Benchmark – Effective Approaches in Leadership and Management
Nursing practice has many issues that affect it. These issues may be related to the work environment, remuneration, or professional development among others. For instance, nurse may find that they are not as productive as they would wish because the work environment they are in curtails their resourcefulness. Most of the time, this kind of scenario is related to oppressive leadership on the part of nurse managers. The nurse may also find that the remuneration they are getting for their services are not congruent with the skills that they have and the workload. Or they may find that the organizational policies towards professional development in terms of…
In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following: Benchmark – Effective Approaches in Leadership and Management
Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue. Benchmark – Effective Approaches in Leadership and Management
Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.
Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.
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Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
This benchmark assignment assesses the following programmatic competencies:
RN to BSN
1.1: Exemplify professionalism in diverse health care settings. Benchmark – Effective Approaches in Leadership and Management
1.3: Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.
3.4: Demonstrate professional standards of practice.
Effective Nursing Leadership in the Face of High Nursing Staff Turnover: The Role of Leadership Style in Ensuring Patient Safety
Nursing practice has many issues that affect it. These issues may be related to the work environment, remuneration, or professional development among others. For instance, nurse may find that they are not as productive as they would wish because the work environment they are in curtails their resourcefulness. Most of the time, this kind of scenario is related to oppressive leadership on the part of nurse managers. The nurse may also find that the remuneration they are getting for their services are not congruent with the skills that they have and the workload. Or they may find that the organizational policies towards professional development in terms of training, upskilling, and reskilling are not favorable to them. All these factors normally lead to one undesirable outcome – high nurse turnover. This paper is about this issue of high nurse turnover in nursing practice and the role of the nurse manager in ensuring that patient safety is safeguarded in the face of a reduced workforce. Benchmark – Effective Approaches in Leadership and Management
Nurse turnover in the hospital and other healthcare settings negatively impacts the quality of care that patients receive in such settings. This is because the nurse is the one healthcare professional that is always in contact with the patient and actually delivers the end-product of healthcare institutions. According to Bae et al. (2010), nurse turnover has been shown to negatively impact both the quality and continuity of patient care. Apart from that, they also demonstrated through their study that nurse turnover affects workgroup learning which in turn influences patient outcomes. This position is supported by Antwi and Bowblis (2018) who opine that high nurse turnover is related to lower overall quality of nursing care. Benchmark – Effective Approaches in Leadership and Management According to them, it may also mortality rates in the hospital and other settings like nursing homes. Furthermore, nursing turnover has the effect of lowering effectiveness because new employees are not familiar with an organization’s standard operating procedures and other protocols. In fact, the high turnover may also increase operating costs to the organization; and this is detrimental to the bottom line in fiscal terms. Numerous studies have therefore shown an undisputed statistical association between nurse turnover and health outcomes (Antwi & Bowblis, 2018).
Ensuring Nursing Professional Standards of Practice are Observed
According to standard number 3 of the American Nurses Association’s Standards of Professional Nursing Practice, the registered nurse is tasked with identifying the outcomes that are expected for each individual patient (ANA, 2015). This is in appreciation of the fact that it is the registered nurse who is mandated to plan care for each patient in the care of her team. It is in this nursing care plan that the registered nurse clearly outlines individualised patient outcomes and works towards achieving them together with her team. The team in a typical healthcare setting usually includes other registered nurses, enrolled nurses, and nurse assistants. To achieve the desired patient outcomes, therefore, the registered nurse normally has to take the role of clinical nurse leader and guide care by clinically leading the other team members Benchmark – Effective Approaches in Leadership and Management. This is achieved by delegation of duties. The registered nurse in this case may be administratively involved in the management of the unit or not. That does not exclude her from taking the clinical leadership role. In the face of a shortage of nurses because of high staff turnover, however, the registered nurse who is the clinical nurse leader will find it difficult to maintain professional standards of practice. Yet this is exactly what must be maintained despite all the staffing difficulties.
The answer to the above situation lies in resourceful delegation of duties by the clinical nurse leader, such that the professional nursing standards of practice are respected at all times in the face of the nursing shortage. Care plans must still be made, and individual patient outcomes must still be achieved. The clinical nurse leader can thus delegate appropriate tasks to the other registered nurses in the team because these may not require direct supervision. Other lesser tasks will be delegated to enrolled nurses and both direct and indirect supervision employed depending on their experience. Then the nurse assistants can help the patients with activities of daily living such as feeding and bathing.
