Bridging Leadership Competency Gaps and Staff Nurses’ Turnover Intention: Dual-Rater Study in Saudi Tertiary Hospitals
Background: Nurse-manager competencies shape workforce stability, yet role-based perception gaps between managers and staff may influence staff nurses’ turnover cognitions. Objectives: To (1) compare nurse managers’ self-ratings with staff nurses’ ratings of the same managers on the Nurse Manager Competency Inventory (NMCI); (2) compare both groups’ perceptions of staff nurses’ turnover intention (EMTIS); (3) examine domain-specific links between perceived competencies and perceived turnover intention; and (4) explore demographic influences (age, education, experience) on these perceptions. Methods: Cross-sectional dual-rater study with 225 staff nurses and 171 nurse managers in two tertiary hospitals in Saudi Arabia. Data were collected from August to November 2024. Managers completed NMCI self-ratings, and staff nurses rated their managers on the same NMCI domains; both groups rated staff nurses’ turnover intention using EMTIS. Between-group differences were tested with one-way ANOVA (two-tailed α = 0.05), and associations were examined with Pearson’s r (95% CIs). Findings: Managers consistently rated themselves higher than staff rated them across all nine NMCI domains; the largest descriptive gaps were in Promoting Staff Retention, Recruit Staff, Perform Supervisory Responsibilities, and Facilitate Staff Development (e.g., overall NMCI: managers M = 3.67, SD = 0.61 vs. staff M = 3.04, SD = 0.74; F = 0.114, p = 0.73)with comparatively smaller divergence for Ensure Patient Safety and Quality. Managers and staff did not differ significantly on EMTIS (overall EMTIS: managers M = 3.16, SD = 1.28 vs. staff M = 3.00, SD = 1.15; F = 21.32, p = 0.173). Specific competency domains—retention, supervision, staff development, safety/quality leadership, and quality improvement—showed small inverse correlations with EMTIS facets (typical r ≈ −0.11 to −0.19; p < 0.05), whereas the global NMCI–overall EMTIS correlation was non-significant (r = −0.077, p = 0.124). Effect sizes were modest and should be interpreted cautiously. Conclusions: Actionable signals reside at the domain (micro-competency) level rather than in global leadership composites. Targeted, continuous, unit-embedded development in human- and development-focused competencies—tracked with dual-lens (manager–staff) measurement and linked to retention KPIs—may help nudge turnover cognitions downward. Key limitations include the cross-sectional, perception-based design and two-site setting. Findings nonetheless align with international workforce challenges and may be transferable to similar hospital contexts.
Abstract
Background: Nurse-manager competencies shape workforce stability, yet role-based perception gaps between managers and staff may influence staff nurses’ turnover cognitions. …
Middle East hospitals make all the efforts to manage patient safety in an effective and efficient manner. When the culture of blame and other factors exist, patient safety management efforts and…