NSG/451 Week 5: Influential Leadership Strategies, sample paper

Keeping New Graduates on Nights: Influential Leadership Strategies for a Charge Nurse on a Progressive Care Unit

[Student Name]

University of Phoenix

NSG/451: Professional Nursing Leadership Perspectives

Week 5 Assignment

[Instructor Name]

[Date]

The unit, nurses and figures are a composite written for a model paper.

In one year, a composite 26-bed progressive care unit hired nine new graduate nurses onto night shift, and four of them had resigned or transferred to days before their first anniversary. Each departure cost the unit an orientation period of about twelve weeks and left the remaining nights short, which pushed more overtime onto the experienced nurses who were also the preceptors. The night charge nurse has no authority to hire, fire or change pay, yet she sets the tone of every shift the new graduates work. Retention on nights is decided less by policy than by the dozen small moments in a shift when a new nurse either feels backed up or feels alone. This paper examines why new graduates leave, then proposes three influential leadership strategies that a charge nurse can use without a management title.

Why New Graduates Leave

Duchscher (2009) described the first months of practice as transition shock, a period in which new nurses face a sudden increase in responsibility, a gap between what school taught and what the unit expects, and loss of the support structure that surrounded them as students. Nights intensify each part of that experience. There are fewer senior nurses, fewer educators and fewer physicians on site, and the new nurse must make more independent judgments with less backup.

Leadership behavior shapes how that shock resolves. In a survey of new graduate nurses, Spence Laschinger et al. (2012) found that authentic leadership by the nurses' leaders was associated with less workplace bullying and less emotional exhaustion, and through those, with greater job satisfaction and lower intention to leave. Cummings et al. (2018), reviewing a large body of nursing leadership research, reported that relational styles such as transformational and authentic leadership were consistently associated with better outcomes for nurses, including satisfaction and intent to stay, while task-focused and laissez-faire styles were not.

The composite unit's exit conversations matched these findings. Three of the four departing nurses named the same things: feeling that asking for help on nights was a sign of weakness, two episodes of sharp public criticism during rapid responses and no one checking in after hard shifts. None of the four named workload alone as the reason for leaving, although all four described it as heavy.

Strategy One: Make Asking for Help the Expected Behavior

Bass and Riggio (2006) describe individualized consideration as the part of transformational leadership in which the leader attends to each follower's needs and development, acting as a coach rather than an evaluator. For a night charge nurse, that becomes a routine rather than a trait. At the start of each shift she assigns new graduates a named resource nurse for the night, walks the unit with each new graduate in the first hour and asks one question: which patient worries you most right now? That question gives permission to name uncertainty before it becomes a crisis. She also models the behavior she wants by asking for help herself, out loud, when she needs a second opinion.

Strategy Two: Protect Psychological Safety During Emergencies

Two departing nurses described being corrected sharply in front of others during rapid responses. The charge nurse cannot control how every physician or senior nurse speaks, but she can control the norms of her unit's response. Drawing on authentic leadership, which emphasizes transparency and consistency between what a leader says and does (Spence Laschinger et al., 2012), she agreed with the unit's experienced nurses on a simple rule: correction during an emergency is about the task and is brief; teaching happens afterward, in private or in the debrief. She then began holding a five-minute debrief after every rapid response on nights, in which she named at least one thing the new graduate did well before discussing what to change. The debrief turns a frightening event into a learning event and signals that mistakes are expected at this stage of practice.

Strategy Three: Extend Support Past Orientation

Most of the unit's departures happened between months four and ten, after formal orientation had ended. Goode et al. (2013), summarizing ten years of research on a post-baccalaureate nurse residency program, reported first-year retention well above the rates commonly reported for new graduates without residencies, with the program's structured support continuing through the first year. The charge nurse cannot create a residency, but she can extend part of its logic to her shift. With the manager's approval she set up monthly night-shift check-ins for first-year nurses, held during the quietest hour of the night, where new graduates discuss difficult cases with an experienced nurse. She also asked the manager to schedule new graduates with at least one of their former preceptors on most shifts during the first year, which keeps a trusted person nearby after orientation formally ends.

Strategies Considered and Set Aside

Two other responses were discussed on the unit and set aside, and the reasons matter as much as the choices. The first was to stop hiring new graduates onto nights and fill those positions only with experienced nurses. That would ease the charge nurse's load in the short run, but the regional supply of experienced progressive care nurses willing to work nights is small, and the unit would likely replace new graduate turnover with agency use at a much higher cost. It would also move the problem to day shift rather than solve it. The second was a retention bonus paid at the one-year mark. A bonus is outside the charge nurse's authority, and the exit conversations did not point to pay as the main reason for leaving. The manager raised the bonus with human resources as a separate question, but the charge nurse's plan does not depend on it.

Setting these options aside is itself part of influential leadership. A charge nurse who spends her credibility arguing for changes she cannot deliver has less of it left for the changes she can. By concentrating on routines she controls every shift, and by bringing the manager the one request that required formal approval, she used her influence where it would have the most effect.

Measuring Influence

Influence is hard to measure directly, so the charge nurse chose outcomes and signals. The main outcome is first-year retention of night-shift new graduates, compared with the prior year's five of nine. Signals along the way include attendance at the monthly check-ins, the number of rapid responses followed by a debrief and a short anonymous question added to the unit's quarterly survey: on nights, I can ask for help without being judged. If retention improves but the survey answer does not, the improvement may be due to something else, such as a pay change, and the strategies would need another look.

Reflection on My Own Leadership

Writing this plan changed how I think about my own role. I have tended to see leadership as something I would do after a promotion. The research on new graduate retention suggests that the behaviors that matter most, checking in, correcting privately and staying available, belong to whoever is in charge of the shift, and often to whoever is simply the most experienced nurse in the room. My goal for the next year is to practice the first-hour question on every shift I work, whether or not I am in charge.

Conclusion

Four of nine new graduates leaving a night unit in one year is a leadership problem as much as a staffing one. The evidence links retention to how leaders treat new nurses during the first year, particularly whether leaders are relational, transparent and available. A night charge nurse can influence all three through routines that make asking for help normal, keep emergencies safe for learning and extend support past orientation. None of these strategies requires authority; each requires consistency.

References

Bass, B. M., & Riggio, R. E. (2006). Transformational leadership (2nd ed.). Lawrence Erlbaum Associates. https://doi.org/10.4324/9781410617095

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016

Duchscher, J. E. B. (2009). Transition shock: The initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65(5), 1103-1113. https://doi.org/10.1111/j.1365-2648.2008.04898.x

Goode, C. J., Lynn, M. R., McElroy, D., Bednash, G. D., & Murray, B. (2013). Lessons learned from 10 years of research on a post-baccalaureate nurse residency program. Journal of Nursing Administration, 43(2), 73-79. https://doi.org/10.1097/NNA.0b013e31827f205c

Spence Laschinger, H. K., Wong, C. A., & Grau, A. L. (2012). The influence of authentic leadership on newly graduated nurses' experiences of workplace bullying, burnout and retention outcomes: A cross-sectional study. International Journal of Nursing Studies, 49(10), 1266-1276. https://doi.org/10.1016/j.ijnurstu.2012.05.012