Exploring the Influence of Toxic Leadership Behavior in Nursing Organizations within Hospital Settings: An Integrative Review

Abstract

Toxic leadership in nursing organizations has emerged as a significant concern due to its negative impact on nurses’ well-being, job satisfaction, patient safety, and overall quality of care. While many scholars highlight its harmful consequences, some argue that the term “toxic leadership” may oversimplify complex organizational and interpersonal dynamics, potentially overlooking contextual factors that influence leadership behaviors. This integrative review aims to examine the influence of toxic leadership behavior in nursing organizations and synthesize current evidence regarding its impact on nurses, organizational culture, and patient outcomes. An integrative review approach was employed using literature from PubMed, Scopus, Google Scholar, and ResearchGate. Studies focusing on toxic leadership among nurse leaders and its organizational consequences were screened and analyzed thematically. Research conducted in various countries including the United States, Canada, Australia, the United Kingdom, China, Korea, and the Philippines consistently shows that toxic leadership contributes to decreased job satisfaction, heightened burnout, increased turnover intention, compromised patient safety, and a deteriorating organizational climate. These effects extend beyond individual nurses and can negatively influence team performance and care quality. Toxic leadership behavior in nursing organizations poses substantial risks to both staff and patient outcomes. Addressing this issue requires organizational strategies that promote healthy leadership styles, psychological safety, and supportive work environments. Future studies should focus on designing and evaluating interventions that reduce toxic leadership behaviors and strengthen positive, evidence-based leadership practices in nursing.