Good Essay About Transactional And Transformational Leadership In Recruitment And Retention Of Nurses

Type of paper: Essay

Topic: London, Staff, Nurse, Recruitment, Bass, Journal, Agency, Quality

Pages: 6

Words: 1650

Published: 2020/09/09

Transactional and Transformational Leadership in Recruitment and Retention of Nurses Introduction

Recruitment and retention of nursing staff in the NHS is not just a local problem but also a national problem too. About this, the need for the identification of methods that are both efficient and sustainable in recruitment and subsequent retention of nurses. In both my organization and field of practice, this has posed numerous challenges. The challenges resulting include increased expenses, disruption of normal procedures and it is also posing a threat to the quality of care and patient safety. The Francis Report published last year demonstrated a strong link between the staffing levels, skill mix and patient safety. In response, most London hospitals trusts have increased their number of nursing posts this year. The aim of this essay is to outline the problem of recruitment and retention of nursing staff in a London General Hospital. In this paper, the primary focus shall be on the application of the leadership theories; Transactional Leadership and Transformational Leadership. It is this paper’s stand that both these leadership theories if applied effectively would improve; or rather revolutionize the process of recruitment of nurses and their retention in the London General Hospital. Therefore, this paper shall define the leadership theories and explore the how they can be applied effectively in the Hospital to help and improve the recruitment and retention of nurses.

Local Evidence Area of Improvement and Description of Current Challenges

The General Hospital has 520 beds in total that include the medical, surgical, orthopedic, elderly care wards, and a stroke unit. The current cost of staffing in the hospital is phenomenal. Therefore, it is a vital requirement that the recruitment and retention of nursing staff are well managed while applying the appropriate leadership models to ensure its effectiveness. To remain viable in today’s rapidly evolving environment, the General Trust Hospital must reduce its operating costs while continuing to improve the quality of healthcare and its outcomes. These aims are in accordance with the Trust’s vision that is ‘delivering healthcare of exceptional quality, with better health outcomes for all, greater and improved patient access, experienced, empowered, engaged, and well supported staff, inclusive leadership at all levels’
I have been involved in the hospitals previous recruitment process. The process involved interviewing various nursing staff in London, travelling to Spain and Portugal as part of a recruitment drive, even Skype interviewing other European nurses and working with a recruitment agency to recruit nurses in the Philippines. I have also participated in the hospital’s monthly meetings with the Director of the Workforce, the Director of Nursing, and other senior staff in the hospital. The meetings have highlighted and emphasized that in this General Trust Hospital, 35 percent of nursing Staff leave in the first year and in the second year this figure rises to 55 percent; this was discovered by thorough discussions and data analysis. The leaving rate of nurses has led to serious concerns as to the reasons that could be causing the leaving.
In the most simple of all economics, the nurse supply is proving difficult especially with the demand for nurses soaring in hospitals. The shortage of nurses was verified by the recent report from the Health Education Nursing Steering Group. In this report, the shortage was emphasized because of fewer nurses in the job markets and increasing hospitals, expanding hospitals and the hospitals such as ours that seeks to increase its nurses. In addition, other hospitals are following this example and implementing policies to increase their nurses. In our organization, there are around a thousands more nurses than the last year’s nurses. Nonetheless, the number ought to be higher as 14 percent of the nursing posts available lie vacant. According a report from Royal College Nursing the 8,000 vacant positions end up being filled with agency staff who are expensive. The agency staff put a strain on the hospitals budget due to their expensive nature as compared to the ordinary nurses. In fact, as of July 2014 this hospital has had a vacancy rate 19 percent. It is paramount to note that the vacancy rate emerged after the Trust increases the nursing posts after the Francis Report.
Aside from the obvious numerical shortage of trained nurses, there are numerous reasons that are contributing to the shortage and failure in retention of nurses. The cost of living in London is among the key causes of the absence of nurses in the Hospital. Keeping in mind that most of the newly established posts are at a pay rate aptly termed as “Band five” that starts at 21,478 Euros. The London Staffing Report of 2014 reported of some recorded instances where some trusts were unable to find any qualified or suitable candidate to the advertised posts.
The scarcity of nurses as previously mentioned has resulted in the hospitals having to resort to the agency nurses or recruit abroad. The reliance on the agency nurses has several ramifications including the increased costs, lack of continuity for the patients, inexperienced staff, and more pressure placed on the permanent nurses. The increased pressure on the permanent nurses in also a leading contributor to their leaving. The entire process is a vicious cycle where the hospitals attempts to fill their nursing staff with agency nurses results in the permanent nurses leaving and starting the process all again. It becomes apparent that better long-term strategic planning and implementation of policies is needed as opposed to the temporally fixes such as agency nurses that seem to worsen the situation.
The situation is becoming direr especially in the London region; the nursing shortage is increasing with more than 8,000 nursing post being vacant. The shortage trend is on the rise with the shortage increasing from last year’s 11 percent of the nursing posts being vacant to this year’s 14 percent of the posts remaining unfilled. The Hospital need to keep their patients safe and the present crisis puts the patients life’s in jeopardy. The hospitals must, therefore, recruit more nurses to keep the staffing at a level that can be considered safe for the patients.
The cost of living in London shows no indications on decreasing creating the need for the hospitals to conduct encompassing and even radical changes in their policies and institutions. The aims of the changes would be to ensure that hospitals remain affordable and attractive places of work for nurses to allow them the recruit and sustain the enough nurses to delivers top quality patient care.

