Nursing Turnover: Effective Approaches in Leadership and Management

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Nursing Turnover: Effective Approaches in Leadership and Management


The success of organizations usually depends on a variety of factors. According to Kurnat-Thoma et al. (2017), the necessity to evaluate the facility’s operational effectiveness by means of employee turnover enhances the creation of a supportive work environment and quality improvement. Managers and leaders have to recognize the needs of nurses, and their approaches and styles play a crucial role. In this paper, professional standards of nursing practice, nursing turnover, and the transformational leadership style will be discussed to promote patient safety and quality care.

Nursing Turnover

Nursing turnover is a problematic issue in modern healthcare systems around the globe. It is a tendency when nurses leave their jobs or even professions because of burnout, the lack of benefits, and the rise of demands (Halter et al., 2017). Organizations suffer because of the necessity to find new people, check their skills, and understand the requirements of a positive environment. Employees are not able to grow and increase their salaries due to regular experiences and well-developed abilities. The hospital turnover rate is approximately 19%, and managers aim to reduce it by 3.2% on average (Nursing Solutions, 2019). It happens because of poorly chosen leadership styles, inexperienced management approaches, and unstable cooperation.

Impact on Quality of Care

Nursing turnover occurs suddenly and has to be solved in a short period. Its impact on care is important because the absence of experienced and skilled nurses decreases the quality of services (Kurnat-Thoma et al., 2017). New employees are not aware of hospital standards and misunderstand their responsibilities (Halter et al., 2017). Cooperation between the staff is poor, which leads to care retardation. When nurses know each other, they can support, motivate, and exchange information about patients quickly. Turnover means that nurses should not only spend additional time studying their working opportunities but also investigate their patients, resources, and clinical guidelines. The quality of care is not as high as expected, and medical workers focus on the development of effective interventions.

Impact on Patient Safety

As soon as care quality is decreased, other challenges may occur, and patient safety is one of them. Turnover means that new nurses have poor knowledge about scheduling, orientation, and communication in a particular healthcare facility. These factors put patients and the conditions under which they receive treatment and care at risk (Kurnat-Thoma et al., 2017). If a hospital has enough nurses and resources, there are no questions about the quality of services.

However, turnover proves the growth of problems among the staff and increased safety risks. Nursing workload provokes care delivery and the promotion of negative outcomes. Nurses make mistakes, confuse their duties, and fail to help patients and their families. Researchers frequently discuss associated cost consequences to prove the impact of turnover on patient safety (Halter et al., 2017). Instead of cooperating with patients, nurses correct their mistakes and investigate the ways of improvement and required standards of care in nursing practice.

Professional Standards of Practice

One of the ways to reduce the impact of nursing turnover on patient safety and care quality is to pay close attention to understanding professional standards of nursing practice. For example, a nursing home that has been challenged by turnover during the last year requires improvements. Nurses poorly know their obligations to explain to their managers and leaders what is going wrong in a facility. The American Association of Nurse Practitioners (2019) developed a guide with standards where licensed and independent practitioners recognize their roles in providing specialized and medical care in various settings.

Professional conduct is maintained when nurses realize that performing assessments and the development of comprehensive care plans are not their only duties. To rectify the problem of turnover and improve care quality, interprofessional and collaborative responsibilities, patient advocacy, and continued competence should never be ignored (American Association of Nurse Practitioners, 2019). Nurses become care providers, mentors for patients, researchers, and team partners, and their leaders must support them by any means.