Companies generally organize themselves into tall (vertical), flat (horizontal), or wide organizational structures. When you picture an organizational chart, the CEO of the tall organization generally leads from the top and leads from a distance. There are typically lots of spaces steps between leaders and employees with a well-defined chain of command. In flat organizations, there are fewer levels of management and employees have more autonomy; the CEO may be more knowledgeable about the daily activities in the organization and are more connected with employees. On the other hand, wide organizations are generally more “loosely coupled”. In the loosely coupled organization, like a franchise operation, people work for the same organization but may be disconnected daily. They may come together for training, but generally, there are separate cultures for each of the organizations. Nursing Turnover: Nursing turnover is one of the biggest issues impacting profitability and performance in healthcare organizations. Healthcare organizations require a highly trained, fully engaged, and stable workforce. Losing critical employees impacts healthcare in many ways including a) Decreased quality of patient care, b) Loss of patience, c) Increased accident and absenteeism rates, and d) Increase staffing costs. It could be argued that “employees quit managers, not businesses.” Depending on the organizational type, it may be easier for some nurses to quit. Here are a few factors that drive turnover in nursing: Feeling disrespected in the workplace Poor communication among team members Lack of trust Ineffective collaboration with others