Toxic Leadership in Hospital Nursing and Its Psychological Impact on Staff Well-Being: A Scoping Review

This scoping review examines the psychological impacts on staff resulting from toxic leadership in healthcare, specifically in hospital nursing, and offers recommendations to mitigate and manage this dark side of leadership.

Toxic leadership can have serious psychological effects on hospital staff, negatively impacting their health. Beyond individual well-being, it can also undermine hospitals' efforts to increase risks to patient safety and ultimately contribute to poorer patient outcomes.

Following PRISMA guidelines, a systematic search for both quantitative and qualitative evidence across four databases yielded 10 quantitative research articles, examining the experiences of 4850 healthcare professionals (3499 hospital nurses identified across 9 articles) worldwide with toxic leadership.

Five key themes were identified. Themes underlined that toxic leadership has a profoundly negative impact on nurses' psychological well-being and emotional functioning, with a final theme identifying strategies for mitigating its effects.

The findings confirm that psychological impacts for nurses encountering toxic leadership include anxiety, burnout, depression, emotional exhaustion, low motivation, malaise, negative affectivity, stress and withdrawal. Adopting the transformational leadership style in healthcare should be the gold standard, coupled with 360-degree appraisals. Future qualitative research is required to provide a more in-depth understanding of the psychological impacts of toxic leadership. Its associated costs can be substantial and warrant further exploration.

Strengthening nurses' awareness of toxic leadership, how to manage or escalate toxic leadership styles, and understanding its psychological impacts are essential tools for nursing management. Ensuring a supportive culture for reporting and recovery for those impacted by toxic leadership is vital, ultimately improving healthcare delivery, staff well-being and hospital performance.