Posted: March 24th, 2023

Effective Approaches in Leadership and Management


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Nursing shortage is explained when the demand for professional nursing practitioners such as the registered nurses exceeds the supply of the caregivers. On the other hand, nurse turnover explains the tendency of nursing employees to leave their jobs both voluntarily and involuntarily (Cox, Willis, & Coustasse, 2014). It is worth noting that the nurse shortage and turnover have critical and undesirable outcomes in the nursing profession. Particularly, the healthcare employers realize the great loss through the disruptions and poor quality patient care resulting from the shortage and the turnover (Cox, Willis & Coustasse, 2014). Evidently, the nurse shortage and turnover present a critical issue to both the nursing leaders and nursing managers. Therefore, by analyzing the approaches that would be embraced by the nurse leaders and managers in resolving the issue of nursing shortage and nurse turnover, possible factors will be found to increase the number of caregivers in healthcare sector.

How Nursing Shortage and Turnover is Approached by Leaders and Managers

It is worth appreciating that nurse turnover can both have its advantages and disadvantages, especially to any organization. In fact, the good turnover occurs when the employee is fired by the management while the bad turnover ensues when a well-behaved and desirable nurse opts to resign from his/her position. Consequently, the nurse turnover issue has direct impacts on the performance and profitability of the healthcare organizations. To start with, although the terms “leadership” and “management” are often used interchangeably, both titles carry different meanings as applied to the nursing profession. Huber (2013) avers that not every nurse manager portrays traits of an effective nurse leader, and the nursing leaders are not necessarily good managers. Notably, a nurse manager has an assigned role in the organizational hierarchy and participates actively in the decision-making processes. In contrast, a leader may not have any recognized roles or powers within the organization (Huber, 2013). In fact, a leader is often defined by the power of the individual to influence others through interpersonal skills and communication. Accordingly, nurses might demonstrate leadership skills at all levels of experience and stages of career development.

Furthermore, to resist the tendency of the nurse turnover and shortage, the leaders should develop an effective understanding of the work environment within which the nurses operate (Butts, Bandhauer, & Rich, 2013). Through the understanding, the leaders should find out the issues affecting the nursing practitioners, including the high rates of turnover or the shortage. Therefore, an unofficial frontrunner would be expected to communicate with any particular nurse before making the decision to leave. In addition, the mentorship skills acquired will position a nurse leader strategically to share insights and knowledge that would be valuable to fellow nurses, hence lowering the rate of nurse turnover. Besides, the leaders are known to rely on critical thinking as well as the ability to envision a positive future (Butts, Bandhauer, & Rich, 2013). Accordingly, the mentors also employ the principles of inspiring, motivating, and empowering others to influence their decisions.

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Similarly, the nurse managers have critical roles in handling the issue of nurse turnover and the nursing shortage because they possess the power to influence decisions and organizational processes, hence the responsibility of addressing the issue. Moreover, just as the leaders, managers also rely on critical thinking and the ability to visualize a positive future while addressing the issue of the nursing shortage and nurse turnover (Butts, Bandhauer, & Rich, 2013). Again, the effective nurse managers are empowered through skills to coordinate resources in the form of personnel and finances to meet the goals and objectives of the organization. Indeed, control as a key element in the duties of the nurse manager enables him/her to employ reward and punishment effectively in tackling the issue of the nursing shortage and nurse turnover.

