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Nursing Turnover and Leadership & Management Approaches


Nurse turnover has been a growing human resource issue with a significant impact on the healthcare sector. The problem perpetuates the shortage of nurses in both private and public healthcare facilities. According to Dewanto and Wardhani (2018), the rate of nurse turnover worldwide ranges from 15 % to 44 %. The national average rate of nurses who voluntarily or involuntarily leave their position in the United States is between 8.8 % and 37.0 % (Haddad et al., 2020). This information illustrates variations of known data about the issue and its impacts in different regions. While nurse turnover can negatively affect the quality of care and patient safety, nurse leaders and managers have a vital role in addressing and mitigating its impacts.

Impacts of Nurse Turnover on Quality of Care and Patient Safety

Nurse turnover lowers the quality of care services provided in hospitals. The issue leads to a shortage of nurses and hurts their well-being, negatively impacting the quality of care. Notably, a decreased number of nurses in healthcare facilities increases the workload per care provider, overtime, and temporary nurses (Dewanto & Wardhani, 2018). As a result, staff fatigue, work-related stress, and lower morale among the working nurses are inevitable. Thus, the nurses may not concentrate well on their duties and responsibilities. The temporary nurse is likely to have low skills and lack the necessary experience. Equally, there would be ineffective communication between them and other staff and the hospital’s management due to unfamiliarity with the working environment (Dewanto & Wardhani, 2018). These factors hurt the nursing staff’s satisfaction and engagement, decreasing the quality of care.

High rates of nurse turnover in healthcare facilities jeopardize patient safety. The problem is associated with increased medical errors due to burnout and new hires (Dewanto & Wardhani, 2018). The increased workload caused by some nurses leaving their employment increases work-related stress, which heightens the possibility of making errors such as overdosing and administering of wrong medication to the patient. Additionally, exhausted nurses have less concentration on their duties and can easily forget to check their client’s condition or incorrectly record patients’ information. Conversely, new nurses hired to replace those who left have higher chances of making errors because of possible lower skills and experience and being unfamiliar with hospitals’ environment and processes (Dewanto & Wardhani, 2018). Consequently, patient well-being is threatened whenever nurses voluntarily or involuntarily leave their positions.

Demonstration of Professional Standard of Practice

Nurse turnover is an ongoing issue in the healthcare industry that necessitates a practical approach to address it and guarantee quality care and patient safety. Employee retention initiatives such as motivation through better payment, promotions, and mentorship programs can help alleviate the problem (Weiss et al., 2019). However, nurse leaders and managers need to demonstrate professional standards to help rectify the issue. For instance, they should ensure effective communication between them and their subordinates and among staff in their facilities. It is easier to notice and respond to various factors that can contribute to nurse turnover. They should embrace and promote collaboration and teamwork among healthcare providers. This approach minimizes workload, risks for medical errors, and work-related stress, which also causes nurse turnover. Nurse leaders and managers should also develop policies and programs such as training and mentorship that facilitate personal and professional growth. The strategy can make nurses feel valued and motivated, lowering the possibility of them intending to leave.

Role of Nursing Leaders and Nursing Managers and Approaches They Take to Address Nurse Turnover

Nursing leaders’ roles in healthcare facilities include equipping members with the tools and knowledge necessary to deliver quality care, managing nurse turnover, mentoring nurse, and influencing other staff. Nurse leaders motivate employees in their facilities by rewarding them for job well done and offering promotion opportunities (Weiss et al., 2019). Additionally, they provide training and mentorship programs to the nurses to facilitate personal and professional development. Moreover, they ensure effective communication and interpersonal relationship among individuals for a friendly working environment. These approaches enhance nurse satisfaction and engagement, minimizing turnover and improving patient safety. Nursing leaders apply transformation leadership theory, which focuses on guaranteeing their subordinates’ satisfaction through encouragement and inspiration (Weiss et al., 2019). The principles of communicating at all levels and emphasizing employee satisfaction and interpersonal skills allow them to mitigate nurse turnover effectively.

Nursing managers’ roles concerning nurse turnover include supervision and scheduling daily activities, hiring and evaluating nurses, and handling conflicts among care team members (Weiss et al., 2019). Unlike the leaders, nursing managers’ approach to addressing the problem focuses on alleviating all risk factors. They ensure adequate staffing and skills, a safe and conducive working environment, and effective collaboration with the staff in decision making. The managers apply human relation management theory that accentuates participatory decision-making (Weiss et al., 2019). They also use conflict resolution, communication, and leadership skills to help address nurse turnover in their facilities.

Additional Aspects Nurse Managers and Leaders Would Need

It is also essential for leaders and managers to be emotionally intelligent, critical thinkers, respectful, and with a high level of integrity. They should help their subordinates develop emotional intelligence to allow them to cope with stressors and challenges as they execute their responsibilities (Weiss et al., 2019). Critical thinking will enable them to make a decision based on prevailing factors. While respect facilitates an effective relationship with others, integrity allows nurse leaders and managers to make ethical decisions.

Leadership Style

Transformational leadership is the best style that would help address nurse turnover in hospitals. Notably, the leading causes of the issue are non-conducive work environments and reduced satisfaction among employees. Transformational leadership focuses on establishing a better workplace for all workers through empowerment (Xu, 2017). Nurse leaders and managers who adopt this style give their staff tools and confidence to execute their responsibilities and make decisions when necessary rather than giving direct orders. As a result, the employees are motivated and inspired and own their work, portray strong ethics, and demonstrate commitment to their organization (Naseer et al., 2018). Undeniably, effective collaboration and clear communication are vital in delivering high-quality and safe care to patients. Transformational leadership can ensure that all nurses feel valued and understand the importance of their work, which increases their engagement and satisfaction and reduces turnover.

The leadership style could help resolve nurse turnover in hospitals because various studies have demonstrated its effectiveness. Naseer et al. (2018) found that their style significantly reduces nurse turnover since leaders provide adequate support, ensure equity, and trust inspiration to the staff to minimize the possibility of intending to leave their organization. Their findings were supported by Suliman et al. (2020), who confirmed that transformational nursing leaders motivate and inspire their subordinates, enhancing their satisfaction and engagement. Undoubtedly, the leadership style is an effective way of resolving nurse turnover in health facilities and mitigating the problem’s negative impacts.


Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing, 17(2), 1-15. Web.

Haddad, L., Annamaraju, P., & Toney-Butler, T. (2020). Nursing Shortage. StatPearls Publishing.

Naseer, A., Perveen, K., Afzal, M., Waqas, A., & Gillani, S. (2018). The impact of leadership styles on staff nurses turnover intentions. International Journal of Academic Research in Business and Social Sciences, 7(12), 1133-1138. Web.

Suliman, M., Almansi, S., Mrayyan, M., ALBashtawy, M., & Aljezawi, M. (2020). Effect of nurse managers’ leadership styles on predicted nurse turnover. Nursing Management, 27(5), 23-28. Web.

Weiss, S., Tappen, R., & Grimley, K. (2019). Essentials of nursing leadership and management (7th ed.). F.A. Davis Company.

Xu, J. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155-157. Web.

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StudyKraken. (2022) 'Nursing Turnover and Leadership & Management Approaches'. 16 August.

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