Mediating Effect of Nursing Organizational Culture on the Relationship Between Ambidextrous Leadership and Staff Nurse Clinical Leadership

Abstract

Aim: This study aims to explore the relationship of head nurses’ ambidextrous leadership with staff nurse clinical leadership and the mediating effect of nursing organizational culture.

Background: Clinical nurses are an important part of the nursing team, and their clinical leadership is of great significance to improving the quality of nursing and developing a nursing career. The ambidextrous leadership of head nurses, which combines transformational and transactional leadership, is a new leadership style. There are few studies on the effect of head nurses’ ambidextrous leadership on staff nurse clinical leadership.

Methods: This study was a cross-sectional study, and convenient sampling method was used to extract 500 nurses from first-class comprehensive hospital in Hangzhou City, Zhejiang Province, as research participants. The participants were administered an electronic questionnaire consisting of the General Information Questionnaire, Ambidextrous Leadership Style Scale, the Chinese version of Nursing Culture Assessment Tool, and the Chinese version of Clinical Leadership Survey. All the three scales used in this study had satisfactory construct validity, content validity, and reliability. Multiple stepwise linear regression analysis was used to explore the influencing factors of staff nurse clinical leadership. AMOS 24.0 software was used to construct a structural equation model to verify the mediating effect of nursing organizational culture between the ambidextrous leadership of head nurses and staff nurse clinical leadership.

Results: The score of staff nurse clinical leadership was 66.69 ± 7.42. Significant positive correlations were noted between staff nurse clinical leadership and head nurses’ ambidextrous leadership (r = 0.461, p < 0.01), between nursing organizational culture and staff nurse clinical leadership (r = 0.685, p < 0.01), and between ambidextrous leadership and organizational culture (r = 0.641, p < 0.01). Professional title, role at work, marital status, participation in leadership training, and nursing organizational culture were the main predictors of staff nurse clinical leadership, collectively accounting for 49.8% of the total variation. Nursing organizational culture played a complete mediating role between head nurses’ ambidextrous leadership and staff nurse clinical leadership, and the mediating effect was 0.555 (95% CI [0.454, 0.692]), accounting for 98.8% of the total effect.

Conclusion: Staff nurse clinical leadership represents the upper-middle level of clinical leadership. Nursing organizational culture can independently predict the level of staff nurse clinical leadership and has a complete mediating effect between head nurses’ ambidextrous leadership and staff nurse clinical leadership. However, due to time, energy, and sampling methods, this study’s sample is insufficient to represent the national nursing staff. Future research should further expand the survey’s geographical scope and sample size.

Implications for Nursing Management: Senior managers can encourage the head nurses to adopt the ambidextrous leadership style and consequently raise the enthusiasm of the organizational culture to improve staff nurse clinical leadership. Managers should rework the rules and regulations and increase work enthusiasm among nurses. Furthermore, they should carry out hierarchical training of clinical leadership for nurses and reasonably empower them to increase their work autonomy and self-efficacy and to encourage and support them in their clinical leadership practice.