Nursing and Servant Leadership How to Help

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Two issues that affect our hospital are staff shortage and high turnover resulting from poor job satisfaction. As more and more physicians leave primary care to enter into specialized care and the lack of RNs to fill that gap persists, we are left with a staff shortage, which is further exacerbated by turnover among nurses who find satisfaction the job to be non-existent. Our hospital's ability to provide optimal quality care to patients depends upon having enough staff to meet patients' demands and having a quality culture within the organization to ensure that burnout and overwork do not become symptomatic in the hospital.

The problem of primary care physicians moving into the specialized sector is not a new one and has been ongoing for many decades (O'Brien, 2003). While nurse practitioners have moved into the gap left by the exodus of primary care physicians, the gap is far from being closed even still today. Patients who do not have access to primary care often resort to our hospital facilities as a result, which places more stress upon our staffing infrastructure, which is already suffering from overwork and burnout. The more our staffing infrastructure is stressed by both staff shortages and turnover, the more our quality care to patients suffers. As Cimiotti, Aiken, Sloane, and Wu (2012) have shown in their survey off data from the American Hospital Association, there is a significant correlation between burnout reductions in hospitals and a decline in the onset of infections among patients -- a correlation that translates into more than $65 million in savings per year. If our hospital can adequately address the dual issues of staff shortages and of turnover resulting from poor job satisfaction -- which as Dall'Ora, Griffiths and Ball (2016) have shown is related to burnout -- we could save our facility money as well as provide better quality care to patients.

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In our emergency department, our nurses are tasked with providing care to patients who would benefit from more primary care providers outside the hospital -- but our nurses are also experiencing poor job satisfaction because of the effects of burnout, which is leading to high turnover and exacerbating the situation all the more.

Improved communication, collaboration, and teamwork can improve conditions in our department because they all facilitate the development of a positive culture that is supportive of the quality care aims that we seek to achieve. Communication is especially crucial because it allows nurses to talk to one another and to department heads and to relate times when they feel stressed, overworked, or overburdened by the demands placed upon them. If we are better able to communicate our needs without feeling guilty, we are better positioned to respond to one another and avoid the pitfalls of poor communication. The more we communicate with one another, the more we can look out for one another and promote and foster care among ourselves and in turn among our patients. The style of leadership that can directly impact this variable is servant leadership, and it would be particularly beneficial if our department heads utilized the servant leadership style to show our nurses that their needs come first: by placing others ahead of ourselves, we can start a "pay it forward" mentality that ultimately benefits our patients, and in benefitting our patients our nurses can feel a greater sense of job accomplishment and thereby feel greater job satisfaction (Hunter, Neubert, Perry et al., 2013).

As Gardner (2005) points out, there are a number of competencies that nurses must possess in order to be able to effectively collaborate, communicate and be inclusive towards others: those competencies are: 1) knowing oneself, 2) knowing how to value and manage diversity, 3) knowing….....

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