Cultivating Retention: Exploring Transformational Leadership Dynamics in Military Nursing through Qualitative Inquiry
DOI:
https://doi.org/10.58315/jcld.v11.298Keywords:
Nursing, Retention, Leadership, Transformational Leadership, Military Health SystemAbstract
Background: The shortage of nurses heightened the need to retain nurses in the workforce, particularly within military treatment facilities (MTFs). Despite quantitative analyses on factors affecting nurse retention, qualitative aspects of nurses’ free-text responses in routine surveys remain unexplored.
Objective: This study explored the impact of leadership, using qualitative data from the 2016 and 2018 Military Nursing Practice Environment Surveys, through the lens of the transformational leadership theory on preventable nurse attrition within the military health system (MHS).
Methods: Free-text responses from 1372 nurses in MTFs were analyzed using thematic content analysis methodology.
Results: Leadership emerged as the most prevalent concern, with 647 comments referencing leadership’s impact on preventable loss. Analysis revealed 25 leadership subcodes, highlighting negative sentiments about manager and executive leader presence and engagement, lack of acknowledgment, and ineffective communication, constituting 61.3% of negative comments.
Conclusions: This study highlighted the importance of leadership in nurse retention within the MHS. The findings align with Bass’s transformational leadership theory, emphasizing the need for idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration. Dissatisfaction with leadership trends resonates with the four pillars, suggesting that adopting a transformational leadership culture could positively impact MHS nurse retention. The recommendations include enhancing leadership visibility, improving communication channels, and fostering a supportive environment to address nurse dissatisfaction and prevent turnover.
Downloads
References
Bass, B. M. (1985). Leadership and performance beyond expectations. Free Press.
Bass, B. M., & Avolio, B. J. (1993). Transformational leadership and organizational culture. Public Administration Quarterly, 17(1), 112–121. https://doi.org/10.1080/01900699408524907
Bishop, C. T., Esaki, N., & Taub, M. E. (2023). Learning to be a leader worth following. Human Service Organizations: Management, Leadership & Governance, 47(5), 422–433. https://doi.org/10.1080/23303131.2023.2228853
Bryman, A., Bresnen, M., Beardsworth, A., & Keil, T. (1988). Qualitative research and the study of leadership. Human Relations, 41(1), 13–29. https://doi.org/10.1177/001872678804100102
Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Gabel, S. (2013). Transformational leadership and healthcare. The Journal of the International Association of Medical Science Educators, 23(1), 55–60. https://doi.org/10.1007/BF03341803
Givens, R. J. (2008). Transformational leadership: The impact on organizational and personal outcomes. Emerging Leadership Journeys, 1(1), 4–24.
Hoch, J. E., Bommer, W. H., Dulebohn, J. H., & Wu, D. (2018). Do ethical, authentic, and servant leadership explain variance above and beyond transformational leadership? A meta-analysis. Journal of Management, 44(2), 501–529. https://doi.org/10.1177/0149206316665461
Jackson, J., Maben, J., & Anderson, J.E. (2022). What are nurses’ roles in modern healthcare? A qualitative interview study using interpretive description. Journal of Research in Nursing, 27(6), 504–516. https://doi.org/10.1177/17449871211070981
Jyoti, J., & Bhau, S. (2015). Impact of transformational leadership on job performance: Mediating role of leader-member exchange and relational identification. Sage Open, 15(4), 1–13. https://doi.org/10.1177/2158244015612518
Kamalaveni, M. S., Ramesh, S., & Vetrivel, T. (2019). A review of literature on employee retention. International Journal of Innovative Research in Management Studies (IJIRMS), 4(4), 1–10.
Kariuki, J. (2021). Idealized influence and inspirational motivation in a microfinance context: Review of literature. International Journal of Organizational Leadership, 10, 120–140. https://doi.org/10.33844/ijol.2021.60539
Khan, H., Rehmat, M., Butt, T. H., Farooqi, S., & Asim, J. (2020). Impact of transformational leadership on work performance, burnout, and social loafing: A mediation model. Future Business Journal, 6, 40. https://doi.org/10.1186/s43093-020-00043-8
Klenke, K., Martin, S., & Wallace, J.R. (2016) Qualitative research in the study of leadership. Emerald.
Lai, F.-Y., Tang, H.-C., Lu, S.-C., Lee, Y.-C., & Lin, C.-C. (2020). Transformational leadership and job performance: The mediating role of work engagement. Sage Open, 10(1), 215824401989908. https://doi.org/10.1177/2158244019899085
Lake, E. T. (2002). Development of the practice environment scale of the nursing work index. Research in Nursing & Health, 25(3), 176–188. https://doi.org/10.1002/nur.10032
Mengyue, J., Shuyan, T., Rui, C., Wangshanyu, Ying, H., & Kok Loang, O. (2023). The role of transformational leadership in fostering innovation and employee happiness in the workplace. International Journal of Accounting, 8, 445–455. https://doi.org/10.55573/IJAFB.085031
Miller, M., Korbut, N. A., Amador-Garcia, L. M., Agazio, J., & Cartwright, J. K. (under review)(2024). Military medicine.
Poncheri, R. M., Lindberg, J. T., Thompson, L. F., & Surface, E. A. (2008). A comment on employee surveys: Negativity bias in open-ended responses. Organizational Research Methods, 11(3), 614–630. https://doi.org/10.1177/1094428106295504
Sow, M., Ntamon, A., & Osuoha, R. (2016). Relationship between transformational leadership and employee retention among healthcare professionals in the United States. Business and Economic Research, 6(2), 235–254. https://doi.org/10.5296/ber.v6i2.9831
U.S. Department of Defense. (2020, November 23). Coronavirus: DOD response timeline. https://www.defense.gov/Explore/Spotlight/Coronavirus/DOD-Response-Timeline/
Warner, G. (2023, December 8). Lawmakers look for fix to nurse shortage at military health care facilities. Stars and Stripes. https://www.stripes.com/theaters/us/2023-12-07/military-nurse-shortage-health-care-legislation-12290349.html
World Health Organization. (2020). State of the world’s nursing report: Investing in education, jobs, and leadership (978-92-4-000327-9). https://www.who.int/publications/i/item/9789240003279
Published
How to Cite
License
Copyright (c) 2024 The Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors contributing to Journal of Character & Leadership Development agree to publish their articles under the terms of the Creative Commons CC-BY 4.0 License. Authors retain copyright of their work, with first publication rights granted to the JCLD.
