Impact of Ethical Leadership and Organizational Culture on Nursing Personnel's Organizational Commitment: A Cross-Sectional Study

TL;DR

This study explores how ethical leadership and organizational culture affect nursing staff's commitment in Greek hospitals, finding that smaller hospitals and supportive cultures lead to better outcomes.

Contribution

The study reveals how ethical leadership and organizational culture interact to influence nursing commitment, with insights specific to hospital size differences.

Findings

Ethical leadership positively correlates with all three types of nursing commitment.

Supportive and innovative organizational cultures are linked to higher affective and normative commitment.

Smaller hospitals show better commitment scores compared to larger ones.

Abstract

Introduction

Nursing personnel's organizational commitment is a growing global concern, influencing retention in dynamic and high-demand healthcare environments. Ethical leadership and organizational culture both contribute to organizational commitment. Little is known about the interaction between these variables when they coexist, and whether the results vary between secondary and tertiary hospitals. This study aims to investigate the impact of ethical leadership and organizational culture on nursing personnel's organizational commitment in Greece and to examine whether this varies according to nursing institutions’ sizes.

Methods

A cross-sectional study was conducted, enrolling 724 nursing personnel from two secondary and two tertiary Greek hospitals. Data were collected from January to May of 2023. The tools used were the Ethical Leadership Scale, the Organizational Culture Profile, and the Three-Component Model of Commitment. Descriptive statistics, independent t-test, Spearman and Pearson correlation coefficient, and multivariate linear regression analyses were performed to explore the variables’ relationships.

Results

Ethical leadership was related to affective (β = 0.38, CI = 0.27-0.49), normative (β = 0.44, CI = 0.33-0.55), and continuance commitment (β = 0.21, CI = 0.09-0.31). The organizational culture factors of supportiveness (β = 0.31, CI = 0.15-0.47), decisiveness (β = 0.30, CI = 0.12-0.47), and team orientation (β = 0.30, CI = 0.13-0.46) were related to affective commitment. Innovation (β = 0.36, CI = 0.23-0.49), emphasis on rewards and growth (β = 0.21, CI =0.07-0.36), focus on results (β = 0.19, CI = 0.04-0.34), and team orientation (β = 0.25, CI = 0.07-0.42) were related to normative commitment. Secondary hospitals had better scores on commitment.

Conclusion

This study reinforces existing evidence on nursing personnel's organizational commitment being correlated to ethical leadership and organizational culture. Furthermore, it highlights that a smaller hospital size contributes to better outcomes. Nursing personnel's commitment is imperative and achievable through a strong organizational culture with benefits for nurses, patients, and organizations. These findings can guide health policies on hospital management style and nursing personnel leadership development education.