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Nursing Admin Quarterly, 33 (4) 301 -- 309

Retention of high-quality nursing staff is an equally critical component of addressing the nursing shortage as hiring newly-qualified nurses. Nursing leadership can have a significant impact upon retention, satisfaction, and even nurses' perception of their exhaustion. The study "Leadership styles of nurse managers in a multinational environment" attempted to understand what leadership styles had a positive and a negative impact upon nurses' desires to stay within the organization and function effectively. To answer this research question, the study examined a nursing environment in Saudi Arabia, a nation with a patient population that is notably diverse that has a notable shortage of nurses, forcing healthcare institutions to rely upon expatriates as a source of labor (Suliman, 2009: 301). Given the importance of culturally-specific dialogue and care in nursing, this can prove challenging. Effective leadership that facilitates dialogue between providers and patients and between managers and employees within the nursing environment is a critical aspect of dispensing effective care.

The study submitted the Multifactor Leadership Questionnaire to 31 nurse managers and 118 staff nurses. The study was grounded in comparative theories of leadership development, examining individual nurse's preference for transformational, transactional, and laissez-faire leadership styles. These theories emphasize the interactions between leaders and followers -- transformational leaders inspire subordinates to expand their vision of what is possible, transactional leaders merely focus on the 'here and now' technical aspects of leadership and laissez-faire leaders employ a hands-off style. While a transformative, participative approach was favored by nearly all respondents, there was a discrepancy between managers' perceptions of their own leadership styles and staff nurses' perceptions. Managers felt that they favored a transformative approach most of the time, while staff nurses felt they did so only some of the time (Suliman, 2009: 306). Still, "the stated intention of 77.1% of staff nurses to stay at work suggests that nurse managers as transformational leaders are more likely to be successful in creating a positive working environment…and that transformational leadership enhances staff nurses' retention by the hospital" (Suliman, 2009: 307). However, the authors of the study do caution that the respondents tended to come from a more culturally homogeneous background than was typical in Saudi Arabian hospitals, and other factors such as work conditions, setting, and personal reasons also impacted individual's decisions to remain or leave their places of employment.