Research Paper on Nurses: Challenges Facing the Profession & Impact on Quality Care

Introduction

Nursing as a profession faces similar challenges to other forms of employment, which impact on the quality care delivered. Nurses are one of the primary players in the healthcare sector, particularly of individuals, families, and even communities. They ensure populations attain and maintain a high quality of life and optimal care. Nurses work closely with physicians in a majority of the healthcare settings, and therefore, potential employment issues tend to affect the two professions. The job turnover is a significant problem faced by nurses because it results in nurses leaving their occupations in search of other job opportunities. The turnover of nurses negatively impacts on quality of care and need to be corrected nursing leaders and nursing managers using professional standards of practice through the established leadership styles.

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An Issue from the Following List

Nursing turnover is an undesirable trend for the majority of the healthcare facilities due to the potential negative impacts it holds.

How the Issue Impacts the Quality of Care and Patient Safety in the Setting it Occurs

The process is disruptive, expensive, and jeopardizes the quality of care and patient safety. For instance, a particular family or population had been used to a specific group of nurses who aligned with their values and cultures. A turnover may likely bring in newer nurses without adequate knowledge of the values and cultures of the patients. Unless a turnover is exceptional, probably originating from dismissal or poor performance, higher rates of nurse turnover would be a concern for any employer entitled to offer quality care.

Nurse turnover has a wide range of negative impacts on the delivery of quality care based on the perspectives of nurses, physicians, nurse managers, and even patients. Nurses are likely to experience periods where they have unmanageable workloads due to the inadequacy of personnel (Dewanto & Wardhani, 2018). Whenever nurses in a particular department are understaffed, they are overloaded with work. The senior nurses are the most likely to face huge workloads as they try helping out the new nurses adapt to their environments. Turnover makes it difficult for nurses to adapt and build new relationships, teamwork, and trust with the new teams or workers. Additionally, most of the nurses feel reluctant to repeatedly learn to adapt to new work environments and forging new relationships.

The high turnover of the nurses may develop negative perspectives of physicians about the new employees. Doctors may perceive that the high rates of turnover are caused by the lack of skills of the nurses, where incompetence is likely to disrupt the delivery of quality services (Dewanto & Wardhani, 2018). Some doctors may also be unwilling to repeatedly teach and help new personnel to adapt to their new job roles. Consequently, physicians' complaints become inevitable. Patients may also develop negative perspectives that either the healthcare center is not professional or nurses generally lack skills. As a result, they develop satisfaction and trust issues while others may raise concerns about the services offered by the nurses.

Overall, the turnover of nurses disturbs the delivery of hospital services due to disruptions in staffing practices (Kovner et al., 2014). An organization is likely to be missing out on experienced and more skilled employees in exchange for inexperienced and less skilled nurses. Additionally, the interruption of the staffing practices creates further problems in the recruitment and managerial processes. The manager may be tasked with the role of conducting frequent replacements that are time-consuming, thereby eating much of their time that could be used on other productive duties. Moreover, the turnover is expensive due to the recruitment, training, and other costs related to termination.

Professional Standards of Practice

Nursing managers may develop a set of techniques that could be used to reduce the high rates of turnover in healthcare facilitates. First, they need to hire the right people during the recruitment process. The hiring process should be comprehensive to include thorough interviews and screening to ensure that the chosen candidates demonstrate the competency and necessary skills needed to fill the vacant positions. Nursing managers need to refrain from rushing in the recruitment and selection processes.

Nursing managers need to develop effective training programs for new employees. They need to foster the skills, knowledge, and attitudes needed to develop a workforce of high performing employees. The training would also filter out incompetent nurses since they would not see any opportunities for them to succeed in their careers.

Nursing managers need to create an effective reward system for meeting practice goals and individual targets. Employees become happier and more committed to their work whenever their efforts get recognized. Additionally, they can be offered competitive benefits and pay that values their work-life balances to keep them more productive all through.

Alternatively, nursing managers need to conduct regular evaluations to assess the performance of nurses. The employees need to be guided accordingly to be accountable for their deeds by improving their performance and employing the most effective strategies for meeting individual targets.

