Journal of Nursing Management

Aim. The aim of this study is to analyse the toxic leadership behavior of nurse managers perceived by nurses and its related factors. Background. Toxic leadership is becoming more common as a risk factor in nursing. However, there is a scarcity of research on the elements that influence toxic leadership practices from the perspective of nurses’ perceptions. Methods. A cross-sectional study was conducted with 455 nurses from August to October 2022. A demographic information questionnaire and a negative behavior scale for nurse managers were used. Descriptive statistics, Kruskal–Wallis H test or Mann–Whitney U test, and multiple linear regression were used to explore the relevant factors of nurses’ perceived toxic leadership behaviors of nurse managers. Results. The population was dominated by 423 (92.97%) females, 318 (69.89%) married, and 420 (92.31%) with a bachelor’s degree. The toxic leadership behavior scale score for nurse managers was 109 (87, 123) and the score for each entry was (2.94 ± 0.92). Gender, educational level, department, number of night shifts, and nature of employment were the influencing factors of the negative leadership behavior of nurse leaders as perceived by nurses ( < 0.05), explaining a total of 43.1% of the total variance. Conclusion. In general, nurses’ perceived toxic leadership behaviors of nurse managers were at a moderate level. More toxic leadership behaviors were observed by nurses who were female, less educated, on busy units, with unstable nature of appointments, and with frequent night shift rotation. Implications for Nursing Management. Focus on the psychological condition of nurses who are female, less educated, work in busy units, have an unstable nature of employment, and rotate night shifts frequently. The negative impacts of toxic leadership behaviors might be lessened as a result.

Aim. This study aims to identify the factors that influence humanistic practice ability, validate the relationship among social support, empathy, self-efficacy, and humanistic practice, and provide reference basis for developing intervention measures. Background. Cultivating humanistic practice ability in clinical nurses is essential for improving the quality of nursing care. Methods. From February to March 2022, a cross-sectional survey was conducted in top three hospitals in central China. The study used a self-designed questionnaire to ascertain the general characteristics of the participants. The Nurses’ Humanistic Practice Ability Scale, Jefferson Empathy Scale, Perceived Social Support Scale, and General Self-Efficacy Scale were used. Data were analyzed using Spearman’s correlation and a structural equation model through statistical product and service solutions (SPSS) and analysis of moment structure (AMOS). Results. A total of 650 clinical nurses were included in this study. The average age was 32.35 ± 8.35 years. The Nurses’ Humanistic Practice ability Scales score was 107.49 ± 19.32. Nurses’ humanistic practice ability showed a positive correlation with social support (r = 0.455), self-efficacy (r = 0.369), and empathy (r = 0.375) (all  < 0.001). Empathy totally mediated the relationship between social support and humanistic practice ability. In addition, self-efficacy and empathy served as sequential mediators in the association. Conclusion. Social support can influence the humanistic practice ability through self-efficacy. In addition, the higher the level of social support, the higher the level of self-efficacy, which further promotes the improvement of their empathy and eventually leads to stronger humanistic practice ability. Therefore, the corresponding measures to promote the humanistic practice ability of nurses can be formulated from the abovementioned three aspects. Implications for Nursing Management. We recommend that hospital administrators provide nurses with more comprehensive social support and develop intervention strategies to enhance nurses’ self-efficacy and empathy, which help to improve the nurse’s humanistic practice ability.

Aim. This systematic review aimed to synthesise the relationship between transformational leadership style and staff nurse retention in hospital settings. Background. It is known that globally there is a shortage of nurses. Thus, nurse retention and organisational commitment have never been more critical. Nurse managers are responsible for staff retention. Therefore, nurse managers could reduce staff turnover by adopting the “right leadership style.” Methods. Systematic review, following the guidance of PRISMA. Databases CINAHL, MEDLINE, PubMed, PsychInfo, Cochrane Central Register, and Embase were searched between 27^th December 2021 and 22^nd June 2023 to find relevant publications. Relevant studies were hand searched in January 2022 and June 2023 to source further potential evidence. A total of twelve articles were retrieved. Results. Twelve studies were included in this review, including six cross-sectional studies, two correlational studies, two cross-sectional correlational studies, and two surveys. In relation to retention, the primary outcome, data from eleven of the twelve studies reported statistical significance favouring transformational leadership improving staff retention. One study reported a statistically nonsignificant improvement in retention. Conclusion. There is evidence to suggest that transformational leadership may have a positive and significant relationship with staff nurse retention, job satisfaction, and quality of care. Implications for Nursing Management. Nurse managers should attend leadership and management training programs. This will allow them to understand and practice transformational leadership which may have a positive connection with staff nurse retention.