Theories of Leadership and their Justification

Leadership must involve a change movement, the inspiring and energizing, role modeling and empowering other people. It is on this basis that King and Anderson point out the fundamental role of a leader as a change agent with the knowledge, networking abilities and a commitment to move teams forward. The leadership attributes of listening skills, and facilitation, negotiation skills and feedback are paramount. Collins English Dictionary further elucidates that a leader is an individual who inspires other and guides them. For the purposes of this paper, leadership encompasses the previously mentioned attributes alongside the leading of people or an organization, in the process to achieve a common set out goal. It is acknowledged that various individual skill in the leaders coupled by the institutional structures of their organizations will play a major role. Nonetheless, the defining aspect of leadership is achieving results, setting out good and positive examples and embracing responsibility for their actions.
The effect of leadership in revolutionizing and empowering organizations cannot be overstated; history is full of leaders who turned situations that seemed impossible around. Nurse leaders according to McPhee can create empowering working environments. The empowered working environments will be primarily in relation to the information and resources. In support of this these authors state that management science literature identifies empowerment strategies based on power sharing, participatory decision making, and enhanced communication that enable the motivation, innovative behaviors, job satisfaction and enhanced leader outcomes.
Transformational and transactional leadership styles are in practice opposites especially when it comes to their underlying theories on management and motivation

Transformational Leadership

A transformational leader extends beyond managing the day-to-day operations, and draws up strategies designed to take his work team, department, or company their next level in performance and success. Transformational leadership style will on aspects such as motivation, team-building, and collaboration with employees at varying positions and different levels of an organization to accomplish change for the better. Transformational leaders set the goals and incentives in order to push their subordinates to attain higher performance levels while providing equal opportunities for the personal and professional growth for each employee.
Transformational leadership styles are important and critical to the strategic development of an organization. Organizations with transformational leaders at the helm will aim for ambitious goals so that they can achieve rapid success through the team-building skills and vision of the transformative leader.
Cummings et al. (2010) conducted a systematic review of published research studies investigating nursing leadership styles and outcomes for the nursing workforce and work environment. To ensure the veracity of the data obtained only quantitative studies were included in this systematic review. Furthermore, the authors acknowledge and explain that limited control for extraneous variables was evident in many included studies that formed a part of the final result. In the critical appraisal of included studies while utilizing a quality and validity assessment tool and content analysis, Cummings et al. (2010) identified distinctive patterns between leadership styles and outcomes. The conclusion arrived at determined that the transformation leaderships attributes of nurse leaders resulted in a higher job satisfaction among the nurses especially in provision of the proper and effective nursing care delivery to the junior staff who fell beneath them in the Hospital.

