Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses
| DOI | https://doi.org/10.1108/PR-05-2015-0118 |
| Pages | 1200-1216 |
| Published date | 05 September 2016 |
| Date | 05 September 2016 |
| Author | Cindy Cheng,Timothy Bartram,Leila Karimi,Sandra Leggat |
| Subject Matter | HR & organizational behaviour,Global HRM |
Transformational leadership and
social identity as predictors of
team climate, perceived quality
of care, burnout and turnover
intention among nurses
Cindy Cheng
School of Allied Health, La Trobe University, Melbourne, Australia
Timothy Bartram
La Trobe Business School, La Trobe University, Melbourne, Australia, and
Leila Karimi and Sandra Leggat
School of Psychology and Public Health,
La Trobe University, Melbourne, Australia
Abstract
Purpose –The purpose of this paper is to examine the role of transformational leadership (TL) in
developing social identity and its subsequent impact on team climate, intention to leave, burnout and
quality of patient care among nurses.
Design/methodology/approach –Data for this cross-sectional study were collected from a sample
of 201 registered nurses in Australia through questionnaires. Structural equation modelling was used
to test the hypotheses.
Findings –Results illustrate that social identification appears to be the psychological mechanism
through which TL impacts important employee outcomes, including perceived quality of patient care.
Practical implications –This study provides valuable insights into understanding the critical role
of human resource management (HRM) practice and policy in healthcare environments. Findings from
this study indicate that human resource managers can assist nurse unit managers to deliver their HRM
roles effectively when adequate support and relevant HRM infrastructures are put in place.
Originality/value –This research considers the role of first-line nurse managers in healthcare
organisations. It provides evidence-based knowledge about the type of leadership style required to
achieve desirable employee outcomes and the essential HRM opportunities to facilitate this.
Keywords Quantitative, Retention, Healthcare, Socialidentity, Human resource management (HRM),
Transformational leadership (TL)
Paper type Research paper
Healthcare organisations worldwide are striving to offer high quality patient care
(Greenfield et al., 2014) whilst plagued by a shortage of nurses (Currie and Hill, 2012;
Karimi et al., 2015). In the USA, it is predicted that there will be a shortage of 260,000
registered nurses by 2025 (American Association of Colleges of Nursing, 2014).
A similar trend is observed in Australia. Health Workforce Australia (2012) reported
that without appropriate intervention strategies, healthcare organisations will face
critical nursing shortage by 2025 with a potential shortfall of almost 110,000 nurses.
The high level of turnover of nurses has been attributed to poor management practices
(Brunetto et al., 2010; Newman et al., 2002). To resolve the current and future
nursing shortage, Council of Deans of Nursing and Midwifery (2012) in Australia and
Personnel Review
Vol. 45 No. 6, 2016
pp. 1200-1216
©Emerald Group Publishing Limited
0048-3486
DOI 10.1108/PR-05-2015-0118
Received 1 May 2015
Revised 14 September 2015
Accepted 1 February 2016
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/0048-3486.htm
1200
PR
45,6
New Zealand argues that building sound nursing leadership at the clinical level,
particularly among nurse unit managers (NUMs) is important. In this paper we argue
that healthcare appropriate leadership and human resource management (HRM) is
critical for effective healthcare organisations (Townsend and Wilkinson, 2010 ;
Townsend et al., 2012).
First-line managers are essential to effectively managing human resources.
They have a profound impact on organisational performance through their influence
on employee performance-related attitudes and behaviours (Brewster et al., 2013;
Gollan, 2012; Hutchinson and Purcell, 2010). In healthcare, the push for greater
efficiency and cost-effectiveness has expanded the role of NUMs from the traditional
focus of clinical duties to encompass greater management responsibilities. NUMs are
first-line managers where they assume responsibility in budget management and HRM
(Bolton, 2005; Duffield and Franks, 2001; Townsend et al., 2012). It is believed that these
first-line nurse managers have the ability to enhance patient and staff outcomes
(Duffield and Franks, 2001).
Despite this, clinical nurses were found to be ill-prepared for line-manager positions
(Townsend et al., 2012). They felt unsupported, isolated and neglected (Hutchinson and
Purcell, 2010). Factors such as heavy workloads and stress, role conflict and ambiguity,
inadequate resources and training, as well as poor organisational support were cited as
major barriers which prevented nurse managers from performing effectively in their
HRM role (Hutchinson and Purcell, 2010). Moreover, nurses’satisfaction of their
supervision appears problematic (Brunetto et al., 2010). These findings signal serious
challenges regarding patient outcomes, as previous empirical research has sugg ested
that the HRM function is associated with reduced patient mortality (Aiken et al., 1994).
Furthermore, leadership scholars advocate that first-line nurse managers should
embrace transformational leadership (TL) to deal with existing challenges in the health
service environment (Jooste, 2004; Karimi et al., 2015; Sabina et al., 2003; Thyer, 2003).
Enhancing the retention of nurses and improving the quality of patient care
represent critical HRM challenges. Notwithstanding the pivotal role of nursing
leadership, few studies have investigated the leadership role of nurse managers (Casida
and Pinto-Zipp, 2008; Hutchinson and Purcell, 2010). Moreover, social identification has
been found to explain individual’s performance, well-being and turnover, particularly
in a hospital and nursing context (Bartram et al., 2014; Cregan et al., 2009; Van Dick
et al., 2004). Yet, previous studies have not paid sufficient attention to the psychological
mechanisms through which TL can exert its influence on employee outcomes (Nielsen,
et al., 2009). Building upon the literature on TL, this research links social identification
with TL. The primary proposition advanced in this paper is that transformational
nurse leaders who are capable of strengthening the social identification of their
employees will contribute to nurse retention, well-being and quality of care. Nurses are
often devalued in their role in the contemporary health system, representing one of the
primary reasons nurses quit the profession (Chan et al., 2004). Using a sample of
registered nurses employed at a large metropolitan public health service in Australia,
this paper focuses on the role of TL in developing social identity that facilitates
teamwork and positive nurses perceptions of quality of care, as well as reducing nurse
burnout and turnover intention.
This research is important given that nurses constitute the largest group of hospital
staff and deliver a large proportion of direct patient care (Townsend et al., 2011).
A shortage of nurses can have an adverse impact on the quality of patient care
(Armstrong-Stassen and Schlosser, 2010). Results from this research will assist
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TL and social
identity
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