Assessing the Impact of Community Factors on Acute Care Nurses' Job Satisfaction and Turnover Intention.

BACKGROUND: Community factors may affect nurses' job behavior and decision making. There is a gap in the literature regarding the impact of community satisfaction, family ties, and community preferences on acute care nurses' turnover intention and job satisfaction. Furthermore, no studies have examined the differences in community satisfaction, community preferences, and family ties among nurses working in rural and urban settings. PURPOSE: To identify the impact of family ties, community satisfaction, and community preferences on turnover intention and job satisfaction among acute care nurses working in Ontario's urban and rural areas. METHODS: Descriptive correlational survey design was used in this study. A targeted stratified sampling technique was used to recruit acute care nurses working in Ontario's urban and rural areas (N = 349) between May 2019 and July 2019. Dillman's approach was used to guide data collection. Parametric and non-parametric tests were used for data analysis. RESULTS: A significant association was found between working settings and community preferences. A statistically significant positive relationship between community satisfaction and nurses' job satisfaction was identified. Furthermore, community satisfaction had a negative impact on turnover intention. Neither community preference nor family ties were significantly associated with turnover intention or job satisfaction. CONCLUSION: The study suggests that community satisfaction can influence important nurse work-related outcomes. Future studies should replicate and validate these results in different contexts and cultures. Retaining nurses may be difficult if they are not satisfied with their communities.

Development and Testing of an Acute Care Nurses' Job Satisfaction Scale.

BACKGROUND AND PURPOSE: Factors affecting nurses' job satisfaction in the acute care setting may differ from nurses working in other settings. The aim of this study was to develop a new tool that measure the job satisfaction of acute care nurses who provide direct patient care. METHODS: Content validity then exploratory factor analysis (EFA) were used for validation of the new tool using a random sample of 349 acute care nurses. RESULTS: The EFA resulted in 31 items suggesting 6 factors were present in the instrument. The identified factors were: achievement/job interest/responsibility, hospital policy, quality of supervision, peer support/work condition, growth/advancement, and benefits/job security. CONCLUSION: A new tool for measuring acute care nurses' job satisfaction was developed based on a robust theoretical foundation and demonstrated sound psychometric properties.

Factors affecting job satisfaction among acute care nurses working in rural and urban settings.

AIMS: To: (a) identify the differences and similarities in the extrinsic and intrinsic factors that influence job satisfaction among nurses in urban and rural Ontario; and (b) determine the impact of job satisfaction on nurses' turnover intention among nurses working in rural and urban settings in Ontario. DESIGN: Cross-sectional correlational design was used for this study. METHODS: Data were collected between May 2019-July 2019 in southern Ontario. Participants (N=349) completed the Acute Care Nurses' Job Satisfaction Scale and The Anticipated Turnover Scale. A stratified sampling technique was used for recruiting the sample population and participants were given the option to respond either online or by mailed survey. RESULTS: There was no significant difference between rural and urban nurses in either overall job satisfaction level or turnover intention. Peer support/work conditions, quality of supervision, and achievement/job interest/responsibility were significant predictors of job satisfaction. There was a significant difference between rural and urban nurses in terms of satisfaction from benefits and job security and the nurses' job satisfaction levels correlated negatively with their turnover intention. CONCLUSION: Several extrinsic and intrinsic factors are associated with nurses' job satisfaction in rural and urban settings. Developing strategies that improve satisfaction by modulating these specific factors may improve nurses' job satisfaction and reduce turnover. IMPACT: This study discussed how working in a rural or urban hospital may affect nurses' job satisfaction and turnover intention. The findings can help in improving nurses' job satisfaction and inform workforce planning to increase nurses' retention.

Factors affecting nurses' job satisfaction in rural and urban acute care settings: A PRISMA systematic review.

