Research Proposal: Impact of Leadership Styles on Nurse Turnover

This research proposal investigates the impact of head nurse leadership styles on staff nurse turnover intentions within general hospitals in Saudi Arabia. The study aims to determine the relationship between transformational and transactional leadership styles and nurse turnover rates. The proposal includes an introduction outlining the importance of the research, a literature review covering various leadership styles and their effects on staff performance, and the research methodology, including a cross-sectional survey with 200 nurses. It also presents the research objectives, hypotheses, and ethical considerations. The findings of this study are expected to inform strategies for improving staff retention, enhancing the work environment, and reducing turnover in the healthcare sector. The research utilizes a quantitative approach and a 5-point Likert scale questionnaire to gather data, which will be analyzed using SPSS. The proposal also includes a Gantt chart and references to support the research design.

Running Head : RESEARCH PROPOSAL
Research Proposal
Name of the Student
Name of the University
Author Note

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Abstract
The head nurses are considered to be one important part of the hospital administration as they
play many roles such as the educator, the leader, the manager of the departments and the
subordinate nurses and the like. The supportive leadership can further retain all of the employees
so that the better health care services can become ensured properly. The current proposal
declares the aim of the research, the objectives, the background research , the methodology that
will be used in the research itself. The study will conduct the cross sectional survey and there
will be 5 items in the questionnaire which will be distributed among the 200 nurses of the
general hospital of Saudi Arabia.
Key words- Nursing, leadership, types of leadership, patient care, nurse turnover.

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Table of Contents
Introduction......................................................................................................................................3
Significance of the study.............................................................................................................4
Gap in the knowledge..................................................................................................................5
Research Hypothesis....................................................................................................................5
The conceptual framework..........................................................................................................5
The Literature Review.....................................................................................................................6
The transformational leadership..................................................................................................6
The transactional leadership........................................................................................................6
The impact of leadership on staff performance...........................................................................7
The research aim and objectives......................................................................................................8
Research design and methods..........................................................................................................8
The ethical consideration.............................................................................................................9
Gantt Chart...................................................................................................................................9
References......................................................................................................................................12
Appendix........................................................................................................................................13

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Introduction
The nurses are the trained people who are supposed to provide care to the injured and
sick people in the hospital specifically. The hospitals require the highly experienced and trained
nurses who can provide effective care to the sick patients. The health institutes that deliver the
medical and the surgical treatments to the sick people are the main focus of trained nurses. The
head nurse in a hospital is highly responsible for providing the supervision of all of the clinical
aspects. There are many roles that are performed by a head nurse such as the educator, the leader
and the charge nurse (Boamah, 2018). There are different leadership styles that are performed
by the head nurse for managing the staff nurses in the departments. The nursing leadership is
about influencing the subordinates for improving the quality of the care with direct participation
in the whole clinical care. The nursing leadership further consists of a clear vision along with the
staffs that are empowered and motivated too. The strong nursing leadership further helps people
in encouraging the other nurses for functioning in the form of the team units (Clark & Springer,
2010).. They make use of the administration with the values of change under the actions , the
obstacles and the visions under the innovations , the dangers that are under the remunerates.
Notably, there are different leadership styles used by the head nurses for managing the duty of
the nurses and some other problems in the health institutes.
The first style is the transformational leadership where a leader easily motivates the
subordinate nurses and provides them proper attention to the subordinate having known the
weaknesses and strengths of the job. There are four specific components of the transformational
leadership such as the intellectual stimulation, the individualize consideration, the idealized
influenced and the inspirational motivation. There is another leadership style such as the
transactional leadership that can involve the animated order to the disappointment for going with

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all the standards. This leadership style helps the staffs with respect to the expectations, the
structure and the prizes. The intention of the turnover is one such thought where a person can
decide on leaving the job or the organization because of some causes. The turnover of the nurses
is such as unwanted trend for all of the healthcare providers (Huis et al.,2013).. It is such a
common issue and all of the health institutes are facing this issue and the healthcare performance
is further impacted by this issue. There are many such reasons that are there behind the turnover
of the nurses such as the environment of the workplace, the excessive workload, the poor
leadership styles and others. Additionally, the intentions of turnover happens when a staff cannot
comply with the job , the health organization or the manager. The dissatisfaction among the
nurses sometimes leads them directly to leaving the job and exit from the nursing profession
(SPENCE LASCHINGER et al.,2012).. Through the adaptation of effective leadership style, all
of the head nurses can develop a comfortable and favorable ambience for all of the staff nurses
which can help them in fulfilling the expectations of the job and also stay satisfied. The study
will be the aimed at investigating the leadership styles such as the transformational and the
transactional for analyzing which leadership style is more appropriate in terms of overcoming the
turnover issue in the nursing care.
Significance of the study
This study is important as it will provide information about the effective leadership style
for retaining the nursing staffs in the hospitals. The outcome of this study will enrich the
knowledge of the head nurses regarding the effective leadership so that they can avoid the nurse
turnovers. The study will further be helpful in terms of the reduction in the nurse turnover in
public hospitals of the SA. The government and the administrations of the hospitals will be
helped a lot through this study.

