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Balancing the Focus Between Productivity and Relationships

Balancing the Focus Between Productivity and Relationships

You are a top-level nursing administrator in a large, urban medical center in California. As in many acute-care hospitals, your annual nursing turnover rate is more than 25%. At this point, you have many unfilled licensed nursing positions, and local recruitment efforts to fill these positions have been largely unsuccessful. The problem has been exacerbated by the recent passage of legislated minimum licensed staffing ratios in your state. During a meeting with the CEO today, you are informed that the hospital vacancy rate for licensed nurses is expected to rise to 35% with the implementation of the new minimum staffing ratios in 3 months. The CEO states that you must reduce turnover or increase recruitment efforts immediately or the hospital will have to consider closing units or reducing available beds when the new ratios take effect. You consider the following “industrial leadership” paradigm options:

1. You could aggressively recruit international nurses to solve at least the immediate staffing problem.

2. You could increase sign-on bonuses and offer other incentives for recruiting new nurses.

3. You could expand the job description for unlicensed assistive personnel and LVNs to relieve the RNs of some of their duties.

4. You could make newly recruited nurses sign a minimum 2-year contract upon hire. You also consider the following “relationship leadership” paradigm options:

1. You could hold informal meetings with current staff to determine major variables affecting their current satisfaction levels and attempt to increase those variables that increase worker satisfaction.

2. You could develop an open-door policy in an effort to be more accessible to workers who wish to discuss concerns or issues about their work environment.

3. You could implement a shared governance model to increase worker participation in decision making on the units in which they work.

4. You could make daily rounds on all the units in an effort to get to know your nursing staff better on a one-to-one basis.

ASSIGNMENT: Decide which of the options you would select. Rank order them in terms of what you would do fi rst. Then look at your list. Did it reflect more of the industrial leadership paradigm or a relationship leadership paradigm? What inferences might you draw from your rank ordering in terms of your leadership skills? Do you think that your rank ordering might change with your age? Your experience?

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