Posted: June 5th, 2015

Transformational leadership and retention

Transformational leadership and retention 2500 words

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The title of this paper is transformational leadership and staff nurses’ intent to stay ( retention). So the aim of this paper is to examine the relationship between transformational leadership and retention. There are many paper talking about this topic however in this paper I need to arise new information and knowledge related to this topic.
Below is the structure of the paper and I have written some parts ( I want you to revise and adjust what I have written. Also I want you to add more 2500 words.

Transformational leadership and staff nurses’ intent to stay
Aim:
The aim of this study is to examine the relationship between transformational leadership and retention.

Organizing Construct:
Literature review of published research articles discussing the impact of transformational leadership in staff nurse retention.

Method:
Published research articles between 1995 and 2015 that examined transformational leadership (leadership behaviours) and staff nurses’ intent to stay were selected from 6 electronic databases, including the EMBASE, ERIC, PSYCHINFO, SCOPUS, MEDLINE (OVID), and Academic Search Complete. In consultation with a health librarian, databases were accessed using key words: transformational leadership, retention, nurs*
Findings:
A total of 8 studies satisfied our inclusion criteria and were retained. The higher nurses rated their manager as having transformational leadership style, the lower was the unit turnover rate. Studies indicated that transformational leadership style was positively associated with staff nurses’ intent to stay at work.
Conclusion:
This study supported a positive relationship between transformational leadership and staff nurses intention to stay at their current positions. Nurse managers should be appropriately equipped with the best leadership skills using the transformational model.
Clinical Relevance:
The findings provide enhanced awareness and understanding of correlation between transformational leadership and retention. Findings may assist with the development of leadership strategies decrease turnover rate and improve patient outcomes.
Keywords:

Transformational leadership, retention, nursing

Introduction
Healthcare systems all over the world are experiencing an immense nursing workforce shortage. According to World Health Organization (2006) the estimated shortage of doctors, and nurses is almost 4.3 million. The demand of nursing is expected to grow 40% by 2020 and only 6% of registered nurses will increase (Fraser 2010). As a result, nursing leaders encounter numerous difficulties such as problems of recruitment and retention, and turnover rate. To successfully lead in this context, there is a need of nurse leaders who are successful, motivated, and visionary. Proper leadership approaches should be aimed at improving the nursing workforce.
Retention studuies show that nurse managers’ behaviour have a significant impact on nurses’ intentions to stay his/her current position. From the literature, it is evident that there is a relationship between effective leadership styles and organizational outcomes such productivity, staff recruitment and retention, willingness to undertake additional efforts, and job satisfaction (Bass & Riggio 2006). A transformational style of leadership has been shown to bring about favourable outcomes including job satisfaction, performance, and intentions to stay (Abualrub & Alghamdi 2012). Gardner (2010) asserts that nurse retention can be improved through applying the transformational leadership model.
The vision and mission of Transformational leaders are able to be communicated to and understood by followers and can help in the development of staff to a higher level of ability and potential. Thereby, it leads to the attainment of intended and positive organizational outcomes (Bass 1985). This literature review seeks to address a number of aims and objectives. These are:
1. To identify the relationship between transformational leadership and retention;
2. To determine the impact of leadership behaviours on staff nurses’ intent to stay at their current work.
Methods and Search Strategy
A literature search strategy was formed with electronic databases as the initial source. A search was conducted in five reference databases: EMBASE, ERIC, PSYCHINFO, SCOPUS, MEDLINE (OVID), and Academic Search Complete. In consultation with a health librarian, databases were accessed using key words: leader*, transformational*, retention, nurs*. The second approach was hand searching of reference lists to identify any additional articles. The final search strategy was to use Google Scholar using the established search terms to identify additional articles.
The electronic database search resulted in the retrieval of 19, 835 articles. EMBASE (n = 39 ), ERIC (n = 17), PSYCHINFO (n = 96), MEDLINE (n = 36), Academic Search Complete (n = 114), and SCOPUS (n= 230). The hand searching process proved to be a cross-referencing activity because no new articles were identified given it was undertaken after the electronic search. With the same parameters used, a search result of 895 was attained via Google. Following the removal of duplicates, a review process by abstract was undertaken where the exclusion and inclusion criteria were applied (Table 1).
Articles that met the inclusion criteria were retrieved and a full text review undertaken: EMBASE (n = 1 ), ERIC (n = 1), PSYCHINFO (n = 3), MEDLINE (n = 0), Academic Search Complete (n = 1), and SCOPUS (n= 2). This process resulted in the identification of 8 articles suitable for inclusion in this review (see table 1).
Table 1. Inclusion and Exclusion Criteria
Inclusion Exclusion
 Studies within time frame of 2000-2014
 Peer-reviewed
Journals
 Published in English language
 Editorial and/or commentaries
 Book reviews and/or letters to the editor
 Published in a language other than English
Table 2. Overview of studies included
Author/Year Aim Method Findings Implication
1. Abualrub & Alghamdi (2012) To examine the impact of leadership styles of nurse managers on Saudi nurses’
job satisfaction and their intent to stay at work. Qualitative descriptive correlational design
(n = 308)
Nurses were more satisfied with leaders who demonstrated transformational leadership styles, and those who were more satisfied with their jobs intended to say at work. Nurse administrators in Saudi Arabia should capitalise on the importance of transformational leadership style in enhancing the level of job satisfaction.
2. Cowden, Cummings, & PROFETTO-MCGRATH (2011)
To describe the findings of a systematic review of the literature that examined the relationship between managers’ leadership practices and retention. Systematic Review. Transformational leadership behaviours influence staff nurses’ intent to stay in their current position. Leaders who practice transformational leadership are more likely to retain their staff.
3. Cummings et al. (2010)
To examine the relationship between leadership styles and outcomes for the nursing workforce and their work environment.
Systematic review. Transformational leadership were associated with higher nurse job satisfaction. Efforts by healthcare administrator to encourage and develop transformational leadership to enhance nurse satisfaction.
4. Kanste (2008) To explore the association between leadership behaviour and burnout among nursing in healthcare. Descriptive The correlation between transformational leadership and burnout subscales were rather low (range between -0.01 and 0.22) The findings of the study can be used in leadership education in the area of healthcare
5. Kleinman (2004)
To describe the relationship between leadership and retention in nursing. Prospective correlational design. Nurses without clinical specialty certification perceived higher idealized influence behaviours among their managers. Efforts by healthcare administrators to develop transformational leadership.
6. Larrabee et al. (2003)

