Toxic Leadership in Emergency Nurses: Assessing Abusive Supervision and Its Team-Level Impacts on Conflict Management and Organizational Commitment

Abstract

Background. Emergency departments suffer from authoritarian and manipulative leadership styles that affect team dynamics, emotional exhaustion, and quality patient care. However, little research specifically explores these toxic leadership effects on conflict management and nurses' organizational commitment. Objectives. This cross-sectional study aimed to assess the correlations between perceived toxic leadership, conflict resolution strategies, and commitment dimensions among emergency nurses while evaluating conflict tendencies as a mediating mechanism. Methods. A cross-sectional design that included multiple regression and mediation analyses was utilized. The sample consisted of 387 emergency nurses from five major Saudi hospitals surveyed using validated scales that measure perceived toxic leadership, conflict styles, and organizational commitment. Results. High prevalence rates for perceived authoritarian (77%), narcissistic (75%), and unpredictable (63%) leadership were reported. Increased toxicity was positively related to dominating and avoiding conflict styles but negatively related to integrating and compromising strategies. Toxic leadership is also associated with lower affective/normative commitment but higher continuance commitment. Conflict management partially mediated the leadership-commitment relationship, which explained 29% of the total effect. Finally, higher experience and education predicted greater perceived toxicity. Conclusions. The significant correlations between destructive leadership, adverse conflict, and reduced commitment in emergency nurses underscore the need for context-specific leadership training. Fostering supportive environments through multifaceted interventions can counteract toxicity impacts, impart constructive communication techniques, improve nurse well-being, and ensure high-quality patient care. As conflict tendencies and nurse characteristics influence susceptibility to detrimental leadership, tailored programs addressing experience levels are vital.