Effective Approaches to Leadership and Management

Effective Approaches to Leadership and Management


Nursing managers and other health care leaders play a significant role in ensuring the safety and quality of healthcare services that are provided within healthcare facilities as well as the overall business of healthcare institutions. As one of the primary roles and functions of managers and leaders, they independently endeavor to affect the conducts of the rest of the nursing employees. They provide direct, specialized, and personalized nursing care. Therefore, despite the fact that managers and leaders play a facilitated role, their duties and style of attaining responsibilities in health care organizations might be different. Practically, both nursing managers and leaders are likely to apply expressively different methods in recognizing and utilizing resources within healthcare institutions as well as resolving issues that may cause problems in the smooth operations of health care facilities and organizations. In addressing the problem of nursing staff ratios among organizations, nursing managers and leaders are likely to use different philosophies and abilities in deciding on the issue, thereby solving it differently. The current paper seeks to define different approaches that nursing managers and leaders are expected to apply in resolving nurse-staffing ratio in a healthcare organization. The objective of the paper is to analyze the nurse to patient ratio and how health care leaders and management integrate principles, theories, as well as leadership qualities and styles that are significant in providing quality management and leadership to the affected employees, in this case nurses.

Several disparities exist between managers and leaders, such as their styles, qualities and objectives, which define them. In many healthcare facilities, the impact of nurse staffing ratio can be felt at different levels of the organization. Globally, the concern of nurse-to-patient ratios has been a general topic of discussion, mainly in the medical community. Many people in the medical field have continually argued for the need of the government to intervene in the prevalent scenarios of limited staff in nursing. Several calls have been made for the laws to be enacted in order to enhance effective nurse patient ratio. Currently, in the United States, California is the only state with an official enactment of edict that has fully acknowledged this concern. Other states have continued to witness different nurse battles for their own effective workplaces conditions to be implemented.

After the California enactment, there have been several parallel nurse staffing decrees, which have not been successful in many other states mainly because many hospitals refused to take part in the struggles (Kaiser Health News, 2013). Several hospitals have continually argued that the laws are aimed at stripping off their capability and powers to incorporate simple staffing resolutions and hence result in negative implications on the health care organizations. On the other hand, several nursing unions have maintained that numerous hospitals have taken advantage of the systems to abuse them by employing few nurses as compared to many patients who receive care and treatment in the facilities. Nurses argue that they became victims of nursing shortages, which have made them go through job burnout and strain that is detrimental to the care and safety of patients. As stated by the Michigan Nurses Association President in footage of Kaiser Health News (2013), “Hospitals right now are run like businesses and they’re focused on the short-term bottom line. Therefore, nursing shortages have turned out to be a prevalent problem. Despite the continuous legal battles and intervention being experienced, the topic will continue to impact the health care facility and provision. Nonetheless, leadership and management approaches in health care are the only avenue that can be used to address the issue and improve the nursing environment that causes the negative outcomes of the unfortunate nurse-to-patient ratios.

Leadership and Manager Approach to the Nurse to Patient Ratio Concern

Nursing management can be a difficult responsibility since it forces a manager to supervise the operations of a given healthcare institution and make sure that all the nursing personnel play their role in the facilities. In case of poor performance or delivery of health care in the institutions, managers are held responsible and must consequently ensure that nurses undertake their roles and responsibilities effectively and accurately. The nursing staff ratios can have a negative implication on managers since the nursing shortages increase the likelihood of errors in the provision of services by nurses. Furthermore, nursing shortages could also lead to patients being treated in an inappropriate way since nurses can easily burn out.

