Understanding the impact of nurse manager leadership behaviours on staff retention

Sandra Crewe

Nurses play a vital role in the delivery of healthcare services. Yet, the World Health Organisation and World Bank predict a shortfall of over seven million nurses by 2030, affirming the persistence of the global nurse shortage phenomenon. The literature identifies several reasons for nurse shortages, with the most salient being the challenge to retain nurses. The literature points to transformational leadership as the panacea for managing retention but fails to account for how an individual nurse manager’s leadership behaviours enable the navigation of the complex systems in healthcare to achieve positive outcomes. This qualitative study applies the Concept of the Rhizome to provide a non-linear but holistic approach, in a field of study dominated by linear perspectives, to understand how retention of the nursing workforce is influenced by the leadership behaviours of the nurse manager. Interviews with nurse managers (n=24) and other stakeholders (n=57), conducted in Australia and Seychelles, affirm the link between leadership behaviours and retention. Through reflective storytelling, this study showed that the identity of nurse managers, shaped by various cultures inside and outside the work environment, determined their behaviours. This research found enabling leadership is underscored by the harnessing of a paradox mindset, which is posited as the way forward for managing retention in the healthcare sector. Nurse managers influenced the work environment through positive deviant behaviours and taking on a multiplicity of roles. They weaved between positive leadership styles and activities to develop positive strategies, intentionally confronting challenges to find redress with positive resolve. These findings have important implications for Positive Organisational Scholarship in Healthcare. Furthermore, this study endorses leadership development focussing on navigating the paradox and tensions within healthcare, as a useful support for nurse managers to cope with tensions in this challenging work environment to influence retention of nurses within the system. Key Words: enabling leadership, paradox navigators, positive deviance, Positive Organisational Scholarship in Healthcare (POSH), nurse managers, staff retention

Understanding the impact of nurse manager leadership behaviours on staff retention

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