Abdelrahman Mahitab Mohamed, Nashwan Abdulqadir J, El-Boudy Doaa Fawzi
Nursing Administration and Education Department, College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
Nursing Administration Department, Faculty of Nursing, Suez Canal University, Ismailia, Egypt.
J Nurs Manag. 2025 Jun 28;2025:1734502. doi: 10.1155/jonm/1734502. eCollection 2025.
This study aimed to explore the relationship between toxic leadership by nurse managers and staff nurses' intentions to engage in whistleblowing practices, both within and outside their hospital. Nurses are pivotal in providing high-quality care, but toxic nurse manager leadership in the workplace can lead to challenges in patient care and the workplace environment. In response, whistleblowing serves as a mechanism to mitigate these problems and foster accountability. This descriptive correlational study was conducted from October 2023 to March 2024 with 292 inpatient and critical care unit nurses from a university hospital who were selected through simple random sampling. They completed the 15-item Toxic Leadership Scale to assess their views of toxic leadership in five domains: self-promotion, abusive supervision, unpredictability, narcissism, and authoritarian leadership. Nurses' intention to report misconduct was assessed using the 8-item whistleblowing intention questionnaire, including both internal and external whistleblowing. Descriptive statistics summarised the data; relationships between variables were evaluated using Spearman's correlation. Linear regression analysis provided the predictors of whistleblowing intention, exploring how personal characteristics and toxic leadership can affect this intention. The study revealed that nurses reported moderate levels of toxic leadership among their managers, with a total mean of 45.97 ± 11.545. They were more likely to intend to blow the whistle within the organisation (15.63 ± 3.085) than outside the organisation (10.77 ± 3.331), with the overall whistleblowing intention mean being 26.4 ± 5.008. Toxic leadership was significantly positively correlated with external whistleblowing ( = 0.282, < 0.001). A positive correlation was found between toxic leadership and external whistleblowing. Toxic leadership is a significant predictor of nurses' intentions to blow the whistle, and the educational level of nurses also contributes to these intentions. Addressing toxic leadership is crucial for encouraging whistleblowing and fostering a healthier work environment. Hospital managers and leaders need to combat toxic leadership, encourage a culture of safe whistleblowing practices, reinforce legal protections for whistleblowers and create ethical leadership training programs for nurse managers.
本研究旨在探讨护士长的不良领导行为与护士在医院内部和外部进行举报行为的意愿之间的关系。护士在提供高质量护理方面起着关键作用，但工作场所中护士长的不良领导行为可能会给患者护理和工作环境带来挑战。作为应对措施，举报是减轻这些问题并促进问责制的一种机制。本描述性相关性研究于2023年10月至2024年3月进行，研究对象为一所大学医院的292名住院部和重症监护病房护士，他们通过简单随机抽样选取。他们完成了一份包含15个条目的不良领导行为量表，以评估他们在自我推销、辱骂性监督、不可预测性、自恋和独裁领导五个领域对不良领导行为的看法。护士举报不当行为的意愿通过一份包含8个条目的举报意愿问卷进行评估，包括内部举报和外部举报。描述性统计对数据进行了总结；变量之间的关系使用斯皮尔曼相关性进行评估。线性回归分析提供了举报意愿的预测因素，探讨了个人特征和不良领导行为如何影响这一意愿。研究表明，护士报告其管理者的不良领导行为处于中等水平，总平均分为45.97±11.545。他们更倾向于在组织内部进行举报（15.63±3.085），而不是在组织外部（10.77±3.331），总体举报意愿平均分为26.4±5.008。不良领导行为与外部举报显著正相关（r = 0.282，p < 0.001）。不良领导行为与外部举报之间存在正相关。不良领导行为是护士举报意愿的一个重要预测因素，护士的教育水平也对这些意愿有影响。解决不良领导行为对于鼓励举报和营造更健康的工作环境至关重要。医院管理者和领导者需要对抗不良领导行为，鼓励安全举报行为的文化，加强对举报人的法律保护，并为护士长创建道德领导培训项目。