Differing Roles of Nursing Leaders and Nursing Managers in this Instance

Nursing leadership constitutes the process of influencing people to enthusiastically and willingly achieve their individual and organizational goals (Antrobus & Kitson, 1999). Nursing management is defined by the status of the formal role accorded to a person who is expected to carry out specific duties and responsibilities. Although nursing leaders and managers are expected to exhibit a particular set of quality characteristics such as trustworthiness, critical thinking, empathy, and excellent communication amongst others, leaders excel in good communication and interpersonal skills that are used to influence the subordinates.

The difference between leadership and management is attributed to models developed to explain their approaches. For example, leadership theories include transformational leadership, Servant Leadership, adaptive leadership, Leader-Member Exchange Theory, and Strengths-Based Leadership (Sarabi, 2015). On the other hand, theories of management include Scientific theory, administrative theory, bureaucratic theory, human relations theory, and X&Y theory (Raduan, Jegak, Haslinda & Alimin, 2009). These theories have different approaches to leadership and management; while leadership focuses on influencing the subordinates, management uses the positional power to get things done.

Additional Aspects Managers and Leaders Need to Initiate

Managers and leaders can increase their professionalism in different ways throughout a diverse health care setting to reduce nursing turnover. The managers and leaders need to work closely with the human resource manager on the improvement of talent acquisitions (Meyers, Van Woerkom, & Dries, 2013). Recruiters and hiring managers need to thoroughly explore the background fit of the candidates to determine their engagement levels. The leaders need to professionally align with morale, engagement, patient safety, satisfaction, and other quality measures. Managers need to harness the available employees' management tools based on behavioral sciences to achieve critical competencies such as customer orientation, willingness to learn, and compassion (Donavan & Hocutt, 2001). Other strategies that could be used relate to making the employees feel valued and an integral part of the organization's culture. Nursing managers and leaders need to commit employees in the processes of organizational growth and success.

Leadership Style to Address the Chosen Issue

I would recommend the transformational leadership style in solving the high rates of nursing turnover. James McGregor brought the concept of transformational leadership in the 1970s, where the style of leadership entails a leader connecting with subordinates in ways that realize morality and motivation (Diaz-Saenz, 2011). Transformational leadership is based on morality and motivation for the collective good of the involved parties. The model allows leaders to inspire, encourage, and to motivate the staff to create change and innovate ways of helping them shape and grow their future (Zhu, Riggio, Avolio, & Sosik, 2011). The framework helps managers to create a sense of employee independence, ownership, and corporate culture.

References

Antrobus, S., & Kitson, A. (1999). Nursing leadership: influencing and shaping health policy and nursing practice. Journal of Advanced Nursing, 29(3), 746-753.

Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing, 17(2), 52.

Diaz-Saenz, H. R. (2011). Transformational leadership. The SAGE handbook of leadership, 5(1), 299-310.

Donavan, D. T., & Hocutt, M. A. (2001). Customer evaluation of service employee's customer orientation: extension and application. Journal of Quality Management, 6(2), 293-306.

Kovner, C. T., Brewer, C. S., Fatehi, F., & Jun, J. (2014). What does the nurse turnover rate mean, and what is the rate? Policy, Politics, & Nursing Practice, 15(3-4), 64-71.

Meyers, M. C., Van Woerkom, M., & Dries, N. (2013). Talent-Innate or acquired? Theoretical considerations and their implications for talent management. Human Resource Management Review, 23(4), 305-321.

Raduan, C. R., Jegak, U., Haslinda, A., & Alimin, I. I. (2009). Management, strategic management theories, and the linkage with an organizational competitive advantage from the resource-based view. European Journal of Social Sciences, 11(3), 402-418.

Sarabi, A. (2015). Active leadership can promote leadership effectiveness in healthcare organizations. International Journal of Hospital Research, 4(1), 21-26.

Zhu, W., Riggio, R. E., Avolio, B. J., & Sosik, J. J. (2011). The effect of leadership on follower moral identity: Does transformational/transactional style make a difference? Journal of Leadership & Organizational Studies, 18(2), 150-163.