Effective Approaches to Management and Leadership Nursing Shortage and

EffectiveApproaches to Management and Leadership: Nursing Shortage and NurseTurnover

EffectiveApproaches to Management and Leadership: Nursing Shortage and NurseTurnover

Theshortage and the turnover of nurses have remained one of the key costdrivers as well as a source of frustrations for the health leadersand managers. It has become increasingly hard to find experiencednurses and the cost of replacing those who leave is extremely high(Commins, 2011). The fact that nurses leave their present job for awide range of reasons (including workload, low compensation, and thelack of motivation) makes it even more complicated to retain nursesand avoid nursing shortage. This paper will compare and contrast theapproaches used by leaders and managers in addressing the issue ofthe shortage and the turnover of nurses.

Comparingand contrasting managers and leadership approaches

Boththe managers and leaders play critical roles in the field of nursing.The similarity between manager’s approach and leadership’sapproach is that both of them seek to reduce turnover by motivatingnurses. Managers and leaders are expected to make their contributionsto address the issue of nursing shortage and nurse turnover, buttheir approaches may differ slightly. The roles of the manager in thefield of nursing is quite complicated given that managers areexpected to run the operations of health care institutions whileensuring that all nurses play their respective roles in theseoperations. The manager can use three approaches to resolve the issueof nursing shortage and nurse turnover. First, managers are given theresponsibility for hiring new employees, which means that recruitingnew nurses can be an effective option in reducing the shortage ofnurses (Commins, 2011). Managers can use the competency-basedapproaches that will help them recruit nurses depending on theircultural fit, which is associated with a low turnover.

Secondly,managers can address the issue of nurse turnover by developing asuitable compensation package. It is the primary role of the managersto evaluate the performance of nurses and reward them accordingly(McLeod, 2007). Managers can take advantage of the assumptions of thereinforcement theory to motivate and keep nurses in their facilitieslonger. The theory of reinforcement holds that one’s behavior canbe motivated or discouraged through positive or negativereinforcement respectively (McLeod, 2007). Managers can increase thesalary and other benefits with the objective of motivating nurses andreduce their ideation to leave their present health care facilities.However, managers are given the role of ensuring that theorganizational resources are utilized in the best way possible. Thisimplies that any compensation package that is offered to motivatenurses should be commensurate with their performance.

Third,managers serve as liaison between their organizations and otherorganizations (Hill, 2014). Managers in the health care facilitiescan take advantage of this role and establish a relationship with avigorous nurse resident program and nursing schools. The relationshipwill provide nursing students with an opportunity to familiarizethemselves with the culture of the health care facilities before theyare hired. In addition, managers who hire nurses from these programshave better chances of getting effective and strong performance sincethey have enough time to evaluate the clinical performance of thenurses before recruiting them. Graduate nurses who are offered withflexible working hours to help the managers reduce the challenge ofnursing shortage. Managers can also use the outreach program (such asforums for graduate nurses), which helps them keep connected with thehealth care facility as they search for jobs. In essence,familiarizing with the culture of the organization before one ishired reduces turnover, while flexible working schedules offered tograduate nurses address the issue of nursing shortage.

Leaderscan use the participatory leadership style to motivate nurses withthe objective of lowering the rate of turnover. The participatoryleadership style involves the engagement of nurses in the processesof decision making, especially on issues that affect theirprofessional life or daily activities (Explorance Inc, 2015). Inaddition, employee engagement is positively associated with theirsatisfaction, which in turn reduces their ideation to leave theircurrent jobs (Explorance Inc, 2015). This is because allowingemployees to participate in the decision making process creates aperception their contribution to the organization is highlyappreciated. The health care facility that adopts a participatoryleadership style will also benefit because engaging members of staffincreases productivity by about 43 % (Explorance Inc, 2015).

Goodleaders appreciate the fact that employees have their personal needs.A good leader can motivate employees by embracing the Maslow’stheory of hierarchy of needs, which holds that people have somesystems that are not related to unconscious desires and rewards andthey seek to fulfill another need once the current one is fulfilled(McLeod, 2014). Therefore, an effective leader should seek tomotivate nurses using multiple factors, not just the financialrewards that are given the forms of bonuses of salary increment. Forexample, newly hired nurses may desire to achieve self actualizationat work, which means that the leader can easily motivate them byhelping them understand difficult procedures used at work. Thedesires of experienced nurses may differ slightly and may include jobsecurity. A leader can, therefore, motivate experienced nurses byemploying them on a permanent basis and give them a reassurance thatthe going concern of the organization is safe. All these effortsensure that both the newly hired and experienced nurses remain in theorganization, which in turn reduces the shortage of nurses.

Approachthat fits a personal as well as professional philosophy of nursing

Theengagement of nurses is the most appropriate and effective approachthat should be used in reducing the turnover of nurses. Theengagement of nurses is consistent the participatory leadershipstyle. An effective leader includes the ideas of other people, nursesin this case, in decision making (Explorance Inc, 2015). As aparticipatory leader, it is important to give nurses an opportunityto give feedback about the leadership direction. The participation ofnurses is the basis of determining other factors that force them toleave their current job. This is because nurses whose contribution isappreciated will feel free to inform the leader about the cause oftheir dissatisfaction before they even think of leaving theiremployer.


Theturnover of nurses is expensive, but preventing it is challengingendeavor given that nurses are motivated by many factors to leavetheir current jobs. Both the leaders and managers can resolve theissue of shortage and the turnover of nurses by motivating them.However, their approaches differ slightly. For example, managersmotivate employees using financial rewards (such as bonuses andsalary increments), while leaders use multiple approaches that arenot static under the guidance of the Maslow’s theory of hierarchyof needs. Out of all the available alternatives, the engagement ofnurses is the most effective approach that leaders should use toreduce the shortage and the turnover of nurses.


Commins,J. (2011, February 7). Fiveways to reduce nursing turnover in year one.Danvers, MA: Health Leader Media.

ExploranceInc. (2015). Six ways you can benefit from employee engagement.Explorance.Retrieved July 11, 2015, fromhttp://www.explorance.com/blog/2013/05/6-ways-you-can-benefit-from-employee-engagement/

Hill,R. (2014). Buildinggood working relationship.London: Mind Tools.

McLeod,S. (2007). Skinner operant condition. SimplyPsychology.Retrieved July 11, 2015, fromhttp://www.simplypsychology.org/operant-conditioning.html

McLeod,S. (2014). Maslow’s hierarchy of needs. SimplyPsychology.Retrieved July 11, 2015, fromhttp://www.simplypsychology.org/maslow.html