Transformational Leadership and Nurse Retention in Correctional Facilities:
A Path to Workforce Stability
Dr. Eugene Craig EdD, MHA
Correctional nurses are critical to the orderly operations of a correctional institution. These professionals perform various duties that aid in the comprehensive care of the incarcerated population. Shortages of these workers can limit the care offered to incarcerated persons. Additionally, remaining nurses could experience frustration and ethical dilemmas due to the inability to provide adequate care. Such frustrations could enhance the voluntary turnover of correctional nurses. Lazzari et al. (2020) examined moral distress, such as anger and frustration among correctional nurses. The authors concluded that turnover is high among correctional nurses due to moral distress caused by work-related challenges, which render the environment burdensome. Prolonged exposure to the barriers negatively impacts the nurses’ desire to remain with the organization, causing significant setbacks for correctional facilities.
Work-related challenges are extensive and are discussed in research by Shelton et al. (2020). Challenges include a stigmatization of the profession, a lack of standardized academic programs, restriction within the environment, overcrowding, increased workloads, enhanced potential for violence, and a security over care mindset. All these challenges assist in causing delays in care and promote inadequate care delivery, heightening moral distress and turnover among correctional nurses.
Failure to retain correctional nurses jeopardizes public safety because these professionals reduce the need for incarcerated persons to seek treatment outside the facility, minimizing the risk of escape. Further, correctional nurses assist in maintaining the integrity of the healthcare infrastructure by providing offenders with preventative and chronic care, reducing system burden during and after incarceration. Therefore, there is a societal need for correctional facilities to retain these professionals. Empirical research indicates that leadership plays a vital role in the retention of correctional nurses.
Leadership in Correctional Healthcare
Leading medical professionals within a unique and challenging environment such as a correctional setting takes specific skills. These leaders must ensure medical professionals are managed appropriately and foster an environment that promotes commitment and a willingness to remain. Moreover, correctional healthcare leaders must be concerned with care delivery, operational budgets, contract establishment, policy, and procedure development, and working with executive staff to manage departmental concerns. Therefore, these leaders must employ a leadership style that promotes a work environment that will assist correctional nurses in overcoming the inherent challenges associated with the correctional environment.
There is an abundance of leadership styles available to leaders. However, transformational leadership is an effective leadership style that is supported by research. Transformational leadership was introduced in seminal research as early as 1973, with expansion in 1978. Burns (1978) wrote that transformational leaders behave in a manner that motivates followers and demonstrates values such as justice and integrity. Scholars continued to research transformational leadership empirically, defining the construct throughout the years. The most popular expansion of the construct was by Bass and Avolio (1994). These authors developed the 4 I’s, which include Individual influence, Inspirational motivation, Inspirational stimulation, and Individualized consideration.
Using the 4 I’s, transformational leaders gain admiration and trust through ethical behaviors, inspire followers by setting clear goals, and foster creativity by encouraging team members to problem-solve without fear of criticism. Furthermore, they offer individualized support and mentorship, promoting personal development by providing opportunities for followers’ growth while establishing a supportive environment. These leadership characteristics are essential in retaining employees, making transformational leadership a solid leadership style for correctional healthcare leaders.
Dhaliwal and Hirst (2019) provided introductory insight into the suitability of transformational leadership within correctional nursing. Considering the attributes of the leadership style, the authors determined that transformational leadership would benefit the correctional environment. Dhaliwal and Hirst (2019) supported my research that examined the impact of transformational leadership on the commitment and intention to stay of these essential workers.
As an Assistant Health Services Administrator, I have observed and acknowledged the need for improved leadership techniques within correctional healthcare. Thus, I quantitatively assessed the impact of transformational leadership on the affective commitment and intention to stay of correctional nurses. Using a sample of 122 correctional nurses employed in the Southeastern region of the United States, my research indicated a significant correlation between transformational leadership and affective commitment as well as transformational leadership and intention to stay of correctional nurses.
My research reinforced the importance of employing transformational leadership in correctional healthcare as the study showed that it correlated with affective commitment and intention to stay among nurses. In other words, when correctional nurses perceive their supervisors as transformational leaders, they are more inclined to be emotionally attached to the organization (affective commitment). When nurses are emotionally attached to their organization, it implicates a solid relationship between nurses and leaders as leaders represent the organization in such a relationship. Also, transformational leadership behaviors cultivate employee engagement, including vision sharing, mentoring, and involving followers in problem-solving. Employee engagement is characterized by an individual’s dedication and commitment to remain focused during times of difficulty and failure. The prior signifies a personal investment in the organization’s mission, moving nurses to stay with the organization when they perceive their supervisor’s level of transformational leadership as high.