AIMS: This review aimed to systematically assess the findings of primary studies to identify the factors associated with nurse job satisfaction in rural and urban contexts while analysing the findings according to Herzberg's theory. BACKGROUND: While there is evidence linking several factors to nurses' job satisfaction, gaps still exist in understanding the differences between factors affecting job satisfaction for nurses working in rural and urban settings. DESIGN: Systematic review with narrative summary. DATA SOURCES: Six databases were used to identify original studies that discuss the factors associated with the nurse's job satisfaction between 1998-2018. REVIEW METHODS: Two authors independently reviewed each study using the Joanna Briggs Institute's critical appraisal checklists. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to report and examine the study biases systematically. RESULTS: A total of 38 studies were selected for this review. Physical working environment and authority and freedom were the most frequently reported factors associated with nurses' job satisfaction. Several extrinsic, intrinsic, personal, and community factors were also found to be associated with nurses' job satisfaction. Urban studies tended to focus on extrinsic factors, whereas there was more balance between the two sets of factors in rural studies. CONCLUSION: Both intrinsic and extrinsic factors play an essential role in nurses' job satisfaction. Future research should use more robust research methods and pay more attention to contrasting rural and urban contexts. Herzberg's theory can provide conceptual clarity when investigating the factors associated with nurses' job satisfaction. IMPACT: This review discussed the factors associated with nurses' job satisfaction in rural and urban settings. The findings linked several extrinsic and intrinsic factors to nurses' job satisfaction. Nursing management should search for the perfect blend of intrinsic and extrinsic factors based on nurses' needs and organizational commitment to improve nurses' job satisfaction.

Conscience, conscientious objection, and nursing: A concept analysis.

BACKGROUND:: Ethical nursing practice is increasingly challenging, and strategies for addressing ethical dilemmas are needed to support nurses' ethical care provision. Conscientious objection is one such strategy for addressing nurses' personal, ethical conflicts, at times associated with conscience. Exploring both conscience and conscientious objection provides understanding regarding their implications for ethical nursing practice, research, and education. RESEARCH AIM:: To analyze the concepts of conscience and conscientious objection in the context of nurses. DESIGN:: Concept analysis using the method by Walker and Avant. RESEARCH CONTEXT:: Data were retrieved from Philosopher's Index, PubMed, and CINAHL with no date restrictions. ETHICAL CONSIDERATION:: This analysis was carried out per established, scientific guidelines. FINDINGS:: Ethical concepts are integral to nursing ethics, yet little is known about conscientious objection in relation to conscience for nurses. Of note, both concepts are well established in ethics literature, addressed in various nursing codes of ethics and regulatory bodies, but the meaning they hold for nurses and the impact they have on nursing education and practice remain unclear. DISCUSSION AND CONCLUSION:: This article discusses the relevance of conscience and conscientious objection to ethical nursing practice and proposes a model case to show how they can be appreciated in the context of nurses. Conscientious objection is an option for ethical transparency for nurses but is situated in contentious discussions over its use and has yet to be fully understood for nursing practice. Conscience is an element in need of more exploration in the context of conscientious objection. Further research is warranted to understand how nurses respond to conscience concerns in morally, pluralistic nursing contexts.

Conscientious objection and nurses: Results of an interpretive phenomenological study.

BACKGROUND: While conscientious objection is a well-known phenomenon in normative and bioethical literature, there is a lack of evidence to support an understanding of what it is like for nurses to make a conscientious objection in clinical practice including the meaning this holds for them and the nursing profession. RESEARCH QUESTION: The question guiding this research was: what is the lived experience of conscientious objection for Registered Nurses in Ontario? RESEARCH DESIGN: Interpretive phenomenological methodology was used to gain an in-depth understanding of what it means to be a nurse making a conscientious objection. Purposive sampling with in-depth interview methods was used to collect and then analyze data through an iterative process. PARTICIPANTS AND RESEARCH CONTEXT: Eight nurse participants were interviewed from across practice settings in Ontario, Canada. Each participant was interviewed twice over 9 months. ETHICAL CONSIDERATIONS: This study was conducted in accordance with Health Science Research Ethics Board approval and all participants gave consent. FINDINGS: Six themes emerged from data analysis: encountering the problem, knowing oneself, taking a stand, alone and uncertain, caring for others, and perceptions of support. DISCUSSION: This study offers an initial understanding of what it is like to be a nurse making a conscientious objection in clinical practice. Implications for nursing practice, education, policy, and further research are discussed. CONCLUSION: Addressing ethical issues in nursing practice is complex. The need for education across nursing, healthcare disciplines and socio-political sectors is essential to respond to nurses' ethical concerns giving rise to objections. Conscience emerged as an informant to nurses' conscientious objections. The need for morally inclusive environments and addressing challenging ethical questions as well as the concept of conscience are relevant to advancing nursing ethics and ethical nursing practice.

Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review.

BACKGROUND: Leadership is critical in building quality work environments, implementing new models of care, and bringing health and wellbeing to a strained nursing workforce. However, the nature of leadership style, how leadership should be enacted, and its associated outcomes requires further research and understanding. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. METHODS: The search strategy of this systematic review included 10 electronic databases. Published, quantitative studies that examined the correlations between leadership behaviours and nursing outcomes were included. Quality assessments, data extractions and analysis were completed on all included studies by independent reviewers. RESULTS: A total of 50,941 titles and abstracts were screened resulting in 129 included studies. Using content analysis, 121 outcomes were grouped into six categories: 1) staff satisfaction with job factors, 2) staff relationships with work, 3) staff health & wellbeing, 4) relations among staff, 5) organizational environment factors and 6) productivity & effectiveness. Our analysis illuminated patterns between relational and task focused leadership styles and their outcomes for nurses and nursing work environments. For example, 52 studies reported that relational leadership styles were associated with higher nurse job satisfaction, whereas 16 studies found that task-focused leadership styles were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. CONCLUSIONS: The findings of this systematic review provide strong support for the employment of relational leadership styles to promote positive nursing workforce outcomes and related organizational outcomes. Leadership focused solely on task completion is insufficient to achieve optimum outcomes for the nursing workforce. Relational leadership practices need to be encouraged and supported by individuals and organizations to enhance nursing job satisfaction, retention, work environment factors and individual productivity within healthcare settings.

Antecedents, mediators, and outcomes of authentic leadership in healthcare: A systematic review.

BACKGROUND: Leaders are essential in every organization to achieve patient safety and healthy work environments. Authentic leadership is a relational leadership style purported to promote healthy work environments that influence staff performance and organizational outcomes. Given recent growth in authentic leadership research in healthcare and the importance of new knowledge to inform leadership development, there is an obligation to determine what is known about the antecedents and outcomes of authentic leadership in healthcare settings and clarify mechanisms by which authentic leadership affects healthcare staff and patient outcomes. OBJECTIVES: The aim of this systematic review was to examine the antecedents, mediators and outcomes associated with authentic leadership in healthcare. DESIGN: Systematic review. DATA SOURCES: The search strategy included 11 electronic databases: ABI Inform Dateline, Academic Search Complete, Cochrane Database of Systematic Reviews, PubMed, CINAHL, Embase, ERIC, PsycINFO, Scopus, Web of Science, and ProQuest Dissertations & Theses. The search was conducted in January 2017. Published English-only quantitative research that examined the antecedents, mediators and outcomes of authentic leadership practices of leaders in healthcare settings was included. REVIEW METHODS: Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were analyzed through descriptive and narrative syntheses. Content analysis was used to group antecedents, outcomes and mediators into categories which were then compared to authentic leadership theory. RESULTS: 1036 titles and abstracts were screened yielding 136 manuscripts for full-text review which resulted in 21 included studies reported in 38 manuscripts. Significant associations between authentic leadership and 43 outcomes were grouped into two major themes: healthcare staff outcomes with 5 subthemes (personal psychological states, satisfaction with work, work environment factors, health & well-being, and performance) and patient outcomes. There were 23 mediators between authentic leadership and 35 different outcomes in the included studies and one antecedent of authentic leadership. CONCLUSIONS: Findings of this review provide support for authentic leadership theory and suggest need for additional testing in future studies using longitudinal and interventional designs in more varied healthcare settings with diverse and interprofessional healthcare samples. Knowledge generated through this systematic review provides a more comprehensive understanding of authentic leadership, which can be used to educate future leaders and has the potential to improve leadership development strategies and positive outcomes in healthcare workplaces.

Impact of Managers' Coaching Conversations on Staff Knowledge Use and Performance in Long-Term Care Settings.

