Toxic leadership behaviour of nurse managers and turnover intentions: the mediating role of job satisfaction.

INTRODUCTION: Globally, hospitals are confronted with major challenges of turnover of nurses. Knowledge of the factors that account for the turnover of nurses will aid in creating strategies that will enhance nurse managers' leadership behaviour and job satisfaction to reduce turnover. The study, therefore, investigated the mediating role of job satisfaction on toxic leadership and turnover intentions of nurses. METHODS: A multi-centre cross-sectional study was undertaken to assess 943 nurses using the Toxic-leadership Behaviour of Nurse Managers scale, Minnesota Satisfaction Questionnaire and Turnover Intention scale. Descriptive statistics was used to assess the prevalence of toxic leadership, job satisfaction and turnover and Pearson's correlation examined the relationships between the variables. Hayes' PROCESS macro approach of mediation was used to determine the effect of toxic leadership behaviour on the turnover intention on the possible influence of job satisfaction. RESULTS: The response rate for the study was 76.0%. Mean scores for turnover intentions and toxic leadership behaviour were 3.71 and 2.42 respectively. Nurses who work with toxic managers showed a higher propensity to leave their jobs. Job satisfaction acted as a mediator between the toxic leadership practices of managers and turnover intentions. The total effect of toxic leadership behaviour on turnover intention comprised its direct effect (ß = 0.238, SE = 0.017, 95% CI [0.205, 0.271]) and its indirect effect (ß = -0.020, SE = 0.017). CONCLUSIONS: Job satisfaction acted as a mediating factor for toxic leadership behaviour and nurses' turnover intentions. As part of nurse retention initiatives, avoiding toxic leadership behaviours will be the ultimate agenda. Nurse administrators should recognize the value of excellent leadership and develop a structured training programme through the use of evidence-based professional development plans for nurse managers.

Leadership competencies of first-line nurse managers: a quantitative study.

PURPOSE: This paper aims to examine the leadership competencies of first-line nurse managers (FLNMs) at the unit level in the eastern region of Ghana. DESIGN/METHODOLOGY/APPROACH: The paper is a quantitative cross-section design. FINDINGS: Nurse managers exhibited a moderate level of knowledge and ability to apply leadership competencies. Gender, rank, qualification, professional experience, management experience and management training jointly predicted the leadership competencies of FLNMs [(R2 = 0.158, p = 0.016]. However, only management training was a significant predictor in the model. PRACTICAL IMPLICATIONS: Inappropriate leadership competencies have severe consequences for patients and staff outcomes. This situation necessitates a call for a well-structured program for the appointment of FLNMs based on competencies. ORIGINALITY/VALUE: This study is the first in Ghana which we are aware of that examined the leadership competencies at the unit level that identifies predictors of leadership competencies.

Staffing the unit with nurses: the role of nurse managers.

PURPOSE: To explore the staffing practices of nurse managers at the unit. DESIGN/METHODOLOGY/APPROACH: Introduction: Ensuring that units are staffed with adequate nurses to render quality nursing care to clients has become increasingly challenging for most hospitals. There is growing evidence linking best patient outcomes and fewer adverse events to the presence of nurses at the bedside. Hospitals require to attract and retain nurses in the units to address the issues of quality, staff and patient safety. Methods: The study used a descriptive phenomenological design to purposively select 15 nurse managers (NMs) and 47 nurses for in-depth interviews and focus group discussions respectively. FINDINGS: The study found that the demand for nurses to work in the unit was not scientific. Nurses affirmed their frustration of inadequate numbers of staff in the unit especially, at the periphery hospitals. Time can be used as a source of motivation for nurses and nurses should be involved in the development of the duty roster to enable effective compliance. Compensation for additional duties is relevant in nursing. RESEARCH LIMITATIONS/IMPLICATIONS: The research was carried only in one region in Ghana, and the findings may not be the same in the other regions. PRACTICAL IMPLICATIONS: Inadequate staffing level has serious implications on patient safety, quality of care and staff outcomes. This situation necessitates the implementation of health sector staffing norms to ensure the right calibre of mix staff are recruited and retained. ORIGINALITY/VALUE: This study is the first in Ghana that we aware of that explore staffing practices at the unit that identifies factors that impact staff schedules for effective care.