Influence of nurses' perception of organizational climate and toxic leadership behaviors on intent to stay: A descriptive comparative study.

Background: Nursing managers and leaders must fight to retain nurses in hospitals by constructing an inviting organizational climate that is attractive to work in, not toxic. The organizational climate is primarily affected by employees' internal work environment and behavior. Hence, nursing managers and leaders must implement effective strategies to increase nurses intention to stay by address the organizational climate. Aim: This study was designed to assess nurses' perception of the effects of organizational climate and toxic leadership behaviors on their intention to stay and the differences in these domains between the two hospitals studied. Methods: A descriptive comparative design was used. Data were collected in 2022 from 250 nurses working in the two largest hospitals in Assiut, an Egyptian city south of Cairo, using three self-administered questionnaires: the organizational climate questionnaire (42 items categorized into nine domains), the toxic leadership scale (30 items categorized into five domains), and the Chinese version of the intent-to-stay scale. Results: Most nurses reported their intention to stay as "normal." The nurse participants perceived that a positive organizational climate was not present, but toxic leadership was at a low level (13.6% and 25.6%, respectively). The model of regression analysis was significant, showing that the organizational climate represented by supportive systems impacted nurses' intention to stay in the hospitals under study. Meanwhile, toxic leadership behaviors, represented by authoritarian leadership, unpredictability in the university hospital, and self-promotion in the insurance hospital, affected nurses' intention to stay. Conclusion: Positive organizational climate played a significant role in retaining nurses through investing in incentives and providing supportive systems. Authoritarian leadership, unpredictability, and the self-promotion of leaders' behaviors impacted the nurses and the climate negatively. Hence, we recommend investing in potential strategies to improve the nurses' intention to stay through performance standards, increased pay and benefits, clear reward mechanisms, participation in decision making, and assessments of leaders' behaviors. Furthermore, decision and policy makers need to establish effective, supportive systems in hospitals to retain nurses. Hence, nursing managers and leaders must rethink how they can use their leadership skills and behavior in a positive manner to promote nurse retention. Study registration: Not registered.