An analysis of the effect of nurse managers' toxic leadership behaviours on nurses' perceptions of professional values: A cross-sectional survey

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Ozkan A., Çamlıca T., Kartal H.

JOURNAL OF NURSING MANAGEMENT, vol.30, pp.973-980, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 30
  • Publication Date: 2022
  • Doi Number: 10.1111/jonm.13597
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE, Psycinfo, Public Affairs Index
  • Page Numbers: pp.973-980
  • Keywords: leadership, managers, nurses, professional values, toxic, ABUSIVE SUPERVISION, CARE, INTENTION, HEALTH
  • Süleyman Demirel University Affiliated: Yes


Aim: This study aimed to investigate whether or not the toxic leadership behaviours
of nurse managers influence nurses’ perceptions of professional values.
Background: Professional values are among the factors that influence the development
and the enhancement of the quality of health services. The professional development
of nurses at work is particularly shaped by the guidance and counselling of
nurse managers. Therefore, it is vitally important to determine the effects of nurse
managers’ toxic leadership behaviours on nurses’ perception of professional values in
terms of the development of professional values and the nursing image.
Method and Material: This study was designed as a descriptive and correlational study
and was conducted with 244 nurses working in a university hospital between
09.01.2020 and 12.03.2020. The study data were collected using a Personal Information
Form (11 questions) designed by the researchers in line with the recent literature,
the Nurses Professional Values Scale-Revised (NPVS-R) and the Toxic Leadership
Scale. The study data were analysed with SPSS 25.0, and they were evaluated using
frequency, percentage, the Mann–Whitney U test and the Kruskal–Wallis H test, oneway
ANOVA, the t-test for independent groups, the Cronbach alpha coefficient and
Spearman correlation coefficient methods. The significance level was taken as
p < 0.001, and p < 0.05 was used to interpret the study results.
Results: The mean age of the nurses in the study was 31.79  6.68 years. A statistically
significant difference was found between the scores for the NPVS-R and their
previous education about leadership (U:5.273, p < 0.05). A significant difference was
also noted between the Toxic Leadership Scale scores and the educational status of
the nurses (χ2 = 9.971, p < 0.001), whether or not they deliberately chose nursing as
a profession (U:7.777, p < 0.05), whether or not they willingly served as a nurse
(U:8.458, p < 0.001) and whether or not they willingly served in their current
unit (U:8.475, p < 0.05). The total score and the subdimension scores of the Toxic
Leadership Scale and NPVS-R Scale were not significantly correlated (p > 0.05).
Conclusion: The results demonstrated that nurses who deliberately chose nursing as
a career option, who willingly served as a nurse and who willingly served in their current
units were comparatively less influenced by the managers with toxic leadership
attitudes. It was similarly determined that nurses with higher levels of education and those who received in-service training were less influenced by toxic managers. It was
finally noted that working with toxic managers had no significant effect on the
nurses’ perception of professional values.
Implications for Nursing Management: The results indicated that although toxic
leadership and nurses’ perception of professional values were not significantly correlated,
toxic behaviours may cause a depreciation in nurses’ perception of professional
values and beliefs, as noted in other relevant studies. It is thus necessary to be aware
of the effects of toxic leadership behaviours on nurses and the institution and that
precautions be taken by management against any negative effects. Supporting nurses
with in-service training and building up resistance against toxic leadership behaviours
will be beneficial for the proper and effective functioning of the institution.