Leadership matters: Managing our way to a healthier nursing workforce

Mélanie Lavoie-Tremblay, director of research for the Ingram School of Nursing, discusses the challenges faced by people in the nursing profession and outlines the ways in which the situation can be improved.
“Paying close attention to the leadership practices of nurse managers could go a long way in improving patient care and increasing the retention rate among our new nurses,” writes Mélanie Lavoie-Tremblay

By Mélanie Lavoie-Tremblay and Thalia Aube

National Nursing Week in Canada started May 8, and will culminate in International Nurses Day on May 12, celebrating the birthday of Florence Nightingale.

The nursing profession has greatly advanced since Nightingale’s era of the 1800s. According to global health organization Partners in Health, today, nurses deliver 90 per cent of all healthcare services to the world’s 7 billion people (and counting). Healthcare technology has evolved significantly, and people in general are living longer, resulting in higher rates of disease and chronic illness requiring complex care.

While there have been major strides in how illnesses are treated and prevented, now more than ever, nursing is a stressful profession. Nurses provide care to individuals and families, but also to entire communities, workplaces, schools, assisted-living facilities among many other venues, each with multifaceted health issues which can be overwhelming, whether you’re a nursing student or a veteran practitioner. Early on in my career working as a new nurse, I found myself troubled by the workplace environment I witnessed and experienced in the Quebec healthcare setting.

Today, the nursing profession faces major budget challenges, stressful working conditions and a decline in the number of nurse manager positions. What’s more, for nurses already working within the system, workplace stressors such as inadequate staffing and fewer resources can lead to feelings of frustration, inadequacy, psychological and physical distress and fatigue. In one of my studies, we found that 43 per cent of new nurses in Quebec reported psychological distress, with 62 per cent of respondents intending to quit their job and another 13 per cent intending to leave the profession entirely.

As an associate professor at McGill’s Ingram School of Nursing, I am deeply preoccupied by the professional landscape that awaits our students.

But there are solutions.

How we manage our healthcare workforce is key. Paying close attention to the leadership practices of nurse managers could go a long way in improving patient care and increasing the retention rate among our new nurses. Effective leadership, called transformational leadership, is a style of management in which employees are encouraged to work towards a collective goal within a supportive milieu. This type of management is linked to feelings of wellbeing and encourages job retention. Managers need to be trained and supported to enhance their leadership competencies.

Coupled with this, healthcare organizations can work towards enhancing provincially mandated workplace health and safety requirements including:

  • Occupational health and safety initiatives that focus on prevention of injuries and illness
  • Health promotion and wellness activities
  • Supportive organizational culture and leadership practices
  • Employee assistance programs to assist employees with personal issues
  • Management programs including early intervention and return to work initiatives

Transformational leadership should be promoted, but also, it’s important to focus on raising awareness among nurse managers of abusive leadership practices and how they create potentially detrimental working conditions for nurses.

In an era of evidence-based practice, programs aimed at helping healthcare managers develop better leadership skills helps to develop better managers, but also, it improves outcomes for organizations. By creating collaborative and supportive working environments for nurses and their managers, we will be reducing financial demands on the system through ensuring that our frontline health care workers are better able to provide the best possible care for their patients.

Mélanie Lavoie-Tremblay is an associate professor and director of research for the Ingram School of Nursing.

Thalia Aube is an advanced practice nursing student. She is currently completing her graduate degree at the Ingram School of Nursing.