BACKGROUND: Extended lifespans and complex resident care needs have amplified resource demands on nursing homes. Nurse managers play an important role in staff job satisfaction, research use, and resident outcomes. Coaching skills, developed through leadership skill-building, have been shown to be of value in nursing. AIMS: To test a theoretical model of nursing home staff perceptions of their work context, their managers' use of coaching conversations, and their use of instrumental, conceptual and persuasive research. METHODS: Using a two-group crossover design, 33 managers employed in seven Canadian nursing homes were invited to attend a 2-day coaching development workshop. Survey data were collected from managers and staff at three time points; we analyzed staff data (n = 333), collected after managers had completed the workshop. We used structural equation modeling to test our theoretical model of contextual characteristics as causal variables, managers' characteristics, and coaching behaviors as mediating variables and staff use of research, job satisfaction, and burnout as outcome variables. RESULTS: The theoretical model fit the data well (χ2 = 58, df = 43, p = .06) indicating no significant differences between data and model-implied matrices. Resonant leadership (a relational approach to influencing change) had the strongest significant relationship with manager support, which in turn influenced frequency of coaching conversations. Coaching conversations had a positive, non-significant relationship with staff persuasive use of research, which in turn significantly increased instrumental research use. Importantly, coaching conversations were significantly, negatively related to job satisfaction. LINKING EVIDENCE TO ACTION: Our findings add to growing research exploring the role of context and leadership in influencing job satisfaction and use of research by healthcare practitioners. One-on-one coaching conversations may be difficult for staff not used to participating in such conversations. Resonant leadership, as expected, has a significant impact on manager support and job satisfaction among nursing home staff.

Work engagement in professional nursing practice: A systematic review.

BACKGROUND: Work engagement in professional nursing practice is critically important to consider when addressing key challenges of health systems, including the global nursing shortage, pressures to reduce health care spending, and increasing demands for quality care and positive outcomes for patients. However, research on work engagement in professional nursing practice has not yet been synthesized and therefore, does not provide a sufficient foundation of knowledge to guide practice and further research. OBJECTIVES: The overall aim of this systematic review is to determine what is currently known about the antecedents and outcomes of work engagement in professional nursing practice. DESIGN: Systematic review. DATA SOURCES: The search strategy included eight electronic databases: CINAHL, MEDLINE, PsycINFO, PROQUEST, SCOPUS, Web of Science, EMBASE, and Business Source Complete. The search was conducted in October 2013. Quantitative and qualitative research that examined relationships between work engagement and antecedent or outcome factors was included. REVIEW METHODS: Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were synthesized through descriptive and narrative synthesis. Content analysis was used to categorize factors into themes and categories. RESULTS: 3621 titles and abstracts were screened and yielded 113 manuscripts for full text review. Full text review resulted in 18 included studies. All factors examined were grouped into either influences or outcomes of work engagement. A total of 77 influencing factors were categorized into 6 themes: organizational climate, job resources, professional resources, personal resources, job demands, and demographic variables. A total of 17 outcomes of work engagement were categorized into 3 themes: performance and care outcomes, professional outcomes, and personal outcomes. Based on the results, we adapted the Job Demands-Resources (JD-R) model and developed the Nursing Job Demands-Resources (NJD-R) model for work engagement in professional nursing practice, which reflects key adaptations related to organizational climate and professional resources. CONCLUSIONS: Our findings indicate that a wide range of antecedents, at multiple levels, are related to registered nurses' work engagement. Positive outcomes of work engagement are valuable to both performance and the individual nurse. The NJD-R model offers nursing science a valuable beginning framework to understand the current evidence, further direct nursing research, and begin to guide practice and policy. The results offer opportunities for nurse leaders to promote work engagement in professional nurses through action on organizational level resources.

The influence of empowerment, authentic leadership, and professional practice environments on nurses' perceived interprofessional collaboration.

AIM: The aim of this study was to examine the influence of structural empowerment, authentic leadership and professional nursing practice environments on experienced nurses' perceptions of interprofessional collaboration. BACKGROUND: Enhanced interprofessional collaboration (IPC) is seen as one means of transforming the health-care system and addressing concerns about shortages of health-care workers. Organizational supports and resources are suggested as key to promoting IPC. METHODS: A predictive non-experimental design was used to test the effects of structural empowerment, authentic leadership and professional nursing practice environments on perceived interprofessional collaboration. A random sample of experienced registered nurses (n = 220) in Ontario, Canada completed a mailed questionnaire. Hierarchical multiple regression analysis was used. RESULTS: Higher perceived structural empowerment, authentic leadership, and professional practice environments explained 45% of the variance in perceived IPC (Adj. R² = 0.452, F = 59.40, P < 0.001). CONCLUSIONS: Results suggest that structural empowerment, authentic leadership and a professional nursing practice environment may enhance IPC. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders who ensure access to resources such as knowledge of IPC, embody authenticity and build trust among nurses, and support the presence of a professional nursing practice environment can contribute to enhanced IPC.

