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 closers 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.

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Solution

Nurse Turnover

The nursing profession and its effectiveness in addressing patient care needs depend on diverse factors affecting the workplace environment. It, in turn, calls for constant nurses’ motivation and effective employee management to ensure optimum care delivery. One of the issues to have faced the nursing profession and demanding effective leadership and management practices in nurse turnover. According to Dewanto & Wardhani (2018), nurse turnover is simplified as when nurses choose to abandon or leave their position, work, or organization for a different reason(s). Nurse turnover has become a thorn in care delivery, patient outcome, and safety in today’s healthcare industry as it determines healthcare organizations’ output. Nurses’ turnover may directly and or indirectly impact healthcare provisions and organizations. With the uniqueness of nurse turnover in every organization, leaders and managers are focused on devising effective ways of retaining experienced nurses to ensure patient safety and care quality are at the top. This paper discusses the nurse turnover issue, how it impacts care quality and patient safety, and leaders’ leadership style and role in addressing it (nurse turnover).

Nurse Turnover, How It Impacts Quality and Patient Safety

Nurse turnover in healthcare settings such as hospitals, nursing homes, etc., negatively impacts patient safety and care quality accorded to patients. In their research, Dewanto & Wardhani (2018) identified that nurses are healthcare professionals who always contact the patients. Their position in delivering the end product in healthcare dramatically impacts the patient experience when they leave their posts. As nurse turnover affects care delivery and continuity, quality is equally compromised. Additionally, turnover results in a shortage of professionals to serve the patients, affecting patient outcomes and satisfaction. Reduced workforce increases the workload to those left behind, resulting in burnout, reduced effectiveness, and productivity in care delivery. More so, nurse turnover results in a higher nurse-patient ratio, causing work-related stress, fatigue, and subsequent undermining of care quality. Turnover may result in better-skilled nurses leaving work; hence, inexperienced nurses serving patients increased prone to errors in care delivery and compromised care quality.

Patients in healthcare facilities affected by nurse turnover face a high rate of in-hospital mortality, increased risk of infection, a more significant number of falls, and other negative issues, hence compromised safety (Dewanto & Wardhani, 2018). On the other hand, understaffed healthcare facilities may mean overworking the remaining nurses, which can impair their ability to focus and address patient needs effectively and jeopardize safety. Nursing turnover may cause errors, reduced or lack of engagement, missed nursing care, and questionable safety. Further research and statistical links between nursing turnover, unsatisfied patients, and low-level health outcomes (Antwi & Bowblis, 2018).

How Professional Standards of Practice Should Be Demonstrated In Case Of Nursing Turnover to Help Rectify the Issue or Maintain Professional Conduct

Professional standards explain the level or competitive level and care magnitude in every stage of the nursing process. The primary use of professional standards is to maintain and direct clinically competent and safe nursing practice. Additionally, the standards guide and promote the clinical nursing practice, which comprises assessment, diagnosis, planning, implementation, outcome identification, and evaluation components. The nursing process entails actions by registered nurses and the need for effective decision-making. However, in the cases of nurse turnover, nurses’ duties and roles in care delivered must continue. Nurse turnover translates to a delegation of tasks to the rest of the registered nurses in the team, hence being the role of leaders to develop a balanced delegation of duties. However, in the case of nurse turnover, nurse leadership may find it challenging to maintain professionals’ standards of practice

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

In a nursing shortage scenario, nurse managers and leaders can play a critical role in addressing the issue and fostering patient safety and care quality, which priority in the healthcare industry (Antwi & Bowblis, 2018). Nurse Managers must, in turn, find effective ways to mitigate the turnover-related vices. Managers are given diversely responsible and have to devise resources and practices to ensure patient and staff satisfaction. These roles include providing a safe work environment for workers and patients. More so, the managers should undertake motivation initiatives for nurses to execute their functions without the feeling of overburdening, which would fuel turnover. According to Colwell (2019), addressing the nurses’ hierarchy of needs following Maslow’s model increases satisfaction level, teamwork, and higher retention for employees. In turn, managers must address nurses’ needs to foster stability, growth, and productivity, which subsequently positively influence patient experience, satisfaction, safety, and quality of care.

