The Differing Approaches of Nursing Leaders and Managers

The Differing Approaches of Nursing Leadership and Management

As the healthcare sector expands relative to the exponential increases in population, the importance of nurses significantly increases. The subsequent increase in the significance of nurses expounds the need for well qualified nursing leaders and managers. The critical role played by nursing managers and leaders influence the behavior and the type of service offered by nursing personnel in ensuring the providence of individualized, advocated and professional care for patients. Nevertheless, despite the significant roles both managers and leaders play in nursing, their approaches have been found to significantly differ. In practice, nursing leaders and managers are both likely to employ contrasting approaches in dealing with an organization’s operations and in exploiting the resources available to them. One of the main issues affecting nursing practice currently is the nurse-patient ratio which is in-turn affected by nursing shortages and nursing staff turnover. In tackling this issue, nursing managers and nursing leaders are likely to adopt different approaches. In essence, while approaches of the nurse leaders and nurse managers are all viable, the most appealing approach is the leaders approach which mainly involves a “hands-on” and relational approach in tackling the issue of nurse-to-patient ratio (nursing turnover and nursing shortages) in a healthcare organization and this paper will aid in expounding on the issue and ascertaining the approaches.

Tackling Nursing Shortage and Turnover

Nursing scarcity has been a consistent issue in the globe. The number of nursing personnel at all levels has been declining rendering the risk of healthcare organizations lacking the sufficient personnel to offer professional and high quality care to patients. The following is the view of nursing managers and leaders on the issue.



Nursing Managers Approach

In essence, nursing managers have more diverse and complicated responsibilities than nursing leaders. A nursing manager is responsible for running an institution while also ensuring each nurse under his/her control is perming the assigned roles amicably. The role and responsibility a nurse plays in any healthcare entity is assigned and controlled by the manager. Therefore a manager is responsible for the inadequacies or any problems that arise due to the problem of nursing shortages or turnover. Studies have indicated that hospitals or health organizations with low nurse-to-patient ratios experience significant problems in management and service delivery (Force, 2005). To deal with the problem of nursing shortages and turnover, the manager must embrace planning. Planning would involve, for instance, creating a schedule for the nurses available to ensure that each patient in the health organization is served while also ensuring the nurses available are prevented from burnout or excess fatigue. Another way is through staffing. In this case, staffing would involve the manager personally selecting the nurses for different situations by assessing the function and the environment involved, this will increase effectiveness. Another vital way of handling nursing shortages and turnover is by offering direction to the available. Offering directions can involve offering the nurses motivation to work to dispel any concern they would have for overworking. For instance, offering extended recovery times for nurses subjected to longer shifts or were catering for a larger group of patients would go some way in increasing motivations, thus catering for the shortages. With nursing shortages, it is vital for the nursing manager to exercise fair decision making. The decision making must be shrewd to ensure that some parts of the organization are not abandoned due to the shortages of nurses. Decision making involves deciding on the critical sectors that would need more attention than others. The approaches mentioned above illustrate how a manager can handle the problem of low nurse-to-patient ratio.

Nursing Leaders Approach

Leadership in nursing is a different proposition to a manager. In many instances, the leader is appointed although in some instances, the leader is the individual who stands out and exhibits leadership skills. A leader in nursing is supposed to inspire his or her team towards achieving the goals they have set as a team and of the organization. A leader is usually informally appointed and the duty is to inspire, motivate and influence others. Studies have indicated that patient outcomes are usually positively influenced by leadership styles, especially a leadership style where the leader creates a relationship with the team members and the patients (Wong & Cummings, 2013). In dealing with nurse shortages and turnover, a nursing leader must illustrate proper leadership skills. Relational approach is one viable approach to utilize in this situation as a leader. Relational leadership involves coming together of individual to accomplish a certain goal. In this situation, the leader can use this approach to ensure the available nurses combine together to remedy the existing shortage. Another leadership styles that can be utilized in this case is the participative leadership style where the leader can allow the other nurses to be involved in deciding how to solve the shortage problem or other issues that may arise. A leader is also responsible for encouraging teamwork, and in this case, to combat the turnover or the shortage, the leader must illustrate skills that can bring together the team to limit the problems that may arise from the shortage (Nevidjon & Erickson, 2001).

Another important approach is having the team’s set objectives. Without objectives there is the likelihood of most nurses underworking or overworking. As a leader set the groups objectives by ensuring each nurse is striving towards the objectives to limit the overall impact of the shortages. For instance, with proper inspiration from the leader, even with the objective of serving more patients, the nurse can adequately plan how to accomplish the objective within the set time. The approaches explained above illustrate how a leader can tackle low nurse-to-patient ratio.

My Personal Approach

In my opinion, the approaches associated with a nursing leader bode well with my leadership style and philosophy. As a leader, you are able to evaluate and see first-hand the experience of the nurses that have to do excess work due to the shortage. In contrast, as a manager, you are at a certain level that does not give you the view of the nurses directly facing the shortage limiting your productivity. In addition, past experiences have illustrated that I am an individual who functions well as the leader of a small team. Managing a small team is easier and more productive in my opinion. In addition, I feel like the authoritarian structural system exhibited by managers limits the productivity of nurses to a certain extent. As a leader, I would have access to the groups’ resources and thus divide them equally without discrimination. I am also an avid motivator coupled with good leadership and listening skills would are crucial in situations like the one in this case. As such, I believe, I would prefer using the relational leadership style and approach due to its productivity.


Both managers and leaders are vital parts of the nursing system. As such, each section, leadership and management, utilizing their different but effective approaches would fully benefit the health care sector. As such, both sides’ approaches must be implemented in their own accord. Nevertheless, the leadership approach seems the most viable with its, as previously mentioned “hands on” and relational approaches seemingly befitting the issue of nurse shortages and turnovers.




Nevidjon, B. & Erickson, J. (2001). The Nursing Shortage Solutions for the Short and Long Term. Online Journal of Issues in Nursing, 6(1).

Wong, C. A. & Cummings, G. G. (2013). The Relationship Between Nursing Leadership and Patient Outcomes: A systematic review update. Journal of Nursing Management, 21(5): 705-724.

Force, M. V. (2005). The Relationship Between Effective Nurse Managers and Nursing Retention. Journal of Nursing Administration, 35(7-8) 336-341.