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Gap in the knowledge
The study will be based on a gap in the literature/knowledge about the issues of the
leadership style along with the rates of turnover. The knowledge gap is also there founded on
whether the relationships are positive/negative , direct/indirect.
Research Hypothesis
H1- There is the no existence of the positive relationship between the nurse’ turnover and the
Transactional leadership.
H1- There is the existence of the positive relationship between the nurse’ turnover and the
Transactional leadership.
H2- There is no existence of any relationship between the nurse’ turnover and the
transformational leadership.
H2- There is negative relationship between the nurse’ turnover and the transformational
leadership.
The conceptual framework
The turnover intentions
Transactional leadership
Transformational
leadership

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The Literature Review
The administration of the hospitals makes use of various strategies for the
accomplishment of the goals of the organization along with the objectives. They achieve the
goals and the objectives through the help of the leaders who play a significant role in terms of
attaining the fundamental goals. There are further many elements impacting on the turnover rates
of the nurses but the leadership has been found to be the most significant one (Kantanen et al.,
2017). The head nurses are given the responsibility of team management, the staff motivation
and the styles of leadership can provide a strong working environment along with the resects to
all of the nurses.
The transformational leadership
The transformational leadership is a type of leadership style through which the leaders
encourage, motivate and inspire the staffs for innovating and them creating the change which can
help in growing and shaping the future success of the company. This is further accomplished by
setting the instance at the executive level via a strong corporate culture sense, the independence
and the employee ownership in the workplace. The transformational leadership further inspires
and then motivates the entire workforce without any of the micromanagement (Giddens, 2018)..
They further trust the employees who are trained for taking the authority over the decisions in the
jobs that are assigned. The transformational leadership motivates and then inspires the workforce
without any of the micromanagement. The trained employees are trusted for taking the authority
over all the decisions in their jobs. It is a different type of management style that provides the
employees a space for being creative, look into the future and find some of the new solutions to
their old problems.

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The transactional leadership
The transactional leadership was described for the first time in the year 1947 through
Max Weber and Bernard Bass in the year 1981. This is the most often used styles of leadership
by the managers. This style of the leadership actually involves the directing and motivating the
followers primarily through having appealed their own interest. The power of the transactional
leaders usually comes from the formal responsibility and authority in the entire organization. The
primary goal of the followers is to obey all instruction related to the leader. There are some
assumptions in the transactional leadership such as the employees are well motivated through the
punishment and the reward (Lehtonen et al.,2018).. The subordinates have to obey all of the
orders of the superior, the subordinates are not that self-motivated and they have to become
monitored closely and then controlled for getting the work done properly from them. The
transactional leadership styles actually elaborate on the entire work and the completion of all of
the tasks. Therefore, the transactional leadership is aimed at motivating other people for
following the systematic approach and the well organized approach having completed all of the
responsibilities (Leach & McFarland, 2014).. There are also some of the studies that have noted
leadership being the cause of the increasing rate of the employee’ resignation. Additionally,
those staffs who work for the instruction of the boss show some levels of the turnover intention.
Similar to that, the ineffective leadership style can be the reason of higher turnover rates.
The impact of leadership on staff performance
The leadership has many impacts on the subordinates depending on the different
variables such as the personality of the leader along with the individual members of the team.
The authoritative styles further produce the different results than all of the cooperative styles.
There are several researches that have indicated the fact that most effective leaders are those
ones who are appropriately knowledgeable regarding the personalities of the individual which

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make up all of their team. This is notably an integral part of meeting the whole challenge for the
development of a leadership style which has effect on the establishment of the solid teams along
with the motivation of the subordinates. A leadership style which has significant positive effects
on the staffs need proper cultivation (Lehtonen et al., 2018).. It is further as significant of
knowing people on one’ team because it is to know the mission and the policies of the particular
organization. The development of the knowledge is supposed to enhance the respectability along
with getting to know that the team would create the mutual trust.
The research aim and objectives
The aim of the research is to investigate the impact of leadership styles on the staff nurses’
turnover intentions in SA.
Objective 1- To investigate the connection between the transactional leadership style and the
staff nurse’ turnover intentions in a general hospital, SA.
Objective 2- To investigate the connection between the transformational leadership style and the
staff nurse’ intentions of turnover in a general hospital, SA.
Research design and methods
The current study will make use of the quantitative and the cross sectional survey that is
designed to be used for the assessment of the impact of the leadership style of head nurses on the
turnover of the staff nurses. The data collection will be done from the general hospital of Saudi
Arabia with the help of the sampling method and questionnaire that will be self administered
distributed among 200 staff nurses. The participants will be provided with the necessary
information at the time of collecting the data and will ensure the confidentiality of the data. The
5 point Likert Scale questionnaire will be used in the current study. It will then measure the