On the other hand, leaders can devise or play different roles to address the identified issue (nurse turnover). Leaders are responsible for units or groups of nurses; hence they play an integral role in ensuring their subjects follow the proper procedures and protocols towards maintaining high-level quality care and patient safety (Antwi & Bowblis, 2018). According to Naseer et al. (2018), influential healthcare leaders should create opportunities for workers to excel and express themselves, grow and develop, educate others, and mentor them. More so, through transformational leaders, the leaders should foster a positive organizational culture and teamwork that would motivate and make workers feel part of the organization’s goals, hence a low turnover rate.

Additional Aspects Managers and Leaders Would Need To Initiate To Ensure Professionalism throughout Diverse Health Care Settings While Addressing Nursing Turnover

Healthcare leaders and managers are responsible for instituting patient safety, ensuring professionalism and standards of practice stays respected, improves quality while containing the nursing turnover. Conflict resolution skills, ethical thinking, and providing a balanced team of nurses in terms of skills, experience and exposure fosters a balanced team with a positive culture of continuity from one generation of employees to another. The leader/manager should be keen to monitor signs of burnout, i.e., irritability, as this is a factor behind increased turnover, compromised patient safety, and care quality (Naseer et al., 2018). Additionally, the leaders should actively practice transformational leadership in organization management. As identified above, this leadership model ensures employees’ input is recognized, motivated in their work, and establishes a conducive and healthy environment. This would help develop a thriving organizational culture and assist in employee retention and motivation, a solution to the nurse turnover identified issue.

Leadership Style That Would Best Address the Chosen Issue (Nurse Turnover) & Why It Could Be a Success

Effective leadership practices have become an integral asset in managing healthcare organizations and optimizing care delivery, patient satisfaction, quality care, and safety (Colwell, 2019). While different leadership styles have been adopted and had diverse levels of success, transformational leadership has become a significant model integrated and revolutionizing the healthcare industry and environment, increasing an organization’s employees’ retention rates. According to Cheng et al. (2016), the transformational leadership model recognizes all workers’ input; hence, the leader helps establish a healthy environment for the workers. Subsequently, the teamwork approach empowers nurses and other staff to feel honored and respected, resulting in improved patient and staff satisfaction and, most importantly, employee retention, which would address nursing turnover.

On the other hand, strategies identified as key in mitigating nurse turnover include the development of shared oversight and governance practices. These strategies empower nurses to voice their concerns, ideas on workflows and scheduling, hence fostering a positive work environment by establishing a positive life-work balance (Colwell, 2019). The transformational leadership style best befits this setting as it inspires workers to strive past their required expectations, hence being part of the bigger vision for the organization or department they work. In addition to empowering workers, the leadership model fosters a positive organizational environment, making workers feel connected and want to stay. Finally, the style stimulates workers to find a balance between work and life, create a supportive environment, and give tasks based on workers’ strengths and weaknesses hence an indispensable remedy to success and solution to nursing turnover.

In conclusion, the high rate of nurse turnover has become a thorny and a menace to healthcare organizations and systems. It has diverse damaging effects to care quality, patient experience, and safety due to overburdening of staff left behind. However, with the adoption of integrative and collaborative leadership and management models, the trend can be reversed to improve the care delivery process. Transformational leadership is an essential model in establishing a balanced workplace and motivated employees, hence higher retention and lower rate turnover within an organization.

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://doi.org/10.17848/wp15-249

Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200–1216. Doi: 10.1108/pr-05-2015-0118

Colwell, F. J. (2019). Leadership Strategies to Improve Nurse Retention. INTERNATIONAL JOURNAL OF NURSING, 6(1). https://doi.org/10.15640/ijn.v6n1a18

Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC nursing, 17(Suppl 2), 52. https://doi.org/10.1186/s12912-018-0317-8

Naseer, A., Perveen, K., Afzal, M., Waqas, A., & Gillani, S. A. (2018). The Impact of Leadership Styles on Staff Nurses’ Turnover Intentions. International Journal of Academic Research in Business and Social Sciences, 7(12). https://doi.org/10.6007/ijarbss/v7-i12/3702