Aim. To evaluate the knowledge, attitudes, and practices of Chinese bedside nurses regarding antimicrobial stewardship, as well as to identify factors that influence nurses’ engagement in antimicrobial stewardship. Background. Antimicrobial resistance is a pressing global health threat. Antimicrobial stewardship is crucial in combating this issue. Nurses play a key role in implementing antimicrobial stewardship. However, little is known about the involvement of Chinese nurses in antimicrobial stewardship. Methods. An explanatory sequential mixed-methods design was employed. A self-developed questionnaire was administered between March and August 2021 (N = 463), followed by semi-structured interviews with 17 nurses between March and July 2022. Descriptive statistics and qualitative content analysis were used to analyze the data. Results. The study found that nurses scored 75% in knowledge, 82.8% in attitude, and 84.1% in practice domains. There was a moderate correlation between nurses’ knowledge, attitudes, and practices. It revealed that knowing local antimicrobial stewardship programmes information and the frequency of receiving antimicrobial stewardship training had a significant impact on nurses’ knowledge scores. The willingness to participate in related training influenced nurses’ attitude scores. Being a clinical teacher and the frequency of receiving related training influenced nurses’ practice scores. The qualitative phase identified three themes: insufficient knowledge of nurses’ engagement, diverse attitudes towards engagement, and limited scopes and absence of standards in nurses’ participation. Conclusions. Our findings emphasize the importance of enhancing nurses’ perception and involvement in antimicrobial stewardship. While nurses exhibit positive attitudes and practices, addressing the existing knowledge gap is crucial. To achieve this, it is necessary to clarify the role and responsibilities of nurses in antimicrobial stewardship, provide regular training and innovative methods, strengthen communication and collaboration, and foster a positive work environment. Additionally, actively promoting the development of guidelines and evaluation criteria will enable nurses to more effectively participate. Implications for Nursing Management. Regular training of nurses in antimicrobial stewardship needs to be enhanced. Nursing managers should strive to create positive, empowering, and supportive work environments, participate in policy formulation and implementation, and provide clear expectations for nurses’ engagement in antimicrobial stewardship.

Aim. To synthesise and map what is known about second-level nurses’ workplace violence experience. Background. Workplace violence has become a topic of focus in nursing over recent years. Research demonstrates that there is a growing body of literature focusing on first-level nurses’ workplace violence experiences, but those of second-level nurses, a crucial component of the health workforce in many countries, have not been well explored. Evaluation. A scoping review was conducted from January 2000 up to March 2022 using Arksey and O’Malley’s framework and databases, including ABI/Inform Collection, CINAHL, DOAJ, EBSCOhost, and ProQuest Central. Key Issues. Eighteen studies were included in the final review. The review identified three key findings related to second-level nurses’ workplace violence experience. (1) They were found to have experienced physical and non-physical violence. Among non-physical violence, they reported experiencing bullying, mobbing, sexual harassment, racial discrimination, nurse-to-nurse conflict, and electronic abuse. (2) They were more likely than first-level nurses to experience physical violence, and (3) often data from second-level nurses were combined with those of first-level nurses; hence, it was difficult to identify the specific experiences of second-level nurses. Conclusion. The review contributes to new knowledge highlighting the second-level nurses’ workplace violence experiences worldwide. The review indicated that there are gaps identified and there is a need for greater understandings of workplace violence in second-level nurses to understand the scope of their problem and the nature of their experiences. Implications for Nursing Management. Nurse managers play a critical role to develop and implement effective policies and evidence-based interventions to improve the working conditions of the second-level nurses. The results of this current review can be used to guide nurse managers and organisations in providing adequate support to reduce and prevent WPV and advocate for a positive workplace culture.

Background. Several studies identified that emotional intelligence skills are important indicators for nurse engagement and performance. Issues related to nursing performance in healthcare organizations have been gaining greater attention because they influence the effectiveness of improvement approaches to maintain high-quality care. This study aimed to investigate the relationships between emotional intelligence and nurses’ work performance and work engagement. Methods. A quantitative, descriptive, correlational design was used to evaluate the relationships between the study variables. Data were gathered from 150 nurses working at Madinah Cardiac Center, Saudi Arabia. Three scales were used to measure the study variables which were Emotional Intelligence Scale, Job Performance Scale, and Utrecht Work Engagement Scale in addition to demographics. SPSS was used to analyze data. Results. The results of this study showed that emotional intelligence has a total mean of 3.77 (SD = 0.598), nurses’ performance 3.65 (SD = 0.503), and work engagement 4.29 (SD = 1.04). The results also showed that there is a positive and significant relationship between emotional intelligence and nurses’ work performance (R² = 0.657, ). Also, it was found that emotional intelligence has a positive and significant relationship with nurses’ work engagement (R² = 0.621, ). Conclusions. This paper highlights the influence of emotional intelligence in nurses’ improved performance and engagement in work. The field of nursing is associated with care and compassion; thus, it needs a high level of emotional intelligence. Nurses need to enhance their emotional intelligence skills by attending workshops. Nurse leaders also have a role in that by building a culture for nurses that is driven by applying emotional intelligence in the workplaces.