Building the High-Performance Workforce

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:

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. Building the High-Performance Workforce

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.

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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Building the High-Performance Workforce

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Effective Approaches in Leadership and Management

Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.

The selected issue is nurse turnover, described as an undesirable trend in which nurses leave their place of employment or the professional altogether. Nurse turnover can be voluntary or involuntary with about 17.5% new nurses leaving their first jobs within one year of starting the job. It is caused by a range of factors to include nurses feeling dissatisfied, stressed out and overworked, lack of role clarity and low sense of control over the job performance, and poor communication with the management about critical issues. In addition, it is caused by lack of adequate rewards and recognition for accomplishment, minimal opportunities for professional growth, and inadequate collaboration and trust between coworkers (Black, 2016). Nurse turnover presents a costly concern that is harmful for patients and hospitals alike. Firstly, it results in high nurse-to-patient ratios so that nurses are overwhelmed and patients do not receive the required care. This has implications for care outcomes with high possibilities of fatal errors that are accompanied by high mortality and re-hospitalization rates as well as longer lengths of stay in hospital. It increases overtime, workload and utilization of temporary nurses with staff fatigue being a consequence and low skills temporary nurses being used with the result being decreased quality of care and increased incidences of patient safety incidents. Secondly, it causes hospitals and medical facilities to lose approximately $300,000 every year in addressing the resultant human resources gaps. In fact, hospitals can easily spend millions of dollars on overtime, retraining, rehiring and more to address the staffing gaps brought about by nurse turnover. Overall, nurse turnover increases costs, disturbs hospital revenue and managerial processes, staffing practices, and hospital services (Black, 2016).

Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.

Nurse turnover creates personnel shortages. It causes insufficient nursing staff and disturbs nurse well-being. Even with these concerns, nurses still have a professional, legal and ethical responsibility to provide professional care. This implies that the available nurses have the responsibility of providing competent levels of care at each phase of the nursing process even in the midst of staff shortages. In applying the standards, nurses reflect a desired and achievable performance level to be compared against the actual performance level. In addition, the professional standards help the understaffed nurses to direct and maintain clinically competent and safe nursing practice. The standards are important for professional nursing practice because they guide and promote clinical practice, acting as an evaluation tool for nurses to ensure clinical safety and proficiency. Also, the standards act as a framework for developing proficiency evaluations and clinical competency checklists. They act as a comparison tool to evaluate nursing care in terms of adherence to established policies and widely accepted guidelines. Overall, applying professional standards of practice would guide the understaffed nurses to develop safe staffing practices (Joel, 2018).

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.

Nurses play a critical role in providing care for patients and improving outcomes. While staffing changes would be expected as routine management activities, a high nurse turnover rate would be disruptive to the provision of nursing care with a negative effect on patient satisfaction and care. This creates a situation in which nurse leaders can feel frustrated to train and manage nurses only to have them become unengaged and leave the organization. To address this concern, nurse leaders must play a role in decreasing nurse turnover. Firstly, nurse leaders must be more engaged in knowing about the nurses, areas in which they can improve, and regularly offering guidance. This would help with identifying concerns among nurses and knowing when something is amiss (Brensen et al., 2017). In addition, it helps with guarding against the assumption that nurses are self-reliant and need little to no guidance thus ensuring that nurses get regular communication and support from the nurse leaders. Secondly, nurse leaders should be involved in hiring and staffing processes. Communications with the HR about specific staffing needs and helping to choose nurse candidates would help with ensuring that the organization finding candidates more likely to fit in – both in terms of culture and skill fit. This also helps with onboarding new nurses and ensuring that they succeed (Brensen et al., 2017). Building the High-Performance Workforce

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.

Managers and leaders are constantly challenged to recruit and retain nurses in the midst of turnovers and vacancies. As they continue to struggle with this challenge, they must be prepared to leverage the organizational structure with regards to shared leadership models, leadership training and advanced education. Firstly, shared leadership models would be applied by broadly distributing leadership responsibility such that nurse personnel within the organization and in teams lead each other. This helps the nurses to feel that they are valued and have a say in decision making. Also, it helps the nurses to present their opinions on workplace issues that they would like changed to make the workplace more favorable for them (Finkelman, 2016). Secondly, leadership training would help the nurses to acquire and apply leadership skills and practices that would help with improving the workplace. Some of the skills that can be acquired include innovation, civic mindedness, ethical practice, strategic thinking and acting, team development, and self-development. Thirdly, opportunities for advanced education would be important in helping the nurses to meet the challenges in the workplace while improving their investment in the workplace so that they are motivated to continue working for the organization (Finkelman, 2016). Building the High-Performance Workforce

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Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

A democratic style would best address the issue of nurse retention. This is a leadership style that focuses on getting the stakeholders to present their opinions. It enables nurses to share information with their leaders about anything that affects their commitment to the organization and intention to either stay with the organization or leave the organization/profession. In addition, it helps with seeking the opinions of nurse personnel before approving final decisions so that their concerns are addressed and they do not feel ignored and left out of decisions. This is a beneficial leadership approach that focuses on participation to engender trust and promote corporation and team spirit among the nurse personnel. Besides that, it allows for creativity and helps the nurse personnel to growth and develop professionally. Overall, the democratic leadership approach would be used to get the nurses to do what they want done in a way that they want done so that they are motivated to continue working for the organization (Finkelman, 2016).

References

Black, B. (2016). Professional nursing: concepts & challenges. Elsevier Health Sciences.

Brensen, M., Hodgson, D., Bailey, S., Hyde, P. & Hassard, J. (2017). Managing Modern Healthcare: Knowledge, Networks and Practice. New York, NY: Routledge.

Finkelman, A. (2016). Leadership and management for nurses: core competencies for quality care (3rd ed.). Pearson Education.

Joel, L. (2018). Advanced practice nursing: essentials for role development (4th ed.). F. A. Davis Company. Building the High-Performance Workforce