Background
Leadership is important throughout the nursing profession especially in acute care where nurses encounter stress, pressure, decision making and complicated patients. A clear understanding of leadership is that it is not only instrumental to the performance and health of professional nurses it also has a direct influence on the patient (Meyer et al. 2020).
As retention, job satisfaction and quality and safety of patient care remain paramount concerns, especially for the nursing workforce, knowledge of leadership practices and their bearings on organizational commitment becomes inevitable. One of the major functions of leadership in acute nursing centres is to enhance protractive work climate, involvement, and recruitment and selection of talented nurses.
The study discussed in this systematic review mainly seeks to establish a clearer understanding of the various aspects of nursing leadership practices and organizational commitment in acute care facilities. These include; Transformational leadership, Transactional leadership, and Laissez faire leadership, while their influence on nurse commitment in an acute care setting is still a topic of research.
It is of great importance for healthcare organisations to identify the relationship between both leadership and organisational commitment for enhanced turnover and staff productivity and patient satisfaction (Herminingsih, 2020). Organizational commitment, which refers to the emotional, normative, and continuance obligation of individuals to the organization of their working place, is especial in nursing.
The results also showed that perceived organizational commitment has a positive impact on role performance, job satisfaction, and patient satisfaction and clinical outcomes (Putra et al. 2020). This appears to be particularly important in acute care environments characterised by high work demands, turnover rates or unpredictable work schedules.
In this paper, we will first classify various leadership behaviors that we have personally identified in acute care setting based on previous literature, and then briefly examine what impact those leadership behaviors have on the level of commitment of nurses towards their profession as well as to their patients. Finally, based on the literature review, we will provide suggestions for leadership practices that may help facilitate increased commitment among nurses working in acute care settings.
Aim and Objectives
Aim
This study purpose it to provide a systematic and comprehensive evaluation of the relationship between various types of nursing leadership and the proposed effects on the organizational commitment to nurses in ACNs (Acute Care Nursing or Acute Care Nurses); with particular emphasis on the effects on patient care and professional commitment.
Objectives
· To systematically categorize leadership styles exhibited by nurses in acute care settings based on the existing literature.
· To analyze the impact of various nursing leadership styles on different aspects of organizational commitment (e.g., emotional, normative, and continuance commitment) in acute care environments.
· To evaluate the level of commitment, nurses have towards patient care and towards the nursing profession in acute care settings.
· To provide evidence-based recommendations for enhancing nursing leadership practices to improve organizational commitment in acute care settings.
Research Question
What is the relationship between different nursing leadership styles and organizational commitment in acute care settings, and how do these leadership styles influence nurses’ commitment to patient care and their profession?
Research Significance
The systematic literature review seeks to explore the relationship between the leadership behaviour of nurses and their level of organizational commitment within acute care facilities. The relevance of this research is that it can potentially contribute to the existing knowledge available on leadership in the healthcare sector in order to enhance leadership practices and policies. Therefore, this review synthesizing prior literature will offer enlarged knowledge regarding the manner in which leaders’ behaviours affect nurses’ organizational commitment. It can be applied in designing leadership training programs that consolidate appropriate behavioural models to strengthen organisational commitment and consequently advance patient care.
Furthermore, the findings of this study have implications for healthcare policy and management. Recognizing the connection between leadership approaches and employees’ organizational commitment can assist healthcare managers in developing positive working conditions (Agus and Selvaraj, 2020). This will further encourage nurses to remain committed and satisfied with their jobs. This is relevant, especially in acute care facilities where employee turnover is rather frequent resulting in poor patient outcomes and high organizational costs. This study can help advance the state of knowledge of leadership practices that predict organizational responsibility to enhance the quality of care in acute care organizations.
