to enhance service delivery, increase patient safety and reduce mortality rates (Han et al., 2021). For instance, nurse leaders and managers may form staffing committees, with the biggest percentage being registered nurses, which will be involved in developing, implementing, and monitoring staffing plans to ensure they are favorable (Han et al., 2021). They will work collaboratively with the leaders and managers to evaluate and modify the available plans and set overtime requirements and shift patterns.

Another professional standard that may be demonstrated in addressing nurse turnover is protecting and advancing the scope of nursing practice by allowing nurses to operate to their full extent, abilities, and education while delivering the most efficient and quality care. Nurse managers should source employees highly committed to providing quality care and being flexible to organizational changes. They must be at the forefront of monitoring and balancing the needs and expectations of the caring team (Pedrosa et al., 2021). In addition, the organization and leadership must create an enabling environment where nurses are valued, supported, trusted, and involved in organizational decision-making. This will increase nurses’ commitment to enhancing service delivery by providing a diverse array of safe, affordable, and effective care.

Differing Roles of Nursing Leaders and Nursing Managers

Nurse leaders have a critical role in addressing nursing turnover by developing sound strategies and structures to increase satisfaction. This includes supporting and inspiring experienced working staff and rewarding their commitment. On the other hand, nurse managers are expected to adopt efficient leadership styles that motivate nurses to attain organizational goals. They also implement change initiatives based on the prevailing customer needs and opportunities to enhance nurse retention. This is by creating a positive organizational culture, free from violence, stress, and bullying. In addition, nurse managers are involved in the planning and budgeting of the unit. Therefore, they must ensure adequate funds have been allocated for staffing, including sourcing and employment of new employees with the right skills.

Authentic leadership conceptual framework challenges nurse leaders and managers to develop and implement a sustainable healthy working environment where all professionals are actively engaged (Giordano-Mulligan & Eckardt, 2019). Based on this framework, a nurse leader must have personal integrity and possess caring attributes, effective communication, effective decision-making, and ethical and moral values, putting them in a better position to create a sustainable healthcare environment. On the other hand, nurse managers should establish a trusting relationship with the nurses while acting under moral principles, which creates more balance for nurses (Giordano-Mulligan & Eckardt, 2019). The self-determination theory (SDT) also presents nurse managers and leaders with an opportunity to initiate autonomous motivation strategies, which fosters an adaptive behavior outcome, thus reducing turnover intention (van Dorssen‐Boog et al., 2021). This acts as an avenue for minimizing burnout and stress in the workplace while increasing nurse satisfaction and productivity.

Additional Aspects for Managers and Leaders

Nursing managers and leaders need to initiate several aspects of care to ensure professionalism throughout the diverse healthcare setting while addressing nurse turnover. These include the creation of a teamwork spirit, monitoring nurse absenteeism, and ensuring that the team has the correct skill mix. Teamwork in the care setting is essential in streamlining communication between the nurses. It also ensures that care delivery is well coordinated, maximizing each provider’s performance (Rosen et al., 2018). Also, nursing leaders and managers should monitor professionals’ absenteeism, which is one of the indicators of nurse intention to leave. Factors that may lead to absenteeism include unsafe workplace conditions, burnout, mandatory overtime, a high-stress working environment, and increasing volume and acuity (Burmeister et al., 2019). Therefore, it is the role of nurse leaders and managers to analyze the cause of absenteeism and adopt efficient measures to address it. In addition, nursing managers and leaders must ensure that the skill mix is correct by recruiting nurses with the right skills and competencies that match patient demands. Initiating the correct skill mix in the employment process will be critical in reducing work-related stress and burnout experienced since nurses will be working within their specialization area.

Leadership Style

The leadership style that would best address nurse turnover is the transformational style. This is because transformational leadership style enhances the nurses’ psychological empowerment, increasing their well-being and commitment to providing quality care. The leaders and managers are dedicated to helping nurses perform at the highest level by regularly seeking to satisfy employees’ higher needs while engaging them actively in the daily running of the unit (Iqbal et al., 2019). In addition, the transformational leadership style focuses on inculcating positive and valuable changes in the work environment, thus reducing work-related stress and burnout, increasing work engagement, and promoting proactive work behavior, while advocating for knowledge sharing, thus increasing nurse satisfaction and retention.

Conclusion

Nurse turnover is a significant health problem that has adversely affected patient safety and the quality of care. Nursing leaders and managers are challenged to initiate a sustainable healthcare environment that prioritizes nurse needs. This includes initiating professional standards to promote a favorable working environment as they strive to increase nurse satisfaction while reducing turnover. Promoting teamwork, monitoring absenteeism, and ensuring that the skill mix is correct acts as an avenue for addressing turnover. In addition, adopting transformational leadership style may be critical in addressing turnover due to its effectiveness in satisfying the needs of the employees’ while promoting positive and valuable changes in the nurse working environment.

References

Bae, S. H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International Nursing Review69(3), 392–404. https://doi.org/10.1111/inr.12769

Burmeister, E. A., Kalisch, B. J., Xie, B., Doumit, M. A., Lee, E., Ferraresion, A., … & Bragadóttir, H. (2019). Determinants of nurse absenteeism and intent to leave: An international study. Journal of nursing management27(1), 143–153. https://doi.org/10.1111/jonm.12659

Giordano-Mulligan, M., & Eckardt, S. (2019). Authentic nurse leadership conceptual framework: nurses’ perception of authentic nurse leader attributes. Nursing administration quarterly43(2), 164–174. https://doi.org/10.1097/naq.0000000000000344

Han, X., Pittman, P., & Barnow, B. (2021). Alternative approaches to ensuring adequate nurse staffing: the effect of state legislation on hospital nurse staffing. Medical Care59(10 Suppl 5), S463. https://doi.org/10.1097%2FMLR.0000000000001614

Iqbal, K., Fatima, T., & Naveed, M. (2019). The impact of transformational leadership on nurses’ organizational commitment: a multiple mediation model. European Journal of Investigation in Health, Psychology and Education10(1), 262-275. http://dx.doi.org/10.3390/ejihpe10010021

Magbity, J. B., Ofei, A. M. A., & Wilson, D. (2020). Leadership styles of nurse managers and turnover intention. Hospital Topics98(2), 45–50. https://doi.org/10.1080/00185868.2020.1750324

Pedrosa, J., Sousa, L., Valentim, O., & Antunes, V. (2021). Organizational culture and nurse’s turnover: A systematic literature review. International Journal of Healthcare Management14(4), 1542–1550. https://doi.org/10.1080/20479700.2020.1801160

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist73(4), 433. https://doi.org/10.1037%2Famp0000298

van Dorssen‐Boog, P., van Vuuren, T., de Jong, J. P., & Veld, M. (2021). Facilitating health care workers’ self‐determination: The impact of a self‐leadership intervention on work engagement, health, and performance. Journal of Occupational and Organizational Psychology94(2), 259–281. https://doi.org/10.1111%2Fjoop.12352

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