To investigate the relative influence of RN attitudes, context of care, and Predictive Dissatisfaction and intent to leave strongly correlated.
TL+ satisfaction (.53) The findings emphasize the importance of creating and maintaining a work milieu in which participative management thrives .
7. Raup (2008) To determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. Survey A trend of lower staff nurse turnover with transformational leadership style was identified. Transformational leadership may offer some benefits to both managers and staff nurses.
8. Weberg (2010)
To present an evidence review to determine the impact of transformational leadership on staff satisfaction and burnout. Literature review Transformational leadership improves nurses’ job satisfaction and decrease key factors leading to job burnout. Healthcare systems should facilitate transformational leadership for the ultimate purpose of creating healthy work environment, improving job satisfaction, and reducing staff turnover rates
Figure 1: PRISMA flow chart presenting the selection of studies

Key Findings
This section presents findings in relation to the relationship between transformational leadership and nurse’ intent to stay along with the impact of leadership behaviours on retention within the nursing context. Findings will be presented under the following headings: transformational leadership and retention, leadership behaviours and staff nurse’ intent to stay.

a. Transformational leadership and retention Here I need to talk about the findings of the study :
Retention studies show that poor job satisfaction was the primary reason why nurses left their job. One of the reason of their dissatisfaction was leadership styles and motivation (Lu, While & Louise Barriball 2005). Based on the transformational leadership theory, the dimensions of such a form of leadership can generate a wide range of positive outcomes at an individual and organizational level (Avolio & Bass 2002). Across the studies, transformational leadership was shown to decrease turnover rate and increase job satisfaction (Weberg 2010). A study done by Vandenberghe, Stordeur, & D’hoore (2002) showed a direct link between transformational leadership and nurses’ intention to quite. Taking theses into consideration, an appropriate leadership approaches should be targeted towards the improvement of the nursing workforce. Nursing leaders should be capable of addressing the situation of turnover through the use of transformational leadership approaches.

Recent Studies support that there is a positive relationship between transformational leadership and staff nurses’ intent to stay at their current position.
Incorporating transformational leadership model into nurse managers practices will influence nurse retention (Cowden, Cummings & PROFETTO‐MCGRATH 2011).
I want you to adjust the above paragraphs and add more findings
b. Leadership behaviours and retention
Here I need to talk about how some leadership behaviours affect retention

The studies showed that leader behaviours have a significant impact on nurses’ decision to leave their current position. Nurses working under leaders demonstrating transformational leadership behaviours reports higher level of job satisfaction than those under transactional leadership (Gardner 2010). Intellectual stimulation is one of the transformational leadership behaviour and according to Nwoke (2010) it occurs when leaders stimulate their followers to look at problems, beliefs and values from new perspective. Nurses who reported that their leaders had a low frequency of intellectually stimulation behaviours often thought about leaving their job (Gardner 2010). Findings of Kleinman show that nurses who were not thought about leaving their job reported significant higher frequencies of idealized influence, inspirational motivation, intellectual stimulation, and satisfaction.

Individual consideration is one of the transformational leadership approach and it the degree to which leaders support their followers by listening to each follower’s needs and concerns. Klenman (2004) claim that there are no correlations between individual consideration and turnover rate or among nurses who had or had not considered leaving their position. Nonetheless, study of Taunton (1997) identified strong associations between staff nurses’ intent to stay and individual consideration behaviour. The sample of the study was considerably large (N= 1171) and he utilised the Description Questionnaire rather than MLQ.

