Effective Nursing Leadership in the Face of High Nursing Staff Turnover: The Role of Leadership Style in Ensuring Patient Safety

 

Nursing practice has many issues that affect it. These issues may be related to the work environment, remuneration, or professional development among others. For instance, nurse may find that they are not as productive as they would wish because the work environment they are in curtails their resourcefulness. Most of the time, this kind of scenario is related to oppressive leadership on the part of nurse managers. The nurse may also find that the remuneration they are getting for their services are not congruent with the skills that they have and the workload. Or they may find that the organizational policies towards professional development in terms of training, upskilling, and reskilling are not favorable to them. All these factors normally lead to one undesirable outcome – high nurse turnover. This paper is about this issue of high nurse turnover in nursing practice and the role of the nurse manager in ensuring that patient safety is safeguarded in the face of a reduced workforce. Benchmark – Effective Approaches in Leadership and Management

Nurse turnover in the hospital and other healthcare settings negatively impacts the quality of care that patients receive in such settings. This is because the nurse is the one healthcare professional that is always in contact with the patient and actually delivers the end-product of healthcare institutions. According to Bae et al. (2010), nurse turnover has been shown to negatively impact both the quality and continuity of patient care. Apart from that, they also demonstrated through their study that nurse turnover affects workgroup learning which in turn influences patient outcomes. This position is supported by Antwi and Bowblis (2018) who opine that high nurse turnover is related to lower overall quality of nursing care. Benchmark – Effective Approaches in Leadership and Management According to them, it may also mortality rates in the hospital and other settings like nursing homes. Furthermore, nursing turnover has the effect of lowering effectiveness because new employees are not familiar with an organization’s standard operating procedures and other protocols. In fact, the high turnover may also increase operating costs to the organization; and this is detrimental to the bottom line in fiscal terms. Numerous studies have therefore shown an undisputed statistical association between nurse turnover and health outcomes (Antwi & Bowblis, 2018).

Ensuring Nursing Professional Standards of Practice are Observed

According to standard number 3 of the American Nurses Association’s Standards of Professional Nursing Practice, the registered nurse is tasked with identifying the outcomes that are expected for each individual patient (ANA, 2015). This is in appreciation of the fact that it is the registered nurse who is mandated to plan care for each patient in the care of her team. It is in this nursing care plan that the registered nurse clearly outlines individualised patient outcomes and works towards achieving them together with her team. The team in a typical healthcare setting usually includes other registered nurses, enrolled nurses, and nurse assistants. To achieve the desired patient outcomes, therefore, the registered nurse normally has to take the role of clinical nurse leader and guide care by clinically leading the other team members Benchmark – Effective Approaches in Leadership and Management. This is achieved by delegation of duties. The registered nurse in this case may be administratively involved in the management of the unit or not. That does not exclude her from taking the clinical leadership role. In the face of a shortage of nurses because of high staff turnover, however, the registered nurse who is the clinical nurse leader will find it difficult to maintain professional standards of practice. Yet this is exactly what must be maintained despite all the staffing difficulties.

The answer to the above situation lies in resourceful delegation of duties by the clinical nurse leader, such that the professional nursing standards of practice are respected at all times in the face of the nursing shortage. Care plans must still be made, and individual patient outcomes must still be achieved. The clinical nurse leader can thus delegate appropriate tasks to the other registered nurses in the team because these may not require direct supervision. Other lesser tasks will be delegated to enrolled nurses and both direct and indirect supervision employed depending on their experience. Then the nurse assistants can help the patients with activities of daily living such as feeding and bathing.

Role of the Nurse Manager in a Situation of Nursing Shortage Due to Turnover

In a situation in which there is a shortage of the nursing workforce, the role of the nurse manager becomes very important. This is because patient safety

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