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transactional and the transformational leadership style. The SPSS tool will be used for the
application of 6the correlation, the descriptive , the validity , the reliability and the regression
tests.
The ethical consideration
The ethical values are highly important for any of the healthcare providers. The ethical
values are some of the universal rules which provide a practical foundation for the identification
of the types of actions , the motives and the intentions. The ethics are further the moral principles
which can govern the way an individual or a group should behave and will behave. The focus is
on the right or the wrong actions which encompass the decision making method for the
determination of the ultimate consequences of those types of actions. The ethics in the healthcare
are highly important due to the workers who should identify the dilemmas of the healthcare
having made the good judgements and the decisions founded on their values. While conducting
the research, the participants will be made aware of the purpose of the research , the significance
of the research and how it is going to open new ways for the management theories in the nursing
practices. The names of the participants will be kept anonymous as per their opinion and if any
participant is found to be stepping back from the research, full consent and liberty will be given
to that individual. The consent form will be given and filled up by every respondent so that
everything is done properly and smoothly.
Gantt Chart
WORK TO BE ACHIEVED Duration in Months Assigned
person
1 2 3 4

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Literature review throughout the research
project:
 Selection of the research question
 Data collection tools
 Introduction& literature review
 Discussion
Student under
supervision of
supervisor
Finalizing the research proposal,
discussion by PH faculty in departmental
board meeting and its refinement (if any)
Getting the approvals to conduct the
research:
 Departmental board.
 College board
 DSR to get IRB
 DPGS
Pilot study e.g. Test availability of all
independent variables in patients’ medical
records. Then, editing the questionnaire if
required.
Data collection & entry

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Display and Interpretation of results
Extensive literature review to write up the
discussion. Then, writing up the final
report and preparing for the publication.

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References
Boamah, S. (2018). Linking nurses' clinical leadership to patient care quality: The role of
transformational leadership and workplace empowerment. Canadian Journal of Nursing
Research, 50(1), 9-19.
Clark, C. M., & Springer, P. J. (2010). Academic nurse leaders’ role in fostering a culture of
civility in nursing education. Journal of Nursing Education, 49(6), 319-325.
Giddens, J. (2018). Transformational leadership: What every nursing dean should know. Journal
of Professional Nursing, 34(2), 117-121.
Huis, A., Schoonhoven, L., Grol, R., Donders, R., Hulscher, M., & van Achterberg, T. (2013).
Impact of a team and leaders-directed strategy to improve nurses’ adherence to hand
hygiene guidelines: a cluster randomised trial. International journal of nursing
studies, 50(4), 464-474.
Kantanen, K., Kaunonen, M., Helminen, M., & Suominen, T. (2017). Leadership and
management competencies of head nurses and directors of nursing in Finnish social and
health care. Journal of Research in Nursing, 22(3), 228-244.
Leach, L. S., & McFarland, P. (2014). Assessing the professional development needs of
experienced nurse executive leaders. JONA: The Journal of Nursing
Administration, 44(1), 51-62.
Lehtonen, M. R., Roos, M., Kantanen, K., & Suominen, T. (2018). International Nursing: Nurse
Managers' Leadership and Management Competencies Assessed by Nursing Personnel in
a Finnish Hospital. Nursing administration quarterly, 42(2), 164-174.

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SPENCE LASCHINGER, H. K., Wong, C. A., Grau, A. L., Read, E. A., & PINEAU STAM, L.
M. (2012). The influence of leadership practices and empowerment on Canadian nurse
manager outcomes. Journal of Nursing Management, 20(7), 877-888.

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Appendix

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Question no 1- Rank the following factors as per the intensity of influence regarding leaving the
organization
Low growth in career
Bad working condition
Negative behavior of the supervisor
Low salary
Others
Question no 2- Is it agreeable that the supervisors reinforce periodically and support the entire
working system?
Strongly agree
Disagree
Neutral

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Agree
Strongly agree
Question no 3- The employees are allowed in taking the authority and responsibility?
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Question no 4- The environment of work is trustworthy and open
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Question no 5- Do you this that your supervisors need proper leadership training ?
Strongly disagree
Disagree
Neutral
Agree
Strongly agree