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Nursing Shortage and Nurse Turnover
In the United States of America, various factors influence the availability of registered nurses. The total number of licensed registered nurses in America exceeds 3.3 million (Rosseter, 2014). This number could be construed to be adequate for the health needs of the country. However, many dynamics influence the supply and demand for nursing services in the country. For instance, nurse turnover has been very high in the US and not all the registered transition to work as health care providers. Also, there is an increased need for health care due to the aging population. The nursing teaching faculty has also been overstretched. Furthermore, nursing schools in the US have been struggling to expand their capacity to meet the required training needs. Economic and non-economic factors contribute to the nursing shortage and turnover. For example, a poor work environment that demoralizes the nurses and leads to high turnover. However, managers and leaders can provide solutions to create a healthy work environment and hence attract more nurses.
Work Environment
There is adequate evidence that shows that a good work environment characterized is influenced by leadership and management practices that contribute to the satisfaction of staff, retention, and improved health care delivery (Sherman & Pross, 2010). As a result, organizations that deal with nurse related activities such as The Nursing Organizations Alliance have pointed to the importance of managers and leaders in promoting healthy work environments. The alliance noted that the environment of work has been a major issue that has resulted in high nurse turnover. The shortage of nurses has also been aggravated by the numbers of nurses who are retiring. This is against a small number of the nurses joining the profession coupled with the nurse turnover. To attract more nurses, leaders, and managers need to collaborate to transform the work environment of the nursing units. Different approaches can be applied to enhance the environment. An example of an approach that is widely used in the nursing field is the Robert Wood Johnson Foundations (RWJF) approach.
Robert Wood Johnson Foundations (RWJF) Approach
RWJF is an approach that promotes holistic care delivery. The approach is designed to ensure that the health care providers are motivated and to guide the management and leadership of hospitals to create a healing environment. Thus, it covers the dimensions of an advanced leadership approach, transforming work processes, transforming physical design, and transforming hospital culture (Hassmiller & Cozine, 2006). Hassmiller and Cozine (2006) notes, A hospital where patient safety is assured, quality of care is paramount, efficiencies are maximized, and staff are satisfied with and actively supported in their jobs attracts high-quality staff (p. 2). Nevertheless, such an environment cannot be achieved if no management team is dedicated to quality care delivery. Besides the leadership of the hospitals play a critical role in enhancing a friendly work environment.
Roles of Managers and Leaders
According to Cipriano (2011), nurse managers at different levels have the mandate of addressing the emerging trends in nursing and in advancing innovative ideas. They are supposed to lead nurse and contribute to the success of the organization. Cipriano (2011) noted that nurse managers are expected to oversee the operations, budget, and participate in the creation of an environment that upholds employee engagement and professional practice. As a result, they are best placed to liaise with the top management or the concerned government department to create policies that promote a good work environment in the nursing units.
The nurse managers should work in collaboration with the human resource management department to put in place strategies that promote the well-being of the nurses. Studies have shown that increased workload contributes to the high rate of nurse turnover. Furthermore, the workload leads to the nurses burning out and hence affecting the care delivery. Managers can remedy the problem by initiating a work program where nurses have enough rests. In conjunction with human resource management, initiation of programs such as the work-life balance combined with good work units can motivate nurses and reduce the attrition rate.
To ensure that the RWJF dimensions are achieved, nurse leaders are required to promote healthy work relationships at the nursing units. The nurse leaders contribute to building a positive social environment by motivating and inspiring the nurses. This is achieved by adopting a transformative leadership where nurses can freely share their concerns. Also, the leaders can create a social support system to address the concerns of the new entrants who normally leave the profession due to the workload and lack of preceptorship programs. Studies have shown that preceptors play a significant role in guiding new nurses to fit into their roles. They also advise nurses on ways to overcome the common work challenges in the nursing field. Therefore, nurse leaders have an important role in motivating and providing directions, which are vital to achieving healing environments. The processes can be achieved through the collaboration between the leaders and the managers to better the work units.
The collaboration can be anchored in a leadership style that encourages participation of all stakeholders. As noted, transformative leadership style which is based on transformative theory promotes a work environment where every employee is at liberty to voice concerns. Hutchinson and Jackson (2013) stated that it encourages an environment of creativity and innovations. Such an environment can motivate the nurses and contribute to the healing environment stipulated by RWJF. The leadership approach enhances confidence among the employees and makes them feel part of the system due to the shared decision-making process.
My Personal and Professional Philosophy of Nursing
Nursing is a profession that has great importance in the healthcare sector. My personal and professional philosophy is that nursing is a vocation which confers responsibility to registered nurses to provide holistic, safe, and patient-centered care. To deliver comprehensive care, a nurse has to work with other professionals to build a cohesive team that will heal and provides the patients with the best care. Concerning the belief in the provision of holistic care, a healing environment plays a critical role in the work of a nurse as it directly affects both the nurse and the patient. Therefore, an approach that enhances a good work environment is imperative to my practice. In such a case, the approach that fits my philosophy is the RWJF approach. This is because it has the key dimensions that define holistic care and healing environments, i.e. leadership approach, transforming work processes, transforming physical design, and transforming hospital culture. It is worth noting that the dimensions play a critical role in motivating and reducing nurse turnover.
References
Cipriano, P. (2011). Move up to the role of nurse manager. Web.
Hassmiller, S., & Cozine, M. (2006). Addressing the nurse shortage to improve the quality of patient care. Health Affairs, 25(1), 268-274.
Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: Towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22.
Rosseter, J. (2014). Nursing shortage fact sheet. Web.
Sherman, R., & Pross, E. (2010). Growing future nurse leaders to build and sustain healthy work environments at the unit level. The Journal of Issues in Nursing, 15(1), 1-5.
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