Role of the Nurse Manager in a Situation of Nursing Shortage Due to Turnover
In a situation in which there is a shortage of the nursing workforce, the role of the nurse manager becomes very important. This is because patient safety must remain a priority at all times. As such, the nurse manager must find ways of mitigating the negative effects of the nurse shortage. This calls for experience, ingenuity, and resourcefulness. Their roles therefore include maintaining standards of care and patient safety, motivating their remaining staff to carry out the immense task without feeling overburdened, and meeting organizational expectations outlined it its strategic plan. Different nurse managers will adopt different approaches to the situation. There are those that will resort to authoritarianism in order to get things done. This kind of nurse manager will forcefully delegate extra duties to her staff due to the pressure of work and the lack of time to discuss over tasks before allocating them. Of course this approach is counterproductive and can only lead to worsening of the situation as more nurses will leave compounding the turnover crisis Benchmark – Effective Approaches in Leadership and Management. Other nurse leaders will adopt a more consultative and teamwork approach. To begin with, they will put on the gloves themselves and carry out tasks alongside the other staff members. This is the reason why the cl9inical nurse leader should first and foremost be a clinical expert with vast clinical experience. This way, they can fill in where there is a shortage even as they delegate other tasks to the other nurses in the team. This other nurse manager will then make sure that the working environment is conducive despite the pressure of work. The staff members will then feel appreciated and deliver only their best. This is the essence of transformational leadership (Cheng et al., 2016). In doing all these, the nurse managers will be applying the principles of management that are authority and responsibility in that they will be delegating these to the other nurses, even as they retain accountability for all the tasks.
Additional Measures the Nurse Leader and Manager Can Take in the Face of Nurse Turnover
There are additional measures that the nurse leader can institute to make sure that patient safety, professionalism, and standards of practice remain respected. She can make sure that skill mix in her team is correct. Regardless of the shortage, as the nurse and clinical manager she must ensure that the right skill mix among the registered nurses, enrolled nurses, and nurse assistants prevails (Moore, 2012). She must also make sure that she monitors her remaining staff more closely for signs of burnout such as increased irritability. This is because burnout itself will be a danger to patient safety as nurses suffering from burnout have been known to commit medication and nursing errors often.
As stated above, the leadership style that would best address the issue of nurse turnover is transformational leadership. This is a style that ensures motivation to the staff, a conducive and welcoming work environment, and an understanding ear (Cheng et al., 2016). Lack of succession planning has however made it difficult to replicate this kind of leadership, though it remains the best for this situation (Balogh-Robinson, 2012).
Conclusion
High nursing staff turnover is a menace to all healthcare organizations. It has got detrimental effects to the standard of care that is delivered by the remaining staff since they get overwhelmed with work. To effectively manage its impact, transformational nurse leadership is required. Benchmark – Effective Approaches in Leadership and Management.
References
American Nurses Association [ANA] (2015). Nursing scope and standards of practice, 3rd ed. Silver Spring, MD: Author.
Antwi, Y.A. & Bowblis, J.R. (2018). The impact of nurse turnover on quality of care and mortality in nursing homes: Evidence from the great recession. American Journal of Health Economics, 4(2), 131–163. https://doi.org/10.17848/wp15-249
Bae, S.-H., Mark, B., & Fried, B. (2010). Impact of nursing unit turnover on patient outcomes in hospitals. Journal of Nursing Scholarship, 42(1), 40–49. Doi:10.1111/j.1547-5069.2009.01319.x
Balogh-Robinson, L. (2012). The crisis in leadership in the context of the nursing shortage and the increasing prevalence of nursing unions. Journal of Healthcare Leadership, 127-139. Doi:10.2147/jhl.s34024
Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200–1216. Doi:10.1108/pr-05-2015-0118
Moore, A. (2012). Getting ratios right, for the patients’ sake. Nursing Standard, 26(31), 16-19. Doi: 10.7748/ns2012.04.26.31.16.p8021 Benchmark – Effective Approaches in Leadership and Management