Nursing Leadership and Management Approaches

Table of Contents

The issues connected to healthcare staffing such as nurse turnover are often dependent on the decisions and behaviors of nursing managers and leaders. Nurse turnover is a problem that is so widespread that is can be considered an international concern (“The high cost,” 2016). Moreover, the outcome of high turnover rates creates not only staffing shortages but also financial problems for hospitals. There are many reasons why nurses quit their job or profession as a whole. In fact, many nurses who are dissatisfied with their current situation may leave the field if their concerns are not answered appropriately (Mazurenko, Gupte, & Shan, 2015). Thus, the problem of nurse turnover is significant and deserves much attention from managers and nursing organizations.

Currently, the main reasons for high nurse turnover may include job dissatisfaction, burnout, low salary, staffing issues, personal and professional relationships, and job-related conflicts (Feather, Ebright, & Bakas, 2015; “The high cost,” 2016).

The lack of care from managers and low level of confidence in one’s job often lead to the deterioration of the problem. Many of the reasons mentioned above can be addressed by nursing management and mitigated with communication, leadership, and guidance. Therefore, it is vital to analyze the approaches that nursing leaders and managers can take to solve the issue. Nursing leadership and nursing management are two different aspects of one profession that have many overlapping principles which may help solve the problem of high nurse turnover rates.

Leadership and Management Approaches

A nursing manager is a position that a person can hold while working at a healthcare facility. It usually implies that this employee has more responsibilities than a regular nurse, but also more authority and decision-making power than other workers. Thus, nursing managers are people who can guide other nurses and influence their practice and activities. Nursing leader, on the other hand, does not have to hold a position of power, although many of them do (“What’s the difference,” 2014).

Leaders are nurses who use communication and their interpersonal skills to influence people. It is vital to note that leadership characteristics may be inherent to nurses at all levels regardless of their position in the organization. Similarly, nursing managers may exhibit different leadership traits and use various approaches to guide other people.

Concerning the problem of nurse turnover, both leadership approaches and managing styles may be crucial to the nurses’ job satisfaction. For example, the main purpose of the nursing manager is to ensure that the unit, group, or division is functioning properly (“What’s the difference,” 2014). Therefore, managers are primarily concerned with the effectiveness of their subordinates. Thus, the issue of nurse turnover may be addressed by nurse managers by hiring new employees and supporting the retention of existing ones. While dosing that, managers may choose to be autocratic, democratic, or laissez-faire (Alharbi, 2017). The choice between these styles may affect nurses’ retention.

According to Feather at al. (2015), nurses prefer a management style with democratic traits – a manager who communicates with employees and asks for their opinion and engagement in the decision making process. Moreover, fear and control inherent in the autocratic style lead to more nurses leaving the field due to personal and burnout. Thus, a nursing manager can attempt to solve the problem by engaging employees and being democratic.

A nursing leader can also use a number of approaches that have a different impact on nurses’ behavior. The central leadership styles are transactional and transformational. Transactional leadership focuses on deviations and errors made by the nursing team to issue punishments or rewards in an attempt to keep employees productive (Alharbi, 2017). This approach is contradictory to what many nurses consider adequate and satisfactory, which means that it can increase the rates of turnover (Feather at al., 2015). One the other hand, transformational leadership values individual input, engagement, and empowerment of nurses.

Thus, a nursing leader using transformational leadership can positively impact the issue of turnover. A leader can interact with nurses and address their concerns, raise their confidence, and help them become qualified professionals. Moreover, as transformational leadership values continuous personal and professional improvement, nursing leaders can advocate for better education and training for nurses and help create access to learning for the employees. Though transcending self-interest, nursing leaders can build a team of inspired and engaged workers.

It is vital to note that most nursing managers are often appointed because of their leadership qualities (“What’s the difference,” 2014). Therefore, they can combine a management technique and a leadership philosophy in their practice and achieve even better results combating high turnover rates. Moreover, there are similarities between the democratic style and transformational leadership. Both strategies highly value communication and interaction with employees, the role of teamwork, and individual opinions.

Relationships and engagement are significant to these approaches as well as retention rates. While a manager may be mostly concerned with the effectiveness of the team, he or she can use leadership skills to encourage nurses and guide them to become better professionals as a result. Integration of the two roles – a person with authority and an inspirational figure – can produce the best results.

Personal Approach

In my opinion, transformational style of leadership is the most appropriate style that can be implemented in nursing practice. Firth of all, it is focused on individuals’ strengths and capabilities, which means that a leader is engaged with the team and knows their skills. Such a group may be the most effective and ideologically unified, which can positively influence the retention rate of its members. Second, the focus of continuous education and training highlighted ion this approach results in confident and intelligent employees who feel valued and cared for – another aspect significant to many nurses (Feather at al., 2015).

Finally, as transformational leadership is inspirational and communicative, nurses may perform better not because they fear punishments but because they are aware how valuable their input is to the organization and the team. These characteristics of transformational leadership make it the most effective and positively-aligned approach. That is why this strategy fits my philosophy and personal values.

Funding Source

One of the funding sources for reducing turnover rates is HRSA (Health Resources and Services Administration). This organization provides many grants such as Nurse Education Practice Quality and Retention and Advanced Nursing Education that help nurses acquire necessary academic qualifications to perform better and become a more active part of the team (HRSA, 2015). The focus on education is essential in decreasing turnover as it makes nurses more qualified and gives them more self-confidence.


Nurse turnover is a problem that should be combated with communication, education, and engagement of nurses in the decision-making process. Nursing managers and leaders can implement these strategies and use transformational leadership and democratic management to achieve the best results. Nurses can be managers and leaders at the same time as the former is a professional occupation while the latter is a personal characteristic. However, leadership skills are crucial in improving retention rates because nurses value personal relationship and recognition of their abilities and strengths.


Alharbi, A. Y. (2017). Leadership styles of nurse managers and their effects on nurse and organisational performance, issues and problems. International Journal of Information Research and Review, 4(9), 4516-4525.

Feather, R. A., Ebright, P., & Bakas, T. (2015). Nurse manager behaviors that RNs perceive to affect their job satisfaction. Nursing Forum, 50(2), 125-136.

Health Resources and Services Administration [HRSA]. (2015). . Web.

Mazurenko, O., Gupte, G., & Shan, G. (2015). Analyzing US nurse turnover: Are nurses leaving their jobs or the profession itself? Journal of Hospital Administration, 4(4), 48-56.

. (2016). Web.

What’s the difference between a nurse manager & nurse leader? (2014). Web.

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