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Nursing Shortage and Turnover Management


A nursing shortage and turnover remain to be a serious problem for many American hospitals. Thousands of nurses are eager to leave their jobs in the next year after their graduation due to poor or unstable working conditions, long working hours, and the amount of work that has to be performed (Boamah & Laschinger, 2016). In this paper, several theories and practices will be discussed to understand what kind of work can be done by nursing leaders and managers to promote the decrease of a shortage and turnover, what philosophies and approaches may inspire nurses, and what funding source can be used to support medical workers in Florida.

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Nursing Shortage and Turnover in the United States

In this project, two main nursing concepts have to be identified: shortage and turnover. A nursing shortage is a current problem of many American organizations when the demand for professional nurses turns out to be higher than its current supply (“The nursing shortage,” 2018). As soon as a facility experiences a nursing shortage, the quality of healthcare undergoes considerable changes and negative outcomes. Turnover is another challenge when the movement of employees cannot be controlled by the employers, and the number of leaving nurses influences the overall performance of an organization.

The reasons for these problems may vary, including unexpected or unclear healthcare reforms, increased population, the age of retirement, or poorly developed nursing programs that cannot promote the required number of nurses. In addition, a nursing shortage may be defined as one of the possible reasons for poor job satisfaction, organizational conflicts, increased emotional changes, and stress (“The nursing shortage,” 2018). Regarding such causes and outcomes, there is a burning need to solve this problem and promote some changes at the organizational level including the possible impact of leaders and managers.

The Role of Leaders and Managers

There are many methods of how nursing leaders and managers can approach the solution and improvement of the situation with the nursing shortage and turnover. For example, according to Lewin, there are three main styles of leadership that can be applied to nursing practice: autocratic (when all decisions are made by leaders), democratic (when decisions are made by leaders after thorough discussions with the rest of the team), and laissez-faire (when leaders are not involved in decision making). However, the choice of one particular style is not enough to solve the problem of the nursing shortage in organizations.

Compared to leaders who have to make decisions and motivate all employees, nursing managers are more task-oriented. They have to gather enough material for their leaders. Managers also perform the role of a guide and advisor for nurses to ensure that everything functions properly in an organization. This job includes the creation and implementation of schedules, teaching, and coaching. Leaders, in their turn, should follow appropriate completion of all tasks managers have to take. Leaders may establish policies and measures to promote order and identify responsibilities. However, despite the existing differences between these two professions, managers and leaders cannot work without each other. They complement each other in terms of motivation, decision-making, and organization. Leaders and managers have to cooperate and develop mixed approaches in their work to promote such principles as care, trust, cooperation, development, and satisfaction. To achieve such organizational goals, it is possible to use Lewin’s change theory to support nurses and Watson’s caring theory to guide nurses.

Theory One

A nursing shortage and turnover can be reduced in case leaders and managers implement some changes in their organizational processes. Some people face serious problems when a change has to be applied to a facility. Therefore, it is possible to follow the theory of Lewin and take three main steps, including unfreezing (to identify and define a problem), moving (to analyze and clarify the alternatives), and refreezing (to implement and evaluate the ideas) (Garon, 2017). Nursing turnover can be reduced when the leaders and managers clarify the reasons for why nurses want to change their jobs, get some time to think over the benefits and threats of change, and implement a new approach. The main task of leaders and managers in the discussion of this concept is not to stay and wait for some change or improvement to happen without any work. Managers have to investigate what change they can offer to the staff, and leaders have to make a final decision to reduce the number of decisions of nurses to leave hospitals.

Theory Two

In addition to organizational change, it is expected to provide nurses with a helpful guide. Despite the already received knowledge, nurses want to observe support of their leaders. Regarding this need, leaders and managers may use Watson’s theory of caring where the ideas of love and kindness, equanimity, a caring environment, and recognition of personal beliefs are promoted. This theory can help to recognize the expectations patients may have when they visit hospitals and cooperate with nurses. Similar approaches and skills may be appropriate to the relationships developed between nurses, their leaders, and mangers. As soon as leaders explain to managers what they want to observe in nursing work, managers can demand similar things from their nurses, and nurses can explain their attitudes to managers. Watson’s theory is a good approach to rely on in the discussion of nursing shortage and turnover issues.

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Approach to Nursing Practice

My personal philosophy is similar to my professional tactics when the recognition of personal needs and organizational responsibilities is required. It is wrong to expect something from people if you are not able to meet similar expectations. Therefore, I want to believe that the democratic style of leadership and a determined leadership approach can be effective for the solution of turnover and shortage problems. This choice helps to recognize personal weaknesses and opportunities and use them in the development of demands in the workplace.

Funding Source

To address the chosen issue, leaders and managers should also consider a possible funding source. According to the Title VIII of the Public Health Service Act, the distribution and supply of qualified nurses have to be supported by each state to meet healthcare needs of the population. There are many funding systems and grants that can be used by students to become nurses. These grants can increase the number of nurses and decrease nursing turnover. For example, one of the grants offered by the Health Resources & Services Administration (2016) provides about 45-50 grantees from Florida with financial aid annually. Though such support is not huge, it is regular, and students may ask for it regardless of their age, gender, and race.


In general, the discussion of the nursing shortage and turnover issues is open today. Researchers, nurses, managers, and leaders are free to make their own contributions to the promotion of solutions and alternatives. Some hospitals may not experience serious challenges because of turnover, and some organizations cannot demonstrate high-quality care as soon as a nursing shortage occurs. Therefore, it is expected to change the work of leaders and managers so that they can comprehend the level of their responsibility in regard to their nurses and develop the conditions that may be appropriate to hospitals, nurses, and leaders with the help of available funding sources.


Boamah, S.A., & Laschinger, H. (2016). The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses. Journal of Nursing Management, 24(2), 164-174.

Garon, M. (2017). Change and innovation. In D. Huber (Ed.), Leadership and nursing care management (6th ed.) (pp. 32-48). St. Louis, MO: Elsevier.

Health Resources & Services Administration. (2016). 2016 Florida health center data. Web.

The nursing shortage – Why we need more qualified nurses in the field. (2018). Web.

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