According to Kaiser Health News (2013), it is apparent that most healthcare facilities experiencing low nurse-to-patient ratios are in a dangerous situation as compared to the facilities with higher ratios. Furthermore, such institutions also have low outcomes since nurses are easily overworked and dispirited due to the huge number of patients that they handle. Therefore, it is the responsibility of managers to assess the health care work environment and decide how the nurses can effectively work in the stressful environment through effective leadership. For instance, mangers need to ensure that the working schedules are created in such a way that they reduce the rate of high burnout. Moreover, health care mangers need to ensure that in instances where nurses work on longer shifts or handle a large group of patients, their remuneration must reflect their tasks and get adequate recovery time before resuming another shift. These are some of the approaches that health care managers need to adopt when a facility has a low nurse-to-patient ratio.


On the other hand, leadership in nursing is different to some extent and its functions are not similar to management. This is because a manager is allotted to the position. Nonetheless, any employee within the health care setting notwithstanding his/her position can naturally assume leadership. Importantly, the main responsibility of leadership is to encourage other employees to attain an organization’s objectives and employee personal goals. According to Wong et al. (2013), the association that exists between nursing leadership approaches and patient outcomes in addition to discrete nurse inspiration was determined. According to the research, it was concluded that a constructive link exists between the interpersonal leadership style approach and patient outcomes (Wong et al., 2013).

Relational or interpersonal leadership entails an example of a strategy that leaders employ in the nursing environment where there is a problem of staffing ratios. Furthermore, the relational method is described as an interpersonal process individually aimed at creating change in order to attain a common good (Relational Model, 2012). Such kind of approach is also significant for nursing leaders because it involves an inclusive aspect of leadership that takes into account different standpoints and backgrounds. Therefore, nursing leaders can employ this approach as a way of gathering crucial feedback from nurse employees regarding their concerns, particularly in relation to the nursing staff ratios. For instance, nursing leaders’ ability to integrate suggestions from nurses can be significant in improving the health care environment. This approach, therefore, motivates nurses and other employees to be involved in establishing a possible solution to the concern of low nursing ratio.


Personal Approach

In my opinion, I would also apply the relational approach in addressing the problem. This is because incorporating everyone in leadership and decision-making is a way of appreciating employees. Despite the several challenges they face, including the low nurses staff ration, they feel appreciated and part of the system that need to provide a solution. In the experiences, I have also discovered that everything has been well when I incorporate all people in decision- making and finding a solution. Furthermore, I motivate and encourage other people to give feedback concerning my leadership approach. One thing that I have never associated with is the authoritative form of leadership or controlling employees. My explicit approach to the problem of low nurse-to-patient ratio would involve gathering adequate information from the affected nurses and trying to find out what motivates them most in the work environment. Thereafter, I would make a decision to allocate nurses many patients about those areas. After also noting the areas that they do not like, I would try to assign them the least number of patients in those areas. As a way of breaking the work boredom routines and upholding work interest, I would change the schedules frequently, which would also reduce chances of severe burnout. My main objective would be to ensure that nurses are constantly motivated to enhance their productivity.


The concern of low nurse-to-patient ratio can be a cause of many problems and stressful conditions for nurses. This does not only affect the nurses but is also detrimental to patients and the health care facility at large, with managers included. Therefore, several approaches that are pursued by both leaders and managers in health care institutions must be able to address this concern. It is apparent that such approaches are different in terms of leadership styles and management strategies. In my own personal approach to the concern, I would emphasize on the best possible mechanism to ensure that the working environment motivates the affected nurses. I would also ensure that the nurses feel part of the solution to the problem through engaging them fully in the decision-making process. It is crucial that nurses need to be inspired in situations, such as the nurse-to-patient ratio concerns.



Schultz, D. (2013). Nurses Fighting State by State for Minimum Staffing Laws. Kiser Health News. Retrieved from:

http://www.kaiserhealthnews.org/stories/2013/april/24/nurse- staffing-laws.aspx

The Relational Model. (2012). UTA.edu. Retrieved from: http://www.uta.edu/leadership/_downloads/The-Relational-Model.pdf

Wong, C. A., and G.G. Cummings. (2013). The Relationship Between Nursing Leadership and Patient Outcomes. A Systematic Review Update. Journal of Nursing Management 21(5): 709-724.