Leadership Skills and Attributes for Nurse Retention - Essay Example

Leadership Skills and Attributes for Nurse Retention Introduction Currently, nursing shortage is considered as a major challenge facing many health care systems in Australia and other countries around the world. According to the World Health Organisation (WHO), 57 countries have critical nursing shortages enough to negatively impact on the delivery of quality health care (WHO 2008). Although the reasons behind the shortage of nurses vary from country to country, there are certain common contributing factors. In most developed countries such as Australia, nurse shortage is considerably caused by a continuously aging labour force and decreasing enrollments of students into nurse education programmes (Gaynor, 2008; Stanley,2010). In addition to this, a considerable number of research studies have reported that poor retention of nurses within the health care setting is one of the major underlying causes of nurse shortage. Generally, the nursing profession is complex and demanding in nature. Many nurses are often subjected to excessive workload, safety risks, low pay and lack of support and recognition. This in turn causes them to experience stress, low work morale, depression and poor job satisfaction. Consequently, many opt to abscond from work regularly or permanently leave their profession as nurses (Buchan 2009; Stanley, 2010). As a result, there is need for leaders within health care setting to place greater emphasis on nurse retention. In order to enhance nurse retention within the health care system, there is need for leaders to create a supportive work environment and focus on motivating nurses. This paper seeks to examine nursing turnover as major issue that requires change within the stroke rehabilitation unit at Concord Hospital, Sydney. It then explores the leadership skills and attributes that are required in order to facilitate and effect change that will bring about nurse retention. In order to achieve these objectives, this paper foremost provides an overview of the stroke rehabilitation unit at Concord Hospital and the turnover issues that this unit faces. Secondly, it critically analyses the implications of this issue and why change is required. Moreover, it explores possible barriers to change. Lastly, this paper critically discusses the leadership attributes and skills required to effect change and evaluates the possible change process and outcomes. Impending Nurse Turnover at the Stroke Rehabilitation Unit, Concord Hospital The stroke rehabilitation unit at Concord Hospital provides comprehensive stroke rehabilitative services. Although many individuals who suffer from stroke are often left with permanent physical, psychological and cognitive impairments, this unit provides therapy services that help stroke patients to regain their normal functions and return to their normal activities (Concord Hospital, 2014; Gillien,2010). This unit accommodates both in-patient and out-patient stroke patients. Furthermore, it has a multidisciplinary team of various health personnel who work collaboratively with patients, their families and care-givers in order to meet the specific rehabilitative needs of stroke patients. Despite the fact that this unit comprises of a multidisciplinary team of various health personnel such as speech pathologists, occupational therapists, neurologist, psychiatrists and rehabilitation physicians among many others, nurses are the one who do much of the heavy lifting as far the care of stroke patients is concerned. Other health professionals, who work in this unit, work on a part-time basis. Nevertheless, nurses working in this unit have very huge responsibilities as far as the care of stroke patients is concerned. The nature of their work in this unit is extremely demanding. In some instances, nurses working in this unit are forced to work overtime, due to the demanding health needs of stroke patients. They have to grapple with not only the physical health needs of patients but also the cognitive and psychological needs of stroke patients since many patients who have suffered from stroke tend to exhibit psychological and cognitive health issues (Gillien, 2010). Besides this, nurses working in this unit receive very little support their leaders. Often times, when they are faced with issues such as stress and burnout due to the complex nature of their work and high workload they receive little or no support from their leaders. Although nurses in this unit do a commendable job, they hardly receive any recognition or reward for their performance. Consequently, in the recent past there has been significant turnover of nurses in this unit. Due to this, there is a shortage of nurses in this unit. Even so, majority of nursing working in this unit are likely to abscond from work regularly or permanently leave their profession as nurses if necessary changes are not implemented. Critical Analysis of the Issue and Why Change is Required Generally, high turnover is a major issue that is significantly contributing to the shortage of nurses in health care systems in Australia. According to a recent report by the Health Workforce Australia (HWA), due to high turnover in the nursing profession, by 2020 there will be a shortage of over 110, 000 nurses in Australia. This number is likely to increase with time (AHHA, 2012). In reference to the issues discussed in the previous section, it is evident that nursing turnover is major issue that requires change within the stroke rehabilitation unit at Concord Hospital. This issue is mainly caused by the poor work conditions that the nurses in this unit are subjected to. Not only do nurses in this unit have heavy workload, but they also receive little or no support and recognition from their leaders. Over the years, a considerable number of studies have examined the factors that instigate nurse turnover within the health care system. A study carried out by Chiu et al. (2009), established a positive correlation between job demands and low support