The Impact of Perceived Clinical Nurse Managers' Despotic Leadership on Nurse Turnover Intention: A Cross-Sectional Study.

BACKGROUND Nurses play vital roles in healthcare systems, especially in competitive environments that must meet diverse stakeholder expectations, improve quality and foster innovation. However, these efforts are often challenged by workforce issues such as nurse turnover intention, which is a critical concern requiring effective leadership and management. Despotic leadership is harmful and may lead to negative nurse behaviours, including intentions to leave their positions. AIM This study explored the correlations and differences in the clinical nurse managers' despotic leadership and nurse turnover intention based on the sample characteristics as perceived by registered nurses (RNs) working in the selected hospitals in Jordan. METHODS This study employed a quantitative cross-sectional correlational comparative design to measure the relationships and differences between the perceived despotic leadership of nurse managers and nurse turnover intention. In 2024, a paper-format survey was distributed to nurses working in various hospitals. Five governmental and private hospitals in Jordan were purposively chosen to recruit 301 nurses using non-probability convenience snowball sampling techniques. Sample size was collected using G* power, and data were collected using a highly psychometric instrument of the Toxic Leadership Behaviours of Nurse Managers Scale (The ToxBH-NM Scale) and the Turnover Intention Scale (TIS-6 Items). RESULTS The overall score for clinical nurse managers' despotic indicated a moderate level of despotic leadership among nurse managers. Among the nurses surveyed, 53 (17.60%) expressed an intention to stay in their positions, while 248 (82.30%) indicated they intended to leave those positions. There was a statistically significant weak positive correlation between the total score of perceived clinical nurse managers' despotic leadership and the total score of perceived nurse turnover intention (r = 0.215, p = 0.01). This correlation suggests a small effect size (Cohen's guidelines: small = 0.10, medium = 0.30, large = 0.50), indicating that while the relationship was statistically significant, the practical impact was at a small level. No significant differences were found in the perceived despotic leadership of nurse managers or nurse turnover intention. CONCLUSIONS The findings highlighted the critical roles of leaders, policymakers and organisations in reducing the perceived despotic leadership of nurse managers. These roles are crucial in decreasing nurses' intentions to leave their jobs. IMPACT Accurately identifying despotic management behaviours is crucial. To improve nurse retention, healthcare organisations should implement evidence-based interventions targeting job satisfaction, workload management and ongoing professional development. PATIENT OR PUBLIC CONTRIBUTION This study did not include patient or public involvement in its design, conduct or reporting.