PLEASE REPHRASE Nurse turnover in the hospital

PLEASE REPHRASE Nurse turnover in the hospital and other healthcare settings has negative impacts on patient’s quality of care in such environments. The reason for this is that a nurse is the one healthcare professional who is always in contact with the patient and delivers the end-product of healthcare institutions. Nurse turnover has negatively impacted the quality and continuity of patient care. Other than that, nurses also demonstrated through their study that nurse turnover affects workgroup learning, influencing patient outcomes. High nurse turnover is related to the lower overall quality of nursing care. It may also increase mortality rates in hospitals and other nursing homes. Furthermore, nursing turnover lowers effectiveness because new employees are not familiar with an organization’s standard operating procedures and other protocols. The high turnover may also increase operational costs to the organization, which is bad for the bottom line in fiscal terms. Numerous studies have therefore shown an undisputed statistical association between nurse turnover and health outcomes. Ensuring Nursing Professional Standards According to standard number 3 of the American Nurses Association’s Standards of Professional Nursing Practice, the registered nurse is tasked with identifying the expected outcomes for each patient (ANA, 2015). This is in appreciation of the fact that the registered nurse is mandated to plan care for each patient in the care of her team. In this nursing care plan, the registered nurse clearly outlines individualized patient outcomes and works towards achieving them 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, the registered nurse typically takes the clinical nurse leader role and guides care by clinically leading the other team members. A delegation of duties achieves this. 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 precisely what must be maintained despite all the staffing difficulties. The answer to the above situation lies in a 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. Nurses must make care plans, and individual patient outcomes must 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. Additional lesser charges will be empowered to enrolled nurses, and direct and indirect control will be 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 where there is a nursing workforce shortage, the nurse manager’s role becomes crucial. This is because patient safety must remain a priority at all times. As such, the nurse manager must find ways to mitigate the nurse shortage’s harmful effects. 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. Meeting organizational expectations outlined in its strategic plan. Different nurse managers will adopt different approaches to the situation. Some will resort to authoritarianism 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 tasks before allocating them. Of course, this approach is counterproductive and can only worsen the situation as more nurses will leave, compounding the turnover crisis. 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 why the clinical 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 ensure that the working environment is conducive despite work pressure. The staff members will then feel appreciated and deliver only their best. This is the essence of transformational leadership. In doing all these, the nurse managers will apply the principles of management, which are authority and responsibility. They will delegate these to the other nurses, who 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 the 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 prevail. 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 will be a danger to patient safety, as nurses suffering from burnout have often committed medication and nursing errors. Leadership style As stated above, the leadership style that best addresses the nurse turnover issue is transformational leadership. This is a style that ensures motivation to the staff, a conducive and welcoming work environment, and an understanding ear. However, the lack of succession planning has made replicating this kind of leadership difficult, though it remains the best for this situation.

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