Literature Review
| Author name with the publication year | Aims of the research | Methodology | Key findings |
| “Ali, H.M., Abood, S.A., El-baset, A., and Thabet, M.” (2020) | This study seeks to explore the interconnectivity between the leadership styles of nurse managers and the organisational commitment of staff nurses within hospital settings | This research includes the descriptive correlation design. Data has been collected through the survey of the staff nurses and nurse managers | An assertive relationship has been found between transformational leadership and a higher level of organisational commitment among the nurses. The transactional leadership style has been related to a moderate level of organisational commitment while the laissez-faire leadership was firmly linked with a lower level of commitment. |
| “Niinihuhta, M., and Häggman-Laitila, A.” (2022) | This research aims to systematically review the literatures that show the relationship between distinct leadership styles of nurse leaders and the work-related welfare of the nurses | This study utilised the systematic review methodology | Transformational leadership was related to the positive well-being of the nurses which paved the way for higher levels of job satisfaction and lower levels of stress. The laissez-faire leadership imposed a negative impact which leads to a lower level of well-being and a higher level of turnover intentions among the nurses. |
Methodology
Methodology refers to the comprehensive description of the research methods utilised within the research process (Pandey and Pandey, 2021). In this research, secondary qualitative data will be used for analysing data. Through reviewing the existing literature, it is possible to accumulate a wide range of data from different sources. This will further enhance the generalizability of the overall research findings. In this research, the interpretivism paradigm will be utilised as it focuses on the subjective experiences and meanings of the individuals within their social contexts.
Interpretivism research philosophy emphasis perception of mindset, intention and rationale of people (Verma et al. 2024). This is necessary for the analysis of the impact of various forms of leadership on the organisational commitment of nurses. Consequently, the inductive research approach will be used for the conduction of overall research in this study.
This approach helps the researchers generate new theories depending on the data that they have collected, which is particularly vital in the research of the relatively unexplored areas such as the impact of leadership styles on organisational responsibility in the acute care facilities.
The topics most related to the study of nursing leadership styles and organizational commitment in acute care are better approached considering the inductive approach and, therefore, adopting a philosophy of interpretivism: this is because interpretivism focuses on the understanding of human practices and actions.
The inductive approach helps take a bottom-up approach by which theories based on the patterns observed in qualitative data can be developed to explore context-rich leadership dynamics. It is supported by the fact that interpretivism centres on subjective meanings and lived experiences, which will be very crucial in understanding how varying leadership styles influence commitment by nurses. These together offer a nuanced comprehension of complex social relationships in care settings.
“Inclusion and exclusion criteria of the systematic review”
“Inclusion Criteria”:
- Studies that focused on registered nurses working in acute care settings
- Those articles that measured organisational commitment through the utilisation of the validated instruments
- Research that examines the various leadership styles
“Exclusion Criteria”:
- Studies that have not specified the acute care settings, for example, long-term care, outpatient clinics and many more
- Non-peer-reviewed articles or those articles published in languages other than English
- Literature review, theoretical papers and opinion pieces without the accurate data
Timeline
Figure 1: Timeline
(Source: Self-developed)
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References
Agus, A. and Selvaraj, R., (2020). The mediating role of employee commitment in the relationship between quality of work life and the intention to stay. Employee Relations: The International Journal, 42(6), pp.1231-1248.
Ali, H.M., Abood, S.A., El-baset, A. and Thabet, M., (2020). Relation between leadership styles and behaviours of nurse managers’ and organizational commitment of staff nurses. Minia Scientific Nursing Journal, 7(1), pp.54-62.
Herminingsih, A., (2020). Transformational leadership positive influence toward employee engagement through job satisfaction and its effect on improving organizational commitment. Jurnal Manajemen Dan Pemasaran Jasa, 13(2), pp.281-296.
Meyer, T., Quaedflieg, C.W., Bisby, J.A. and Smeets, T., (2020). Acute stress–but not aversive scene content–impairs spatial configuration learning. Cognition and Emotion.
Niinihuhta, M. and Häggman‐Laitila, A., (2022). A systematic review of the relationships between nurse leaders’ leadership styles and nurses’ work‐related well‐being. International Journal of Nursing Practice, 28(5), p.e13040.
Pandey, P. and Pandey, M.M., (2021). Research methodology tools and techniques. Bridge Centre.
Putra, A.P., Kusnanto, K. and Yuwono, S.R., 2020. Effects of job satisfaction and organizational commitment on nurse retention: a systematic review. Indonesian Nursing Journal of Education and Clinic (INJEC), 5(2), pp.197-205.
Verma, R., Verma, S. and Abhishek, K., (2024). Research methodology. Booksclinic Publishing.