Practical Implications
Research suggests that correctional settings are burdensome for nurses due to the challenges associated with these environments (Lazzari et al., 2020). Leadership development is critical to assist nurses in overcoming the challenges of the environment (Almost et al., 2020; Shelton et al., 2020). Therefore, correctional leadership could benefit from the implication of transformational leadership behaviors. Thus, the author’s research supports that correctional executive teams should develop leadership policies grounded in transformational leadership behavior. Such policies include mentoring programs, inclusive leadership committees, career development programs, and employee wellness programs.
Additionally, organizations are encouraged to develop training programs for correctional healthcare supervisors that foster the development of transformational leadership behaviors. These programs should incorporate quarterly in-service training to increase implementation effectiveness and aim to enhance the work environment to overcome barriers linked to the correctional setting.
Finally, it would benefit organizations to include nurses in various operational functions to enhance buy-in from these professionals. Nurses could participate in schedule building, procedure development, attend continuing education programs focused on leadership skill advancement, decision-making processes, and be allowed to vocalize their concerns while leaders support them through challenges actively. These actions could invoke commitment and increase personal investment as such actions show confidence in nurses’ ability to contribute and cultivate a relationship of trust between leadership and nurses.
Personal Observations
I have observed the benefit of implementing transformational leadership behaviors as an administrator. Encouraging followers to participate in the development of operational functions has led to my team taking ownership of their clinic. Further, the prior has assisted with establishing relationships with team members and generating commitment. Specifically, I look to my team to aid in decision-making as most decisions impact their work lives. Therefore, including these professionals in decisions has been essential to promote creative thinking and motivation to meet organizational goals.
I have also worked to cultivate a team-oriented culture within the clinic. The prior has been achieved by avoiding phrases such as “my staff” and instead referring to individuals as team members. The team concept implies that every member is essential, as everyone plays a role in the success or failure of the clinic. The team concept also ensures that each member knows their role, adding a sense of value and willingness to display citizenship behaviors to overcome challenges, meet milestones, and deliver optimal healthcare to the incarcerated population.
Conclusion
In conclusion, correctional nurses have a demanding job that increases moral distress due to the challenges linked to the environment of correctional healthcare. These professionals are essential to the safety of the public and the healthcare infrastructure as they limit the need for incarcerated subjects to leave the secure environment for treatment. Thus, correctional organizations need to retain correctional nurses to protect society and maintain the integrity of the healthcare infrastructure for the general public.
Research highlights transformational leadership’s critical role in improving correctional nurses’ retention and commitment. By fostering a supportive work environment through ethical leadership, mentorship, and employee engagement, transformational leadership could mitigate the challenges associated with correctional healthcare. Implementing leadership policies and training programs grounded in transformational leadership principles can enhance nurse retention, improve patient care, and strengthen care delivery within correctional facilities. Therefore, correctional healthcare leaders should prioritize adopting transformational leadership to address workforce challenges and ensure the sustainability of quality care in these demanding environments.
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Dr. Eugene Craig EdD, MHA, is an Assistant Health Services Administrator with the Federal Bureau of Prisons. He holds a master’s degree in healthcare administration and a Doctorate in Organizational Leadership with an Emphasis in Healthcare Administration from Grand Canyon University. With over 11 years of law enforcement experience and over three years as a department head, he is dedicated to leadership development and mentoring others. For more information, he can be reached at eugenecraig03@gmail.com
References
Almost, J., Gifford, W., Ogilvie, L., & Miller, C. (2020). The Role of Nursing Leadership in Ensuring a Healthy Workforce in Corrections. Nursing Leadership (1910-622X), 33(1).
Bass, B. M., & Avolio, B. J. (Ed.). (1994). Improving organizational effectiveness through transformational leadership. Sage Publications.
Burns, J. M. (1978). Leadership, New York, Harper & Row. Cheung, F., Yeung, D. Y., & Wu, A. M. S. (2017). Employees’ perception of leadership styles and successful aging in the workplace. Journal of Career Development,1-15. https://doi.org/10.1177/0894845317727617
Dhaliwal, K. K., & Hirst, S. P. (2019). Correctional nursing and transformational leadership. Nursing Forum, 54(2), 192–197.
Lazzari, T., Terzoni, S., Destrebecq, A., Meani, L., Bonetti, L., & Ferrara, P. (2020). Moral distress in correctional nurses: A national survey. Nursing ethics, 27(1), 40-52.
Shelton, D., Maruca, A. T., & Wright, R. (2020). Nursing in the American justice system. Archives of Psychiatric Nursing, 34(5), 304-309.