The active approach to management by exception behaviours is one of the transactional leadership behaviours and has been linked to the use of penal action when followers are unable to adhere to the set standards, therefore this increases the monitoring of performance and corrective action (Jamaludin et al. 2011). The active approach to management by exception was correlated with higher level of turnover rate (Kleinman 2004). According to Parkman (2001), healthcare managers were widely demonstrated the management by exception approach of transactional leadership.
Here I want you to adjust the above paragraph and add more information
Discussion:
a. Definition of retention. What is the importance of retention in economic and healthcare delivery; Some statistic about turnover all over the world. And what is the cost of high turnover rate economically (increase personnel and patient care costs, inadequate healthcare delivery) and health care delivery; Statics regarding vacant position for RN. Also % of expansion for RN job by 2020. Also % of shortage at that 2020
Retention is ability to retain qualified nurses or the extent to which nurses remain in their job. Nursing retention considered as a crisis all over the world. By looking at the reason of high turnover rate leadership behaviours was the primary reason. Studies support that there is a relationship between transformational leadership and retention. So it is the time for healthcare administrator need to encourage and develop transformational leadership to decrease turnover rate and increase retention and job satisfaction. Nursing retention is one of the key issues facing all healthcare organizations. According to the Advisory Board (2000), the total cost to replace a registered nurse is $64,000 for an ICU nurse and $42,000 for a medical-surgical nurse. Along with the financial cost of losing qualified nurses, hospitals will suffer long-term negative effects from changing novice nurses (Force 2005). Without strong qualified nurses, patient care are doomed to failure.
b. Job satisfaction affect retention discuss that please 500 words
c. Yes there is a relationship between transformational leadership and retention. But the question HOW can nurse leaders apply the leadership behaviours in their daily practise? Discuss that
In the past 10 years, many studies support the positive relationship between job satisfaction, leadership style and retention. In 2002, the average rate of turnover of staff nurses was 21% (Weberg 2010). Therefore, it is important to identify factors that contribute to high level of job satisfaction. Studies show that one of the factors that contribute to positive job satisfaction is leadership behaviours (Force 2005). Job satisfaction is considered an outcome of the interactions in the work environment because it is a function of the relationship between what an individual seeks from their job and what the individual perceives the job is offering. Lu et al. (2002) provide impressive evidence from their study; they found that nurses with higher levels of job satisfaction tend to demonstrate greater productivity and intentions to. In another study, Aiken st al. (2002) surveyed 10,000 nurses and found that organizational and managerial strongly related to staff job satisfaction and intent to stay. Nonetheless, older nurses found to be less susceptible to predictors that influence younger nurses. They may be motivated more to stay at their current job by salary and seniority (Kleinman 2004).
d. How can we improve retention through transformational leadership and Trough leadership behaviours

e. How to fully develop effective leadership characteristics among nurse managers? And how to intervene to further develop the leaders with positive leadership characteristics? And how approaches should differ to develop the managers with ineffective styles? Dicsuss

Implication for nursing practise and nursing research:300
Conclusion: 200

Abualrub, R. & Alghamdi, M. 2012, ‘The impact of leadership styles on nurses’ satisfaction and intention to stay among Saudi nurses’, Journal of Nursing Management, vol. 20, no. 5, pp. 668-78.
Avolio, B. & Bass, B. 2002, ‘Manual for the multifactor leadership questionnaire (Form 5X)’, Redwood City, CA: Mindgarden.
Bass, B.M. 1985, Leadership and performance beyond expectations, Free Press New York.
Bass, B.M. & Riggio, R.E. 2006, Transformational leadership, Psychology Press.
Cowden, T., Cummings, G. & PROFETTO‐MCGRATH, J. 2011, ‘Leadership practices and staff nurses’ intent to stay: a systematic review’, Journal of nursing management, vol. 19, no. 4, pp. 461-77.
Force, M.V. 2005, ‘The relationship between effective nurse managers and nursing retention’, Journal of Nursing Administration, vol. 35, no. 7-8, pp. 336-41.
Fraser, S. 2010, ‘Influencing outlook: The importance of nursing staff satisfaction’, Nursing management, vol. 41, no. 9, pp. 12-6.
Gardner, B.D. 2010, ‘Improve RN retention through transformational leadership styles’, Nursing Management, vol. 41, no. 8, pp. 8-12.
Jamaludin, Z., Rahman, N.M.N.A., Makhbul, Z.K.M. & Idris, F. 2011, ‘Do Transactional, Transformational And Spiritual Leadership Styles Distinct?: A Conceptual Insight’, Journal of Global Business and Economics, vol. 2, no. 1, pp. 73-85.
Kleinman, C. 2004, ‘The relationship between managerial leadership behaviors and staff nurse retention’, Hospital Topics, vol. 82, no. 4, pp. 2-9.
Lu, H., While, A.E. & Louise Barriball, K. 2005, ‘Job satisfaction among nurses: a literature review’, International journal of nursing studies, vol. 42, no. 2, pp. 211-27.
Weberg, D. 2010, ‘Transformational leadership and staff retention: an evidence review with implications for healthcare systems’, Nursing Administration Quarterly, vol. 34, no. 3, pp. 246-58.