The nursing profession is experiencing an overwhelmingly grim shortage of clinical nurses. It is predicted by the U.S. Bureau of Labor Statistics that the demand for nurses is going to increase approximately 60% between the years 2008 and 2018. Of those who graduate from nursing school, 50% leave the profession within their first two years of practice (Ferrell, et al, 2011). The problem is further compounded by the aging of the currents nursing population. With such a shortage in clinical nurses our nation is facing a healthcare crisis. Patient safety and care are compromised, nurses are stressed and overwhelmed and higher turnover rates are noted (Ferrell, et al). Nurses in managerial and leadership roles must take into consideration all factors contributing to the nursing shortage and implement tactics of recruitment and retention of future and current clinical staff nurses. Below I will compare and contrast tactics nurse managers and leaders may utilize to tackle this issue. I will also discuss the approach I believe best fits my own personal and professional philosophy of nursing.
The challenge of addressing the nursing shortage and retention of experienced nurses falls upon nurse managers and leaders alike. Nurse managers and leaders are utilizing many of the same tactics to combat the nursing shortage. Problem solving, decision making, motivation and communication are skills very important to both managers and leaders. In this situation managers and leaders can make use of the contingency theory. The current nursing shortage is different than past shortages, baby boomers are aging and the demand just outweighs the supply (Ramey, 2002). Nurse managers and leaders must adapt to these changes and recruit and retain nurses based of nurse needs and wants. Communicating with clinical nurses allows managers and leaders to find a solution fitting of the problem. At this crucial time managers need to act as leaders.
Leadership often encompasses management, and while the two will face the nursing shortage in many of the same ways differences must be noted. In light of the nursing shortage much attention is being given to nurse recruitment and retention (Ramey, 2002). Working as problem-solvers under the strategic management theory managers are able to find solutions to the clinical nursing shortage crisis and apply them in ways which benefits staff and the organizations they work for. Managers need to work with executives to enact sign on bonuses, relocation packages and attractive benefits programs to entice nurses into their facilities (Nevidjon, & Erickson, 2001). They must also work with universities to facilitate increased numbers of nursing students and ongoing training.
For example, nursing orientation is now a process lasting up to six weeks after hire to enable new nurses the adequate time to gain knowledge and experience on the job training. New nurses find this helpful for short and long term career goals. Within the hospital setting nurse managers are responsible for schedules, staffing and the development of new employees. Managers need to implement flexible work schedules, satisfactory staffing ratios, competitive salaries and intensive training programs for new and veteran nurses (Nevidjon, & Erickson). It is also important for managers to make the work environment a positive place.
Leaders are in a position to bridge the gap between efforts and goals of followers with their organization. While managers approach the nursing shortage and turnover rates from the organizations point of view, leaders approach it from the clinical nurse’s perspective. Through the transformational leadership style a leader is able to influence his/her team through motivation, inclusion and a shared vision (Huber, 2010). A leader works closely with their team to determine what they need and what they consider to be important for a successful and happy work environment.
Nurses should be able to express their concerns and opinions openly without fear of negative repercussions. Nurses must be praised for their actions and included in decision making when it comes to their environment and profession. Along with the contingency theory, leaders must adapt to each situation and make decisions accordingly. In some cases, this means following a democratic style of leading. In this situation leaders can survey their staff, both new and veteran, to determine what they deem necessary to become a nurse and remain a nurse. Nurses who feel their work is appropriately recognized and valued show higher job satisfaction and lower turnover rates.
Management styles have a significant impact on job satisfaction. By implementing preferred leadership styles job satisfaction will increase leading to lower turnover rates and more successful recruitment. Based on my personal and professional philosophies of nursing, a manager who exhibits transformational leadership skills such as; motivation, consideration, influence and stimulation would be one of the strongest weapons in combating the nursing shortage. Positive relationships between clinical nurses and managers will enable a hospital to function more effectively. The staff will also function more effectively when they feel they are sharing a vision with their manager.
It is unlikely the nursing shortage will end anytime in the near future. In the short term economical strategies may help the shortage, but long term goals must include recruitment, maintenance and retention (Ferrell, et al, 2011). Emphasis needs to be placed on recruiting young adults and retaining senior nurses. Retention of senior nurses can be accomplished through short and long term goals of changing the work environment and making the profession desirable (Nevidjon, 2001). As stated above nurse managers and leaders must work together to accomplish this goal.