with intention to turn over. In their findings, Chiu et al. (2009), noted that nurses working in health care settings where work was extremely demand tend to report high turnover intention. On the other hand, Currie & Hill (2011) suggest that, high turnover in nursing is largely caused by low of job satisfaction. Conversely, Donoghue & Castle (2009) attribute leadership style to nurse turnover. They observe that, leader who take in the input of their staff and involve them in decision experience low turnover (7%). However, leaders who do not take into account the input of their staff nor involve their staff in decision making experience high turnover (30%). In other studies, factors such as poor pay, low staff motivation, lack of support, poor work condition and overwork were found to contribute significantly to high turnover in nursing (Laschinger et al., 2009; Stanley,2010). Based on the findings established through the studies highlighted in the section above it is plausible to argue that the working conditions in the stroke rehabilitation unit at Concord Hospital are the major cause of the current and impending nurse turnover. As demonstrated in some studies, the shortage of nurses can result to negative outcomes such as higher mortality rates, patient injuries, infection rates, accidents, patient complaints and litigations and poor health outcomes amongst patients. Nurse turnover can lead to the loss of experienced nurses and cause health care systems to incur costs associated with recruitment, hiring temporary staff, overtime payments and staffing plans. Therefore, there is a strong need to implement change in this department in order to ensure nurse retention (Chui et al., 2009; Stanley, 2010). Barriers to Change Evidently, there is a strong need to implement change as far as the retention of nurses in this unit is concerned. Nevertheless, in the course of implementing change certain factors are likely to act as barriers to change. For example, inadequate staffing in this unit is a major barrier to change. Demanding and overwhelming workload among the nurses may make it difficult for leaders in this unit to facilitate change. As observed earlier, providing care to stroke patients is usually demanding. As a result, it may be difficult to achieve positive outcomes in the short-term unless more nursing staff are hired in order balance out the existing work demands in this unit. Additionally, the perception and attitudes of nurses in this unit about their leaders may also act as a significant barrier to change. Negative perceptions and attitudes towards the leaders in this unit, may make it difficult for them to facilitate change effectively. Some nurses may show resistance towards the initiatives introduced by their leaders due to negative perceptions and attitudes brought about by unresolved past issues (Walker et al.,2011; Zilembo & Monterosso, 2008). Leadership Attributes and Skills and Change Process and Outcomes Stanley (2010) observes that, in order to ensure nursing retention, the role of leaders is paramount. Firstly, leaders need to be flexible and approachable. This in turn makes it easy for nurses to open up and honestly communicate about the various challenges that they are facing. Benson et al (2012) and Zilembo & Monterosso (2008) suggest that in order to improve nurse retention amidst all the work challenges associated with nursing, leaders need to be supportive. They should be compassionate about issues facing nurses and work towards supporting them by providing necessary resources or manpower required to make their work more easy and fulfilling. They should also create a supportive work environment that allows nurses to feel a sense of belonging and community. This can be realised by organising out of work forums that allow nurses to interact, share their experiences and provide support to each other. Moreover, it is important for leaders in this department to develop good motivational skills. Leaders in this unit can motivate nurses by providing regular feedback and giving recognition to individuals for their achievement. They can also provide opportunities for nurses to advance grow by advancing their knowledge and skills (Duffield et al., 2011; Walker et al., 2011). The proposed leadership skills and attributes are geared towards improving nurse retention in the stroke rehabilitation unit. These attributes and skills are key in effecting the much needed change in this unit. For instance, when leaders in this unit become flexible and approachable, they will improve their communication with nurses. Through honest and open communications with the leaders about the various issues that they face in their work roles, nurses are likely to feel less burdened and stressed. On the other hand, leaders are likely to understand the needs of the nurses in this unit and subsequently implement necessary changes to improve the well-being of nurses at work. By being supportive nurses are less likely to feel overwhelmed by their work or experience work burnout. Lastly, motivational skills will help boost the morale of nurses and enhance their job satisfaction. Consequently, this unit is likely to experience low nurse turn over and high nurse retention (Cummings et al., 2010; Duffield et al., 2009). Conclusion This paper has examined the current and impending nurse turnover as major issue that requires change within the stroke rehabilitation unit at Concord Hospital, Sydney. Subsequently, it has explored the leadership skills and attributes that are required in order to effect change. The findings of this paper suggest that, in order to enhance nurse retention within stroke rehabilitation unit there is need for leaders to create a supportive work environment and focus on motivating nurses. This paper further suggests the need for leaders in this unit to effect change by being flexible and approachable, supporting and employing motivational skills. References Australian Healthcare and Hospital Association (AHHA)(2012). 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