An evaluation of the impact of leadership styles exhibited by emergency department nurse managers in academic health centers on nurse turnover and patient satisfaction

Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing emergency department (ED) nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and to examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire, a statistically reliable and valid leadership style measurement instrument, adapted for online (internet) data collection and a 10-item researcher defined nurse manager role and practice demographics survey. Two staff nurses were asked to complete a rater survey for their respective nurse manager to validate leadership styles. All data were analyzed with SPSS for Windows software. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Due to a limited sample size, descriptive statistics, including frequencies, percentages and Fisher's Exact Tests with 95% Confidence Intervals, were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Transformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. Nurse managers whose leadership style was Transformational were older and had more years of experience than those whose styles were non-Transformational. The ED is an ever changing, highly regulated, critical care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover thereby enhancing staff nurse retention and potentially impacting patient satisfaction.