Emergency Room Nurses’ Perceptions of Transformational Leadership and Its Role in Their Well-Being: A Qualitative Descriptive Study
Badr Ayed Alenazy, Sami Abdulrahman Alhamidi, Sahar Abdulkareem Al-Ghareeb, Mousa Yahya Asiri, Homoud Alanazi, Seham Mansour AlyousefBackground
Emergency room (ER) nurses work under conditions frequently associated with burnout, emotional exhaustion, and turnover intention. Leadership behavior is one of the few workplace conditions that can be modified without additional capital investment, and transformational leadership (TL) has been examined predominantly through cross-sectional survey designs. How ER nurses themselves describe these leadership behaviors and what they attribute to them remains poorly documented in Saudi public hospitals.
Aim
To describe ER nurses’ perceptions of their nurse managers’ TL behaviors and how these behaviors were perceived by the participants to shape their emotional and psychological well-being.
Methods
This qualitative descriptive study used non-probability convenience sampling to recruit eight frontline registered nurses from an ER in Saudi Arabia, each with at least six months of ER experience . Face-to-face semi-structured interviews of 45–60 minutes were audio recorded and transcribed verbatim. The analysis followed Braun and Clarke’s six-phase thematic analysis using a deductive coding strategy; NVivo 14 supported the data management. Two researchers independently coded the data and resolved discrepancies by consensus.
Results
Three main themes emerged from the data analysis: (1) clinical credibility and professional security, (2) individualized consideration and personal advocacy, and (3) empowerment and intellectual stimulation. The participants described managers’ visible clinical presence during crises, bedside teaching, personal advocacy during family emergencies, recognition, and invitations to contribute to workflow decisions as conditions they connected to feeling calmer, safer, and more willing to remain in their ER.
Conclusion
The participants perceived clinically credible, personally attentive, and intellectually engaging leadership as supporting their well-being while also describing clear limits to what leadership behavior alone could offset. The findings are descriptive and self-reported at one point in time; no causal or mediating relationship is claimed.