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Nursing Shortage and Nurse Turnover: Leadership and Management


In the wake of organizational leadership and management, the healthcare sector has been grappling with shortage of nurses due to increasing turnover. Employment-related factors have been contributing to this perturbing situation. Numerous researchers attest that ignorance of such aspects increases the likelihood of failure in medical systems. Although many people wish to pursue nursing courses in institutions of higher learning each year, only a few are enrolled. However, more than a quarter of those administered fail to complete the courses. The bad news is that over 50-percent of those entrants who are employed in medical centers only dedicate their efforts towards nursing activities in their first occupational year. This situation has significantly challenged many healthcare leaders as they deliberate on the best approaches to solve the biting shortage of nurses in medical facilities. Various systems that have been put in place to sustain nurses seem to have failed clearly. Therefore, there is a need to use new approaches that will reduce the high nurse turnovers. A healthy nation depends on adequate, highly skilled, and knowledgeable nursing workforce. This essay seeks to examine the effective approaches in leadership and management by providing an insight into nurse turnover in contemporary healthcare institutions.

Nursing Shortage and Nurse Turnover

The shortage of staff in medical facilities can be attributed to the small number of students who are enrolled in nursing colleges each year. A study that was conducted by the United States Bureau of Labor Statistics in 2008 predicted that the country needed to employ about 3.2 million nurses within a span of 10 years (Mahon & McPherson, 2014). Today, there is still a high demand that does not match with the number of nursing graduates who are ready to join healthcare-related occupations. Each year, the gap between the demand and supply of graduate nurses widens. This situation leaves managers competing against each other in an attempt to fill vacant nurse positions in their respective healthcare facilities. This nature of competition has led to offering and counteroffering of better packages to entice performing nurses from other facilities. As a result, nurses keep on shifting to new employers since they are promised better earnings and benefits. This situation has resulted in high turnover, as most of them prefer to seize remuneration packages that are better than the ones that are offered in their current workplaces. According to Mahon and McPherson (2014), health institutions that offer better packages have a high chance of employing competitive nurses. This situation is a clear indication that those health institutions that offer meagre earnings are left without adequate staff. Surprisingly, a larger part of the population seeks medical attention in the poorly staffed health facilities since they their medical services are affordable.

Addressing Nursing Shortage and Turnover

Despite the abovementioned reasons that lead to increased turnover and shortage of skills in healthcare institutions, nursing leaders can alleviate this menace by adopting various theories and principles (Giltinane, 2013). Nonetheless, effective control of nursing turnover can be achieved through proper implementation of leadership practices rather than mere management philosophies. Giltinane (2013) attests that the recruitment and retention of nurses is a crucial step towards the success of healthcare institutions. Job satisfaction plays a key role in persuading employees to remain in their prevailing job positions. Healthcare leaders need to understand that nurses need an inspiring work environment that makes them feel appreciated for their efforts.

Giltinane (2013) explains various leadership theories and principles that nurse leaders should emulate in an attempt to alleviate turnover and shortage of skills in healthcare facilities. At the outset, there is a need to embrace transactional leadership approaches. Nurses should be rewarded nurses for their relentless efforts to offer care services to patients. Moreover, nurse retention requires transformational leadership practices. Healthcare leaders should develop the skills of nursing staff in an attempt to instill the required work proficiency in them. There is a need to identify their individual potentials. Transformational leadership practices provide opportunities for independent decision-making. This situation improves self-correction. In this manner, nurses become empowered to continue handling their responsibilities; hence, turnover is reduced.

Huber (2013) posits that managers who focus on maintaining high standards create stressful work conditions for nurses. This situation can aggravate turnover. A practicing nurse can find the stress unbearable and opt to leave the career altogether. Such situations add pressure to the existing poorly staffed health facilities.

Huber (2013) reveals that job dissatisfaction is a major reason for high turnover in any organization. Many veteran nurses tend to prefer jobs that are characterized by flexible working hours. A nurse leader should realize and respect these needs to retain the skilled workforce.

Approach that fits Personal and Professional Philosophy of Nursing: Situational Leadership

In the wake of changing roles of nurses in healthcare institutions, there is a need to embrace situational leadership. According to Huber (2013), investing in job satisfaction areas such as benefits, staffing, fulfillment, and pay can help healthcare organizations to retain a higher number of their employees. This situation reduces costs that are incurred due to high nurse turnover. Capitalizing on the welfare of the nurse staff by making their working conditions better serves as a source of motivation. A nursing leader who is concerned with the prosperity of the staff will most likely accomplish both individual and organizational goals. There is also a need to maintain flexibility within the healthcare institution to meet the ever changing social and economic among other needs of the nurses. A management that is focused on accomplishment of tasks without taking the social lives of the nurses into account makes them dissatisfied (Huber, 2013). This situation increases turnover as nurses quit healthcare jobs to seek employment in other sectors.


Nurses are important people in the society who are charged with the responsibility to care for patients. The nature of the job calls for passion. Therefore, they deserve appreciation and protection by their healthcare institutions. In this discussion, situational leadership is perceived as the best approach towards workforce retention in medical facilities. Healthcare leaders should readily respond to changing needs of nurses to make them appreciate their careers. They should establish a working environment that allows nurses to advance their careers without restraints and redundant pressure. However, this approach is only achievable when the leader is focused on the welfare of the nurses. However, researchers and nursing professionals should improve the versatility of the model to fit in simple to complex healthcare institutions. This situation will significantly narrow current the gap between demand and supply of nurses. The approach fits perfectly when executed by nurse leaders who seek long-term explanations to employee retention. Proper implementation of situational leadership provides a basis for enduring solutions to nursing shortage and turnover.

Reference List

Giltinane, C.L. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39.

Huber, D. (2013). Leadership and Nursing Care Management. Philadelphia, PA: Saunders.

Mahon, P., & McPherson, G. (2014). Explaining why nurses remain in or leave bedside nursing: a critical ethnography. Nurse Researcher, 22(1), 8-13.