Theories, Principles, Skills, and Roles of the Leader versus Manager

There are various principles that guide the roles of the nursing management. First, the evidence-based management practices are critical doctrines that encroach on decision-making. Accordingly, the manager would employ research in improving the working environment to overcome the challenges of the nursing shortage and the turnover rates. Therefore, the nursing managers are expected to improve the healthcare working environment for the nurses through the following ways. Firstly, the managers should balance the tension between effectiveness and efficiency. Secondly, the managers have the power to create and enforce trust among the working nurses. Thirdly, the managers are obliged to handle the process of change in the organization. More practically, the managers should create a learning environment and involve the other nursing personnel in work design and decision-making processes (Butts, Bandhauer, & Rich, 2013). Therefore, these ways are considered critical and effective in addressing the concerns of nursing shortage and nurse turnover. Principally, the managers are expected to merge the disciplines of labor relations, human relations, and personnel management for effective administration of nursing shortage or nurse turnover. Besides, managers would have to harness such critical skills as communication, motivation, and leadership if they were to address the healthcare issues effectively (Butts, Bandhauer, & Rich, 2013). Finally, the recruitment and hiring process would require that the manager ensure that the organization acquires skilled and motivated nursing workforce as a measure to counter high rates of turnover and shortages of the nursing personnel.

According to the “Novice to expert theory,” leaders in the nursing field would appreciate the gradual process of learning and the five critical competencies of the nursing practitioners (Butts, Bandhauer, & Rich, 2013). In fact, the skills of a novice, advanced, beginner, proficient, competent, and expert are developed through the time. Accordingly, the leaders would approach the issue of the nursing shortage and turnover for the nurses from the five levels scheme to develop an accommodating system for the future practitioners. Besides, the leader would utilize the independence in decision-making, his/her personal skills in solving problems, as well as critical thinking to influence change within the organization as guided by the novice to expert theory.

Finally, leaders would approach the issue of nursing shortage and nurse turnover through the diversity in leadership styles. For instance, to counter the challenge of shortage of increased turnover, transactional leaders would use rewards to attract and retain the nurses (Giltinane, 2013). Likewise, for the transformational leaders, identifying the strengths of the nurses and building on the self-esteem aspects would work to overcome the challenge of personal satisfaction in the nursing. As such, particular situations would also be best handled by the leaders exhibiting the situational leadership traits (Giltinane, 2013). For instance, with the rampant loss of employees, the situational leaders would address the issue through contingent measures as influenced by the prevailing circumstances.

Approach that fit Personal and Professional Philosophy of Nursing

My duty as a nurse is to arm myself with all the knowledge and skills to attain the goals of preserving health and eventually save lives. I also have the commitment to be updated with the entire relevant concept in my dynamic nursing career and always pursue self-enhancement through continuous learning. Under those study engagements, I ensure that I do not remain stagnant in my philosophies, but embrace professionalism through technology as well as evidence-based advances. In addition, I will always continue learning through relevant journals and books and more importantly engage in the interactions with my fellow members of the nursing team and the experiences of my patients and their families. I will always consider development through knowledge to improve my skills as a nursing practitioner.

In essence, I always endeavor to uphold professional and personal ethical standards in my entire career. For instance, when there is a conflict between my patient’s and my personal beliefs, I always struggle to find a mentor who would guide me through the encounter and eventually come up with a solution that satisfies the patient’s need without compromising my personal belief system. In essence, my approach is suited to my personal leadership style in various ways. First, I believe in the “Novice to expert theory” where everything must be improved to achieve expertise. Therefore, my approach is to examine the situation, try to learn from it and before I tackle anything, I must ensure that I am guided by the most appropriate method that has shown positive results. Finally, I must assist and support my fellow nurses, healthcare providers, and nurse students to offer positive team environments to their patients.


From a subjective position, any person at the management level would need to exhibit definite leadership traits. Through such personalities, the manager, just like the leader, should address the issue of the nursing shortage and the high rates of nurse turnover by guiding the aspects of the theory. Therefore, the philosophy of everyone being a leader at a personal level would break out the above argument. Accordingly, instead of a practicing nurse leaving the current occupation because of manageable issues, one would employ the skills learned in the developmental stages outlined by the novice to expert theory and understand that all matters arising would always have a solution. In essence, the high rates of nurse turnover and the overall nursing shortage would be handled through improved interpersonal relations and the personalized approach in maintaining the nursing discipline.

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