Unit manager's integral nursing leadership linked to job satisfaction and intention to leave among nurses: A...

Nurse leaders and managers face significant challenges in today's rapidly changing and complex healthcare environments. With the important role of leadership, integral nursing leadership has been proposed as a new and holistic approach, considering both the internal and external aspects of individual leaders, as well as nursing organizations. Little research has investigated the effects of this leadership on outcomes in nursing contexts.

To examine the relationships between unit manager's integral nursing leadership and nurse outcomes (job satisfaction and intention to leave the unit, the hospital, and nursing profession), while controlling for individual general characteristics.

Descriptive, correlational study.

Data were collected from nurses (N = 507; 31 units) in two teaching hospitals in Seoul, South Korea, between June 2020 and August 2021. A structured questionnaire, including demographic and work-related characteristics, integral nursing leadership, job satisfaction, and intention to leave at three levels (unit, hospital, and nursing profession), was used. Multilevel modeling was conducted to examine the relationships between integral nursing leadership and nurse outcomes, accounting for nurses nested within their units.

Significant variations across nursing units were found for all nurse outcomes. Integral nursing leadership was statistically significant in relation to nurse outcomes, including job satisfaction (B = 0.23, 95 % CI [0.16, 0.30]), intention to leave the unit (OR = 0.55, 95 % CI [0.40, 0.76]), and intention to leave the hospital (OR = 0.52, 95 % CI [0.37, 0.74]), while no statistically significant relationship was found for intention to leave nursing profession. Of the four aspects of integral nursing leadership, individual leadership qualities (B = 0.14, 95 % CI [0.01, 0.27]) and individual performance (B = 0.18, 95 % CI [0.05, 0.30]) were significantly related to job satisfaction. Only individual performance was also statistically significant in relation to intention to leave the unit (OR = 0.48, 95 % CI [0.28, 0.82]), whereas individual performance (OR = 0.40, 95 % CI [0.23, 0.71]) and organizational excellence (OR = 1.80, 95 % CI [1.05, 3.07]) were statistically significant in relation to intention to leave the hospital.

These findings provide evidence-based insights that can inform the development of leadership training programs. Such programs could help nursing leaders enhance their leadership practices, thereby fostering their internal and external growth while improving organizational outcomes.