Issues in Nursing Leadership and Management Essay

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

Select this issue: use of contract employees (i.e., registry and travel nurses),
Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct. Issues in Nursing Leadership and Management Essay

Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.
Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
his benchmark assignment assesses the following programmatic competencies:

Issues in Nursing Leadership and Management

Use of Contract Employees (Registry and Travel Nurses)


Managers in healthcare organizations experience difficulties in recruiting and retaining nurses during periods of nursing shortage. Therefore, hospital managers utilize temporary employment agencies to recruit temporary nurses and fill the vacancies. Several healthcare organizations use registry and travel nurses to meet their staffing needs. Temporary nurses account for about 30 percent of the nursing staff within the US, yet registry and travel nurses only consist of 1.5-2.0 percent of nurses in acute care settings (Faller et al., 2017). Travel and registry nurses are contracted for a short period, normally 4-26 weeks and they normally perform multiple activities in different regions. After being assigned their assignments and undergoing orientation, registry and travel nurses are supposed to assume their duties of direct patient care immediately. Registry and travel nurses may be essential in addressing the immediate nursing shortage, changes in patient demand, as well as cost burdens (Faller et al., 2017).  This paper will describe the approaches of nurse managers and leaders in addressing the issue of the use of contract employees.

The quality of care and cost containment are the topmost priorities within the healthcare system. Therefore, it is the issue of contract nurses regarding the quality of care is vital. The temporary nursing staff is used to fill vacancies with temporary nurses to improve services in healthcare organizations by ensuring there is an appropriate nurse-to-patient ratio and reducing the waiting period during admission (Salmond & Echevarria, 2017). Because the patient number arriving at a specific time varies significantly, healthcare organizations should maintain reserve capacity to meet the changing patient care needs. Contractual nurses provide healthcare organizations with a less costly option to maintain reserve capacity. Therefore, registry and travel nurses help in increasing patient safety and improving health outcomes. However, safety concerns have been raised regarding the use of temporary nurses, especially regarding the temporary personnel being less familiar with the hospital practices, policies, and procedures (Salmond & Echevarria, 2017). For instance, evidence has shown a positive link between mediation errors and temporary nurses. Additionally, increased use of temporary nursing staff can increase the workload among the permanent nursing staff, who apart from carrying out their assigned nursing activities, should assist and supervise the temporary nurses. Moreover, the fact that travel nurses do not reside near their work assignment, may impact how they deliver care, especially with the changing care needs in healthcare organizations (Faller et al., 2017). Temporary nurses also tend to seek employment opportunities that are well paying and thus there are difficulties in retaining them.


Nurse managers and leaders have the role of replacing nurses to fill the understaffed teams. In addition, they have the role of ensuring adequate nurse‐to‐patient ratios in healthcare organizations. It is therefore imperative for the nurse managers to ensure that the recruitment of temporary nurses does not have n adverse impact on the quality of patient care (Griffiths et al., 2019). During recruitment, the educational qualifications and nurses’ work experience for the temporary nursing staff should be considered. The temporary nurses should be able to complete patient care activities as per the nurses’ scope of practice (Faller et al., 2017). The managers and leaders in healthcare organizations should also effectively manage and ascertain the staffing mix while recruiting the temporary nursing staff (Griffiths et al., 2019). This means nurse managers have the role of managing the potential effect the staffing mix may have on patient care and effectively mentor and supervise the temporary nurses to ensure their competency in care provision. Issues in Nursing Leadership and Management Essay

The management should ensure that the temporary nurses are provided with the appropriate support to provide high-quality care. Apart from ensuring that the temporary nurses are properly trained and competent, nurse managers should provide leadership and guidance to these nurses and address any personnel issue to promote a supportive work atmosphere and productivity (Griffiths et al., 2019). The nurse managers and leaders should use the appropriate management and leadership skill to promote collaboration and good relations between the temporary nurses and the permanent nursing staff. Nurse leaders and nurse managers should constantly evaluate contract nurses through observation and effective communication (Gan, 2019). Travel nurses are supposed to ensure they familiarize themselves with the organization and adhere to the organizational safety standards. Nurse managers and leaders should thus have the required management and leadership skills.

There are various leadership theories and skills that nurse leaders and managers can use to recruit, manage, and monitor the registry and travel nurses in healthcare organizations. Apart from ensuring that the temporary nurses are competent and adhere to the organizational set standards and practices, it is important to ensure the temporary nurses have a support system (Gan, 2019). This is because contract nurses can experience isolation as they relocate often and work in different healthcare organizations. They may also lack a sense of belongingness.

Servant leadership style is an example of a leadership theory that can be used to support the temporary nursing staff. Servant leaders nurture relationships through empathy, listening, and fostering the growth of others (Neubert et al., 2016). Servant leaders also promote collaboration by strengthening relationships among employees. Therefore, nurse managers and leaders can use servant leadership to promote collaboration among the contractual nurses and the permanent nursing staff. This can promote a sense of belonging and improve collaboration and care coordination; this eventually positively impacts patient care. Servant leadership provides support to temporary staff who may often feel isolated (Neubert et al., 2016). Additionally, since the temporary nurses may be unfamiliar with the organizational policies and standards, servant leadership can be useful in guiding them and support them until they familiarize themselves with the set standards and policies.


The selected issue is the use of temporary employees. Travel and registry nurses are contracted for a short period, to perform multiple activities in different healthcare organizations. The temporary nursing staff is used to fill temporary vacancies to improve services in healthcare organizations to address the issue of nurse shortage. However, it is important to ensure that temporary nurses have the appropriate skills, knowledge, competency, and qualifications to provide competent care. Temporary nurses may be unfamiliar with the organizational policies and procedures, and at the same time lack a sense of belongingness. Therefore, nurse managers and leaders can use the servant leadership style to support the registry and travel nurses during their stay in healthcare organizations.


Faller, M., Dent, B., & Gogek, J. (2017). A Single-Hospital Study of Travel Nurses and Quality: What Is Their Impact on the Patient Experience? Nurse Leader, 15(4), 271-275.

Gan I. (2019). How do nurse managers describe clinical nurses’ work arrangements? A qualitative study. Nursing Open, 7(1), 160–169.

Griffiths, P., Maruotti, A., Saucedo, A. R., Redfern, O. C., Ball, J. E., Briggs, J., … & Smith, G. B. (2019). Nurse staffing, nursing assistants, and hospital mortality: retrospective longitudinal cohort study. BMJ quality & safety, 28(8), 609-617.

Neubert, M. J., Hunter, E. M., & Tolentino, R. C. (2016). A servant leader and their stakeholders: When does organizational structure enhance a leader’s influence? The Leadership Quarterly, 27(6), 896-910.

Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic nursing, 36(1), 12–25.

Issues in Nursing Leadership and Management Essay


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