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This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.

This is a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases (SCOPUS, PubMed, Web of Science, CINAHL and Psych INFO) were searched to identify relevant articles. Two independent researchers conducted the data extraction and appraisal. A content analysis was used to identify toxic leadership outcomes.

The initial literature search identified 376 articles, 16 of which were deemed relevant to the final review. Results of the content analysis identified 31 outcomes, which were clustered into five themes: satisfaction with work; relationship with organization; psychological state and well-being; productivity and performance; and patient safety outcomes. Seven mediators between toxic leadership and five outcomes were identified in the included studies.

Organizational strategies to improve outcomes in the nursing workforce should involve measures to build and develop positive leadership and prevent toxic behaviors among nurse managers through theory-driven strategies, human resource management efforts and relevant policy.

The review findings have provided modest evidence suggesting that working under a leader who exhibits toxic behaviors may have adverse consequences in the nursing workforce; however, more research examining if this leadership style influences patient safety and care outcomes is warranted.

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses’ intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses’ intentions to pursue formal leadership roles.

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Semi-structured interviews were conducted with 20 nurses in leading positions. Thematic analysis was used to analyse the data.

Nurse leaders are recruited from clinical settings, and the transition process from clinical nurse to leader is demanding. Their motivation for leadership seems to be in human values and caring for others. Lack of strategic focus might be a challenge. Nurses in leadership positions emphasize the importance of good relationships with the staff and require an increased focus on strategic leadership.

Studies have revealed the frustration associated with the role of a nursing leader. According to an evaluation of a clinical leadership development programme, nurses were found to be inadequately prepared for their roles. They had not experienced positive role models, they felt overwhelmed and they regarded colleagues and nursing management structures as unsupportive. There is a need for further research into effective measures to strengthen nurse managers.

The role of leaders has changed over time. There are now increasing requirements and objectives with regard to laws, action plans, improvement projects and cost-effectiveness. A nurse leader has both many tasks and great responsibility. Good leadership relies on skilled nurse leaders meeting statutory requirements in patient care and delivering good quality and patient-safe services. Engaging in process-oriented guidance, such as mentoring, is one way to become more aware of oneself as a professional leader (Mathena, 2002).

By identifying and understanding the specific challenges that nurse leaders face, this study can contribute to the development of interventions and strategies to improve leadership practices, thereby enhancing organizational effectiveness.

This paper aims to explore the perspectives of registered nurses towards communication with family members of older people with a tracheostomy.

A qualitative design was used. Ten participants were recruited through purposive sampling. Face-to-face, semi-structured interviews were used in collecting data. Data were analysed by thematic analysis.

The four themes identified were as follows: communication by considering time difference; considering factors related to effective communication, either family member–related factors or registered nurse–related factors; strategies of communicating to support family members, such as giving an opportunity to ask for accurate information, communicating to build self-confidence and communicating through cases; and using the art of communication by speaking slowly and clearly, using colloquialisms, being steady and calm, as well as using positive language.

Having strategies and using the art of communication are important to help family members in obtaining accurate information and in building self-confidence in the care of older people.

The paper indicates that registered nurses consider factors related to communication, and they gave more information to family members using effective strategies and the art of communication. Therefore, effective communication training to nursing teams should be performed to promote adherence to treatment and family members’ satisfaction.

The present research paper aims to examine the inter-relationship between organizational justice (Henceforth termed as OJ), psychological well-being at work (henceforth termed as PWBW) and organizational citizenship behavior (henceforth termed as OCB). More specifically, this paper attempts to critically analyze the mediating role of PWBW in the relationship between OJ and OCB. The study solely focuses on nurses working at private hospitals in Kerala, who are the largest group of healthcare personnel.

Data collected from 308 nursing employees were analyzed by using statistical package for the social sciences (SPSS) software.

The outcomes of the analysis demonstrate that significant correlations exist between all the three key variables and their dimensions. Moreover, it has been found that the relationship between OJ and OCB is partially mediated by PWBW.

In the present healthcare scenario, just after the Covid-19 pandemic, there is a paramount need for the well-being of healthcare staff in order to improve the functioning of the healthcare system.

The study enabled us to develop and provide an explanation as to how social exchange relationship works between OJ and OCB.

Drawing on the challenge–hindrance stressor framework and the “too-much-of-a-good-thing” principle, this study examined the curvilinear effects of two emic social challenge stressors (guanxi beliefs and participative decision-making (PDM)) and the moderating effect of an etic social hindrance stressor (perceived organizational politics) on Hong Kong and United States nurses’ job satisfaction.

A quantitative survey method was implemented, with the data provided by 355 Hong Kong nurses and 116 United States nurses. Structural equation modeling was used to examine the degree of measurement equivalence across Hong Kong and US nurses. The proposed model and the research questions were tested using nonlinear structural equation modeling analyses.

The results show that while guanxi beliefs only showed an inverted U-shaped relation on Hong Kong nurses’ job satisfaction, PDM had an inverted U-shaped relation with both Hong Kong and United States nurses’ job satisfaction. The authors also found that Hong Kong nurses experienced the highest job satisfaction when their guanxi beliefs and perceived organization politics were both high.

The results add to the comprehension of the nuances of the often-held assumption of linearity in organizational sciences and support the speculation of social stressors-outcomes linkages.

Managers need to recognize that while the nurturing and development of effective relationships with employees via social interaction are important, managers also need to be aware that too much guanxi and PDM may lead employees to feel overwhelmed with expectations of reciprocity and reconciliation to such an extent that they suffer adverse outcomes and become dissatisfied with their jobs.