The influence of frontline manager job strain on burnout, commitment and turnover intention: a cross-sectional study.

BACKGROUND: The frontline clinical manager role in healthcare is pivotal to the development of safe and healthy working conditions and optimal staff and patient care outcomes. However, in today's dynamic healthcare organizations managers face constant job demands from wider spans of control and complex role responsibilities but may not have adequate decisional authority to support effective work performance resulting in unnecessary job strain. Prolonged job strain can lead to burnout, health complaints, and increased turnover intention. Yet, there is limited research that examines frontline manager job strain and its impact on their well-being and work outcomes. The substantial cost associated with replacing experienced managers calls attention to the need to address job strain in order to retain this valuable organizational asset. OBJECTIVES: Using Karasek's Job Demands-Control theory of job strain, a model was tested examining the effects of frontline manager job strain on their burnout (emotional exhaustion and cynicism), organizational commitment and ultimately, turnover intentions. DESIGN: Secondary analysis of data collected in an online cross-sectional survey of frontline managers was conducted using structural equation modeling. PARTICIPANTS: All 500 eligible frontline managers from 14 teaching hospitals in Ontario, Canada, were invited to participate and 159 responded for a 32% response rate. METHODS: Participants received an email invitation with a secure link for the online survey. Ethics approval was obtained from the university ethics board and the respective ethics review boards of the 14 organizations involved in the study. The model was tested using path analysis techniques within structural equation modeling with maximum likelihood estimation. RESULTS: The final model fit the data acceptably (χ(2)=6.62, df=4, p=.16, IFI=99, CFI=.99, SRMR=.03, RMSEA=.06). Manager job strain was significantly positively associated with burnout which contributed to both lower organizational commitment and higher turnover intention. Organizational commitment was also negatively associated with turnover intention and there was an additional direct positive relationship between job strain and turnover intention. CONCLUSIONS: Preliminary support was found for a model showing that manager job strain contributes to burnout, reduced organizational commitment and higher turnover intentions. Findings suggest that organizations need to monitor and address manager job strain by ensuring managers' role demands are reasonable and that they have the requisite decision latitude to balance role demands.

Examining the relationships between span of control and manager job and unit performance outcomes.

AIM: Our aim was to examine the combination of frontline manager (FLM) personal characteristics and span of control (SOC) on their job and unit performance outcomes. BACKGROUND: Healthcare downsizing and reform have contributed to larger spans for FLMs in Canadian hospitals and increased concerns about manager workload. Despite a heightened awareness of SOC issues among decision makers, there is limited empirical evidence related to the effects of SOC on outcomes. METHODS: A non-experimental predictive survey design was used to examine FLM SOC in 14 Canadian academic hospitals. Managers (n = 121) completed an online survey of work characteristics and The Ottawa Hospital (TOH) SOC tool. Unit turnover data were collected from organisational databases. RESULTS: The combination of SOC and core self-evaluation significantly predicted role overload, work control and job satisfaction, but only SOC predicted unit adverse outcomes and neither significantly predicted unit turnover. CONCLUSIONS: The findings contribute to an understanding of connections between the combination of SOC and core self-evaluation and manager job and unit performance outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Organisational strategies to create manageable FLM SOC are essential to ensure exemplary job and unit outcomes. Core self-evaluation is a personality characteristic that may enhance manager performance in the face of high spans of control.

The influence of personal and workplace resources on new graduate nurses' job satisfaction.

AIMS: This study examined the influence of new graduate nurses' personal resources (psychological capital) and access to structural resources (empowerment and staffing) on their job satisfaction. BACKGROUND: Reports suggest that new graduate nurses are experiencing stressful work environments, low job satisfaction, and high turnover intentions. These nurses are a health human resource that must be retained for the replacement of retiring nurses, and to address impending shortages. Supportive workplaces that promote new graduate nurses' job satisfaction may play an important role in the retention of new nurses. METHODS: A secondary analysis of data from a larger study of new graduate nurses was conducted. Data collection was completed using self-reported questionnaires. Hierarchical multiple regression was used to test the hypothesised model. RESULTS: Psychological capital, structural empowerment and perceived staffing adequacy were significant independent predictors of job satisfaction. The final model explained 38% of the variance in job satisfaction. CONCLUSIONS: Both personal and structural workplace factors are important to new graduate nurses' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Managers should ensure empowerment structures are in place to support new graduate nurses' job satisfaction. Orientation processes and ongoing management support to build psychological capital in new graduate nurses will help create positive perceptions of the workplace, enhancing job satisfaction.

