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Write a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to the issue of nurse turnover. Describe the issue and discuss how it impacts quality of care and patient safety in the setting where it occurs. Discuss how professional standards of practice should be demonstrated to help rectify the issue or maintain professional conduct. Explain the differing roles of nursing leaders and nursing managers in this instance and the different approaches they take to address nurse turnover and promote patient safety and quality care, supporting your rationale with leadership and management theories, principles, skills, and roles. Discuss additional actions leaders and managers should initiate to ensure professionalism across diverse health care settings while addressing nurse turnover. Describe a leadership style that would best address nurse turnover and explain why this style could be successful. Use at least three peer-reviewed journal articles beyond course materials. APA format; abstract not required.

Paper For Above Instructions

Introduction

Nurse turnover—voluntary or involuntary departure of registered nurses from an organization—remains a persistent challenge in health care systems worldwide. Turnover rates vary by setting but are highest in acute care and high-stress specialty units (Hayes et al., 2012). High turnover imposes financial costs, reduces workforce stability, and erodes institutional knowledge, all of which affect patient safety and quality of care. This paper describes nurse turnover, examines its impacts on care quality and safety, explains how professional standards should be upheld, contrasts nursing leaders’ and managers’ roles and approaches, recommends additional actions to ensure professionalism, and proposes an effective leadership style to address turnover.

Defining Nurse Turnover and Its Impact

Nurse turnover includes both voluntary resignations and involuntary separations. It can be short-term (within a year) or long-term and is driven by factors such as workload, burnout, poor staffing, lack of advancement, and workplace incivility (Hayes et al., 2012; Aiken et al., 2014). High turnover compromises continuity of care, increases reliance on temporary staff, and disrupts team dynamics. Empirical studies link higher turnover and lower nurse staffing stability with increased medication errors, falls, infection rates, and mortality (Aiken et al., 2014; Kutney-Lee et al., 2013). Turnover can also degrade patient experience and satisfaction, as consistent nurse–patient relationships are weakened.

Professional Standards of Practice

Professional standards—such as those articulated by the American Nurses Association (ANA) and specialty bodies—require accountability, evidence-based practice, safe delegation, and advocacy for adequate staffing (ANA, 2015). To address turnover, nurses and their leaders must demonstrate adherence to these standards by: ensuring safe staffing models, providing orientation and competency validation for new hires, fostering transparent communication about workload and patient safety concerns, and maintaining ethical practice when using agency staff. Upholding these standards mitigates risks associated with turnover and maintains quality of care while organizational changes take place.

Roles and Differing Approaches: Nursing Leaders vs. Nursing Managers

Nursing managers typically focus on operational tasks: staffing allocation, scheduling, resource management, performance evaluation, and enforcement of policies (Kotter, 1990). Addressing turnover at the managerial level involves tactical interventions: improving recruitment processes, refining orientation programs, optimizing unit schedules to reduce fatigue, implementing retention incentives, and using exit interviews to identify modifiable causes (Hayes et al., 2012).

In contrast, nursing leaders emphasize vision, culture, and long-term workforce strategies. Leaders influence organizational climate, professional development pathways, and interprofessional collaboration (Bass, 1985). To combat turnover, leaders champion systemic changes such as career ladders, mentorship programs, wellness and resilience initiatives, and policies that value psychological safety and recognition (Tourangeau et al., 2010). Leaders also advocate at executive levels for investments in staffing and supportive practice environments, linking workforce stability to strategic quality outcomes.

Both roles are necessary and complementary: managers translate leader-driven strategy into unit-level practice, while leaders create the conditions that reduce the causes of turnover. For example, a manager might implement flexible scheduling piloted by leadership’s commitment to work–life balance; a leader might secure funding for a mentorship program while managers operationalize mentor–mentee pairings.

Theoretical and Practical Support

Transformational leadership theory supports leader actions focused on motivation, vision, and staff empowerment (Bass, 1985). Transformational leaders reduce turnover by fostering engagement, professional growth, and staff commitment. Managerial functions align with classical management principles—planning, organizing, staffing, directing, and controlling (Fayol/Kotter frameworks)—that operationalize retention interventions (Kotter, 1990). Evidence shows that positive practice environments and supportive leadership correlate with lower turnover and better patient outcomes (Aiken et al., 2014; Kutney-Lee et al., 2013).

Additional Actions to Ensure Professionalism in Diverse Settings

To promote professionalism across diverse settings, leaders and managers should initiate coordinated actions: implement culturally competent retention strategies tailored to workforce demographics; standardize onboarding and competency assessments for both permanent and contract staff; develop continuous professional development opportunities that respect varied learning needs; and establish clear codes of conduct addressing workplace incivility and bullying. Data-driven workforce monitoring systems should be used to identify at-risk units and trigger targeted supports (Hayes et al., 2012). Ensuring equitable policies for scheduling, lactation support, and accommodations helps retain a diverse nursing workforce while upholding professional standards.

Recommended Leadership Style

Transformational leadership is the most appropriate style to address nurse turnover. Transformational leaders inspire a shared vision, foster intrinsic motivation, and support professional growth—actions that reduce burnout and intent to leave (Bass, 1985; Shirey, 2006). By articulating a compelling vision for quality care and staff well-being, transformational leaders can mobilize resources, encourage innovation in staffing models, and cultivate a supportive culture that enhances retention. Combined with transactional managerial mechanisms (clear expectations, rewards, and accountability), transformational leadership produces both the motivational and structural conditions needed to reduce turnover.

Conclusion

Nurse turnover poses serious risks to patient safety and quality of care, but it can be mitigated through coordinated leadership and management actions rooted in professional standards. Managers should address immediate operational contributors to turnover through staffing, scheduling, and onboarding reforms, while leaders must pursue cultural and strategic initiatives that foster engagement and professional development. Transformational leadership—paired with sound managerial practices—offers a strong framework for reducing turnover, promoting professionalism, and sustaining high-quality, safe patient care.

References

• Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet, 383(9931), 1824–1830.
• American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. American Nurses Publishing.
• Bass, B. M., & Riggio, R. E. (2006). Transformational Leadership (2nd ed.). Psychology Press. (Original work published 1985).
• Hayes, L. J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., Spence Laschinger, H., & North, N. (2012). Nurse turnover: a literature review. International Journal of Nursing Studies, 49(7), 887–905.
• Kotter, J. P. (1990). A Force for Change: How Leadership Differs from Management. Free Press.
• Kutney-Lee, A., Stimpfel, A. W., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2013). Changes in patient and nurse outcomes associated with magnet hospital recognition. Medical Care, 51(6), 439–445.
• Shirey, M. R. (2006). Social support in the workplace: Nurse leader implications. Nursing Forum, 41(1), 16–27.
• Tourangeau, A. E., Doran, D. M., Hall, L. M., O’Mara, L., & Giovanetti, P. (2010). Impact of hospital nursing care on 30-day mortality for acute medical patients. Journal of Advanced Nursing, 66(10), 2219–2236.
• Duffield, C., Roche, M., Blay, N., & Stasa, H. (2011). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20(1-2), 23–33.
• Kovner, C., Brewer, C., Fatehi, F., & Jun, J. (2014). What does nurse turnover rate mean and what is the rate? Policy, Politics, & Nursing Practice, 15(3-4), 64–71.