Effects of toxic leadership style of nurse mangers on counterproductive work behaviors and intention to quit among staff nurses: A Comparative Study

Background: Leadership style has been given importance in contemporary research because
leaders are considered to be an essential part of an organization’s success. Toxic nurse managers
can have a detrimental impact on the organization's bottom line by increasing nurse’s absenteeism,
creating job dissatisfaction and unnecessary job stress, resulting in high staff turnover and
counterproductive work behaviors (CWB). Aim: The present study aimed to examine toxic
leadership of nurse mangers and its relation to counterproductive work behaviors and intention to
quit from the perspective of staff nurses. Design: A descriptive, correlational and comparative
design was utilized to fulfill the aim of this study. Sample: A convenient sample (n=190) of staff
nurses who agreed to participate in the study were included. Setting: The current study was
conducted in two different selected sectors at Cairo governate. Tool: Three tools were used I. Toxic
Leadership Behaviors of Nurse Managers (ToxBH-NM) Questionnaire; II. Counterproductive Work
Behaviors Questionnaire (CWBs) and III. Nurses’ intention to quit Questionnaire (NITQ). The
results: The study revealed that, the majority (73.6%, 63.1 respectively) of staff nurses perceived a
low level of overall nurse manger toxic leadership at both Hospitals. While only (14.9%, 15.5%
respectively) of them perceived a high level of overall nurse manger toxic leadership at both
Hospitals. Moreover, (100%) of staff nurses perceived a low level of overall Counterproductive
Work Behavior at private Hospitals compared to (40.8%) of staff nurses perceived moderate level of
overall Counterproductive Work Behavior at public Hospitals. Furthermore, (51.7%, 48.3%
respectively) of staff nurses had low to moderate intention to quite level at private Hospitals
compared to (33.0 %,514% respectively) of staff nurses had low to moderate intention to quite level
at public Hospitals. While, only (15.6%) of staff nurses had low intention to quite level at public
Hospitals. In addition, there was a statistically positive significantly correlation between total staff
nurses perceived toxic leadership with their Counterproductive Work Behavior (r = 0.250& p= 0.02)
at private hospital. While, there was a statistically positive significant correlation between total staff
nurses’ perceptions of toxic leadership with their intention to quit (r=0.352** and p= 0. 000*) at
public hospital. Conclusion: Overall, the study concluded that, the majority of staff nurses
perceived a low level of nurse manger toxic leadership at both private and public hospitals. All staff
nurses perceived a low level of overall Counterproductive Work Behavior (CWB) at private hospital
compared to around half of staff nurses perceived moderate level of CWB at public hospital.
Around half of staff nurses had low to moderate level of intention to quite at both private and public
hospitals. Also, there was a highly positive statistically significant correlation between staff nurses'
perception of nurse managers' toxic leadership, with their Counterproductive Work Behavior at
private hospital and with their intention to quit at public hospital. Recommendation: Establish
leadership training programs to provide health care supervisors with the skills they need to build a
collaborative and participatory management organization, thus reducing nursing absenteeism and
their CBW behaviors. Implement proper strategies and feedback system from staff nurses regarding
the behavior of their supervisors which might help in identifying toxic leaders.