Factors influencing nurse managers' intent to stay or leave: a quantitative analysis.

AIM: To identify and report on the relative importance of factors influencing nurse managers' intentions to stay in or leave their current position. BACKGROUND: Effective nurse managers play an important role in staff nurse retention and in the quality of patient care. The advancing age of nurse managers, multiple job opportunities within nursing and the generally negative perceptions of the manager role can contribute to difficulties in retaining nurse managers. METHODS: Ninety-five Canadian nurse managers participated in a web survey. Respondents rated the importance of factors related to their intent to leave or stay in their current position for another 2 years. Descriptive, t-test and mancova statistics were used to assess differences between managers intending to stay or leave. RESULTS: For managers intending to leave (n = 28), the most important factors were work overload, inability to ensure quality patient care, insufficient resources, and lack of empowerment and recognition. Managers intending to leave reported significantly lower job satisfaction, perceptions of their supervisor's resonant leadership and higher burnout levels. IMPLICATIONS FOR NURSING MANAGEMENT: Organisations wishing to retain existing nurse managers and to attract front-line staff into leadership positions must create and foster an environment that supports nurse managers.

Exploring managers' views on span of control: more than a headcount.

The purpose of this qualitative study was to explore front-line managers' (FLMs') perceptions of their span of control (SOC) and how they manage it. As part of a larger quantitative study examining relationships between FLMs' SOC and performance outcomes, 10 manager focus groups were conducted by teleconference, involving 48 managers from 14 academic healthcare organizations. Themes and subthemes were identified according to (a) perceptions of the size and scope of SOC; (b) factors influencing the complexity of SOC; (c) supports needed to manage SOC; (d) changing leadership style; and (e) ways of coping with role overload. Participants described system demands as a significant contributor to their work responsibilities and a sense of role overload. About half of managers stated their SOC was unreasonable and that they lacked the necessary supports to manage it. Many managers who described their SOC as reasonable still expressed concerns about internal and external workload pressures that contributed to changing leadership style and role overload. Findings reinforce the importance of organizational strategies to create regular dialogue with FLMs regarding the size, complexity and appropriateness of current spans and to provide the resource supports necessary to ensure they can manage their SOC effectively.

The role of incentives in nurses' aspirations to management roles.

OBJECTIVE: The objective of this study was to describe findings from a study examining nurses' perceptions of incentives for pursuing management roles. BACKGROUND: Upcoming retirements of nurse managers and a reported lack of interest in manager roles signal concerns about a leadership shortage. However, there is limited research on nurses' career aspirations and specifically the effect of perceived incentives for pursuing manager roles. METHODS: Data from a national, cross-sectional survey of Canadian nurses were analyzed (n = 1241) using multiple regression to measure the effect of incentives on nurses' career aspirations. RESULTS: Twenty-four percent of nurses expressed interest in pursuing management roles. Age, education, and incentives explained 43% of the variance in career aspirations. Intrinsically oriented incentives such as new challenges, autonomy, and the opportunity to influence others were the strongest predictors of aspirations to management roles. CONCLUSIONS: Ensuring an adequate supply of nurse managers will require proactive investment in the identification, recruitment, and development of nurses with leadership potential.

Resonant leadership and workplace empowerment: the value of positive organizational cultures in reducing workplace incivility.

Nursing leaders are indispensable in creating positive nursing work environments that retain an empowered and satisfied nursing workforce. Positive and supportive leadership styles can lower patient mortality and improve nurses' health, job satisfaction, organizational commitment, emotional exhaustion, and intent to stay in their position. The results of this study support the role of positive leadership approaches that empower nurses and discourage workplace incivility and burnout in nursing work environments. The findings also provide empirical support for the notion of resonant leadership, a relatively new theory of relationship-focused leadership approaches. This research adds to the growing body of knowledge documenting the key role of positive leadership practices in creating healthy work environments that promote retention of nurses in a time of a severe nursing shortage.