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Effective Approaches in Leadership and Management Essay

The nursing shortage and high turnover rate in nursing impacts the economic life of every health care organization in America. The purpose of this paper is to define and discuss the approaches in leadership and management styles in relation to the nursing shortage and nurse turnover using theories, principles, skills, and roles of the leader versus manager and to identify this student’s professional philosophy of nursing and personal leadership style.


The Affordable Care Act has changed the landscape of health care delivery in America. Many more patients are seeking health care. Mary Force concludes one of the most serious issues facing healthcare delivery is the nursing shortage. It is estimated the current shortage of registered nurses will be 340,000 by the year 2020 (Force, 2005). There is inadequate nursing staff to meet the heavy demands of the current patient climate seen in acute care hospitals today. Hospitals need dependable, highly trained nurses. Nursing turnover and shortages mean current nurses seek different employment, resign, transfer or are terminated.

Causes of turnover and shortages are an aging RN population and a demographically large aging boomer population, low enrollments in nursing schools, increased workload, poor nurse staffing ratios and high patient acuity according to Ribelin (2003). Nurses do not leave hospitals; they leave their managers (Ribelin, 2003). Lack of good leadership by nurse leaders and managers, limited upward mobility, unsatisfactory remuneration, lack of teamwork, poor communication, and inflexibility in work schedule all also contributing factors to high staff turnover.


It is important to understand the different role the nurse manager and nurse leader play in order to understand their approach to the staff they have responsible for, especially in the area of staff retention. The roles are different yet there is interface between both. The nurse manager’s role is defined by the organization that gives her or him authority (control) and has subordinates (nurse leader) to delegate tasks to so that the goals of the organization are met. They value stability and focus on short-term results. Their objectives are to complete tasks, perform time management, control productivity, and maintain necessary equipment. They plan, budget, organize, coordinate, solve problems and make decisions. They focus on the organization’s policy and procedures, systems, efficiency, and doing the work in their assigned area per organizational boundaries. It is little wonder that staff sometimes see themselves as little more than a number in the eyes of some nurse mangers. The nurse manager can address the problem of turnover by being visible and present in the unit and be seen by their staff frequently.

They can assist with flexible scheduling and adequate staff-patient ratios. They can also be champions for adequate reimbursement, benefit plans, and the synchronization of resources that enhance the nursing experience. When coupled with organizational reimbursement for advanced education such as completion of baccalaureate and master degrees, nursing satisfaction is higher and managers are better able to retain their staff. Hunt suggests job sharing as a possibility also (Hunt, 2009). They can also recognize staff for their services and give tokens of appreciation. Unfortunately nurse managers have little control over the nursing shortage. The U.S. federal government must allocate more educational funds to support nursing programs. There must be more programs available so teachers can be trained and additional seats made available to students at universities and community colleges. The nurse leader’s role and activity with the staff is an important link in assisting the organization reach its goals.

They earn the right to lead by influencing people through communication, consensus, explaining vision, listening, teaching, inspiring, motivating, creating, building trust relationships, and empowerment. Effective nurse leadership is about teamwork, listening, mentoring, coaching, and persuasion. Nurse leaders assist staff with the big picture, the vision. Nurse leaders look for new ways to solve problems by being flexible and adaptive. They are excellent at communication and being involved with their staff. They encourage participation by the nursing staff in clinical ladders for career advancement. Their followers value them. They are a positive force through their communication, sense of purpose, and thus assist in staff retention and turnover. Effective leadership is an essential component in staff retention (Kleinman, 2004).


The writer’s own personal and professional philosophy blends well with the role of nurse leader. She has the qualities to be a manager but her personal and professional style revolves around teaching, communicating creating vision and team building. To be positive and inspiring is part of this nurse’s innate character. This nurse has the capacity to be a transformational nurse leader, leading by example, inspiring others of the organizations vision, and to encourage others to further their education. This writer identifies and promotes shared responsibility for actions and a democratic process in which nurses communicate effectively with management. This nurse leader empowers everyone to work as a team and accomplish goals. The collective group then takes ownership if they feel they are heard and valued. They catch the vision.

The organization’s vision becomes their vision. Success comes from people working together understanding that together they can all do great things. The issue of turnover and retention can be addressed by increased satisfaction in the nursing career. This often comes by nurse leaders like myself knowing the strengths and weaknesses of the staff, treating the staff as individuals with great potential to contribute to the team, listening, persuading, encouraging, being sensitive to the workload of the staff, showing empathy for the staff and involving nurses in the decision making process. This also involves nurse leaders communicating clearly with the nurse manager, linking the team together to achieve goals.


Nursing shortages and turnover are ongoing issues. All levels of Leadership must collaborate to address the ongoing issues of nursing shortages and turnover. Good leadership by nurse managers and nurse leaders can reduce the nurse turnover rate but the nursing shortage that is plaguing the health care system is hindering the ability of nurses to provide adequate care of their patients. It is a policy matter to be addressed by the highest levels of government. Nurse managers and nurse leaders have differing roles and methods of obtaining objectives but both are needed to successfully meet the goals of the health care organization.

Force M. V. 2005. Relationship Between Effective Nurse managers and Nursing retention. Force, M. V. (2005). The Relationship Between Effective Nurse managers and Nursing retention. , 35(718), 336-341. D Hunt, S. (2009): Nursing Turnover: Costs, Causes, & Solutions. Retrieved on October 6, 2013 from http://uexcel.com/resources/articles/NursingTurnover.pdf Kleinman, C. (2004). Leadership: A key strategy in staff nurse retention. Journal of Continuing Education in Nursing, 35(3), 128-132. Retrieved from http://tools.hhr-rhs.ca/index.php?option=com_mtree&task=att_download&link_id=5677&cf_id=68&lang=en Ribelin, P. (2003). Recruitment & retention report: Retention reflects leadership style. Nursing Management, 34(8), Retrieved from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=418488

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