TITLE:
Toxic Leadership in Nursing: A Systematic Review of Its Professional and Organizational Challenges
AUTHORS:
Alice P. Lindström
KEYWORDS:
Abusive Supervision, Leadership, Narcissism, Nursing, Toxic Leadership
JOURNAL NAME:
Open Journal of Nursing,
Vol.15 No.6,
June
20,
2025
ABSTRACT: Background: Toxic Leadership (TL) in nursing represents a significant and pervasive challenge in healthcare systems worldwide, with profound implications for both professional well-being and organizational outcomes. Aim: This review systematically examines the prevalence, characteristics, and multifaceted impacts of TL behaviors in nursing across diverse healthcare contexts. Method: Drawing on 15 empirical studies conducted between 2020 and 2024, involving 7910 nurses, the review employs the PEO (Population, Exposure, Outcome) framework to explore the complex interplay between TL, organizational dynamics, and nurses’ individual experiences. Results: Key findings reveal that TL significantly correlates with decreased job satisfaction, increased emotional exhaustion (EE), and higher turnover intentions, ultimately compromising patient safety (PS) and the quality of the healthcare system. TL imposes significant economic burdens, weakens patient care quality, and intensifies workforce instability and organizational inefficiency. The review also highlights the mediating roles of EE and organizational cynicism, as well as the buffering effects of professional resilience and advanced education. Conclusion: These insights underscore the urgent requirement for targeted interventions at individual, organizational, and systemic levels to mitigate the adverse effects of TL.