The Impact of Transformational Leadership on Nursing

Transformative leadership involves a focus on the important goals and objective by the leaders and consequently by their followers. A good leader would, therefore, be capable of highlighting the important aspects of the nursing practice such as top quality healthcare and service to the patients without antagonizing the nurses. In some instances, Leaders have antagonized and pushed way the nurses when attempting to place emphasis on the important and primary objectives of the hospital. In addition, the transformative leader gets the employees to attain the organization's goals through perspiration that derives from reason. As such, unless the nurse involved is unreasonable or illogical they will accept the reasoning behind a decision or policy and implement it efficiently.
The nature of transformational leaders permits them to fit in well in providing leadership for people in a complex organization where the followers need the leader not only to guide them but also to also challenge and empower them. The result of such is that most of them become loyal and high performers. Nursing presently, especially in London is remarkably similar to the situation described; the nurses operate in the complicated hospitals organizational structure and also require their leaders to challenge them rather that leaving them in the situations where their days are filled with routine tasks only.

Identification of Transformative Leaders for their Appointments

The application of transformational leadership to the methods that the hospitals use to in their processes of recruiting and retaining their nurses can result in a great improvement in the current challenges. Transformative leadership often results in a united team that shares a common vision. The team will be inclusive of the leaders and the followers. Clearly, what is expected is that the Trust values must be clear and adhered to from all side need to align and provide effective training. Transformational leadership Bass’s work has a critically important message. He argues that the transformational leaders will behave in ways that achieve superior results mainly by employing one or more of the aforementioned four components of transformational leadership.

Transactional Leadership

Transactional leadership styles are more focused on maintaining the normal flow of operations. The method of transactional leadership can be contained in the statement, "keeping the ship afloat." Transactional leaders will use disciplinary power and a wide range of incentives to motivate their employees to perform at their level best. The term "transactional" points to the fact that this type of a leader essentially motivates their subordinates by exchanging rewards for good performance. A transactional leader does not cater for the future strategic objectives guiding an organization to a position of strength but instead they are focused mainly on management. Such manager’s sole concern is the running of the day to day activities.
Transactional leaders provide several advantages through their abilities to handle the small operational details efficiently and quickly. Transactional leaders handle all the aspects that come together to build an effective team, while keeping the employees productive and on the front line. The transactional approach is best suited to the attainment short term goals. However, the transactional approach has the disadvantage of doing little to create a feeling of loyalty or job satisfaction.
Transactional leadership is also called managerial leadership and as explained earlier focuses on the organization, group performance and the supervision of employees to ensure performance. The performance is sustained through a system of rewards and punishments. The Transactional leadership focuses on the follower's work to discover faults or deviations. It rewards those that comply with the instructions and punishes the followers who divert from the instructions. The main objective of transactional leadership is to keep things the same way unlike transformational leadership whose purpose is to improve things.

Impacts of Transactional Leadership in Nursing

Transactional leaders can be analyzed and recognized by their adherence to the path-goal theory that results them in doing the following; setting goals and having clear understanding of what they expect from their followers and the expected rewards or punishments. Transactional leaders seek to improve the performance by increasing the efficiency of the procedures and routines that are already established. A transactional leader will be more concerned with following the rules as opposed to making changes, positive or otherwise. Finally, the transactional leader will establish and standardize practices and routines in line with the set goals and objectives.

Advantages and Possible Benefits of Transactional Leadership in Nursing

At the first glance, transactional leadership might seem ill-fitting to the current nursing shortage; this is because the nurses are already leaving why we would institute a leadership style that could lead to more nurses leaving. However, when properly applied the transactional leadership style is equally useful in the same situation. Some of the successful transactional leaders have utilized the reward system effectively to improving the efficiency of the process. If the reward is, high enough then more nurses would even sign up and remain in the Hospital to attain it. In addition, the transactional leadership develops standardized practices that are essential to the nursing practice, enabling the Hospitals nurses’ practices to attain maturity with emphasis placed on the increase in efficiency and attaining of the set goals. However, this leadership style must be used with utmost caution to avoid worsening the situation and leading to mass exiting of the nurses.


In conclusion, there has been no robust long-term plan in place, and this has just been plugging the hole. Therefore, a view of leadership that concentrates on results without looking at the other attributes that bring loyalty and respect seems to run the risk of being considered lopsided and further worsening the challenges presently faced. Furthermore, the nurse scarcity problem along with the challenges facing recruitment and retention on nurses can be solved with the proper application of transactional and transformational leadership styles. However, transformative style and leaders should be encouraged and nurtured more in the hospital to ensure that nurses join without issues and remain loyal to the hospital.


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