First, the authors found that influences of guanxi beliefs and PDM are not purely linear and that previous research may have neglected the curvilinear nature of their influences on job satisfaction. Second, the authors echo researchers’ call to consider an organization’s political context to fully understand employees’ attitudes and reactions toward social interactions at work. Third, the authors examine boundary conditions of curvilinear relationships to understand the delicate dynamics.

The purpose of this paper is to assess the level of nurses’ competencies while providing care to COVID-19 patients.

A descriptive, correlational design was used to collect data from nurses who were providing care to COVID-19 patients at four public hospitals.

A total of 377 nurses (64.5% females) aged 23–50 consented to participate and completed the survey. The mean score of nurses’ competencies in providing care to COVID-19 patients was 2.5 (SD = 0.81). The results of correlation coefficient tests disclosed a significant positive correlation between reported competence level and sex r_pb (377) = 0.18, p < 0.01; working area r_pb (377) = 0.2, p < 0.01; disaster experience r_pb (377) = 0.16, p < 0.01; disaster education r_pb (377) = 0.25, p < 0.01; and disaster training r_pb (377) = 0.31, p < 0.01.

The COVID-19 pandemic response heavily relied on nurses. However, they had a gap in clinical competencies that indicates an urgent need to incorporate disaster management courses in basic nursing education and to update training in hospitals based on nurses’ needs to improve their capabilities in dealing with COVID-19 pandemic.

To the best of the authors’ knowledge, this is the first study that investigated the perceived level of Jordanian nurses’ competencies in providing care to COVID-19.

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and rural healthcare scenarios pose additional complexities for providers and patients. This study sought to identify key determinants of patient service quality in wound care.

Patients at the wound care/ostomy clinic (WOC) in a rural hospital were surveyed using the Kano model. The Kano model enables the categorization of quality attributes based on the attributes' contribution to the subject's overall satisfaction (and dissatisfaction). Chi-square goodness-of-fit testing, multinomial analysis and power analysis were then used to determine the Kano categories for each satisfaction-related attribute.

The analyses resulted in 14 one-dimensional attributes and 3 indeterminable attributes. For the one-dimensional attributes, customer satisfaction is directly proportional to the level of performance for that attribute. The one-dimensional attributes included providing correct care on the first, provision of necessary supplies for care, appropriately qualified medical staff and confidence in care provided by medical staff, among others. Understanding the attributes important to the patient drive patient-centered care, which improves positive patient outcomes and recovery. These attributes can then be used by healthcare professionals to design patient-centric processes and services. This research provides a framework for incorporating the voice of the patient into healthcare services.

While the research methodology can be used in other healthcare settings, the findings are not generalizable to other wound care clinics. This research was conducted in one small, rural hospital. In addition, the sample size was small due to the size of the wound clinic; therefore, an analysis of the differences between demographics could not be performed.

Considering the perspectives of rural wound care patients is important, as the patients are an under-served population with unique challenges related to patient care. The research findings detail rural patients' expectations during wound care treatments, which enable the clinic to focus on improving patient satisfaction. This research contributes to understanding the factors that are important to patient satisfaction in wound care. Further, the methodology presented can be applied to other healthcare settings.

While studies exist using the Kano model in healthcare and the literature is sparse in rural healthcare, this is the first case study using the Kano model in wound care to understand patient preferences.

The demand for long-term home care services has been increasing in Taiwan due to the significant growth of the older population. In order to understand the crucial roles that language and communication play in providing better long-term home care services in Taiwan, this study aims to adopt a gerontological sociolinguistic perspective to investigate how professional care workers communicate with older people in this context.

Interviews were conducted with 58 long-term home care workers to identify their communication accommodation strategies for older people, considering their health conditions (dementia), personalities (grumpiness), living status (loneliness) and general principles of long-term home care communication.

The study's findings provide practical insights for long-term home care workers to enhance their communication skills while interacting with older people.

The results could contribute to improving the quality of care services provided to older people and address their specific communication needs.

To the best of the author’s knowledge, this paper is the first attempt to identify contextually specific communication accommodations to older people in existing literature of gerontological sociolinguistics that addresses language, communication and older age. The salience of the findings in this study can be further enhanced if they were applied in the development of training programs for future Taiwanese long-term home care workers.

This paper aims to explore financial anxiety and generalized anxiety as the serial mediators linking perceived organizational support (POS) to career commitment.

Data were collected from 388 managerial and nonmanagerial employees in diverse service areas, such as restaurants, airlines and hotels in Turkey. The direct and mediating effects were tested via the PROCESS macro.

Financial anxiety partly mediates the impact of POS on career commitment. The findings further reveal that financial anxiety and generalized anxiety serially mediate the effect of POS on career commitment.

Management should work with mentors to provide employees with psychosocial support during the COVID-19 pandemic. When employees perceive that the firm really cares about them and values their contribution during these challenging days, they display lower anxiety and higher career commitment. Management should also retain employees who are high on career commitment because such employees possess a sense of calling and are unlikely to quit. These implications may not be considered new. However, management would need such employees concerning the firm’s performance recovery after COVID-19.

Workers in the service industries suffer from financial and generalized anxieties and display reduced career commitment during COVID-19. However, little is known about the antecedents and outcomes of financial anxiety among hospitality and tourism workers. More importantly, no empirical piece has tested these anxiety variables as the mediators linking POS to career commitment in the pertinent literature so far.