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The importance of a servant leader orientation

Jenkins, Marjorie; Stewart, Alice C.

doi: 10.1097/HMR.0b013e3181c22bb8
HCMR Award Winner

Background: Ensuring a quality nursing workforce for the future in a time of increasing labor shortage and declining nurse satisfaction is a key challenge to the health care industry. Understanding what impacts job satisfaction is vital to solving the problem of nurse attrition.

Purposes: We suggest that the approach to supporting staff in the care giving role requires additional expectations of managers who supervise inpatient nursing staff. This study empirically tested the impact of nurse managers' servant leadership orientation on nurse job satisfaction.

Methodology/Approach: Nurses providing direct bedside patient care within inpatient departments of a five-hospital system were asked to respond to four questionnaires. Seventeen departments participated. There were 346 available nurses across the departments. The average response rate was 73% across all of the units surveyed. Hypotheses were tested using multivariate regression analysis of the nurse-nurse manager dyad.

Findings: Statistical findings of this study provided evidence that behaviors and attitudes of the nurse manager do impact employee job satisfaction. Departments where staff perceived that managers had higher servant leadership orientation demonstrated significant positive impact on individual employee job satisfaction.

Practice Implications: Nursing is a unique occupation in that it requires both competence in professional service and compassion in patient caregiving. Hospitals are not factories dealing with inanimate objects or data. The results of this research suggested that the management approach in a health care environment might be enhanced by a more servant-oriented management approach. Specific policy changes that may be implied on the basis of findings of this research include key areas of management selection, management development, and management reward/evaluation.

Marjorie Jenkins, PhD, RN, FACHE, NEA-BC, is Director, Nursing/Magnet Program Director, Moses Cone Health System, Greensboro, North Carolina. E-mail:

Alice C. Stewart, PhD, is Associate Professor, School of Business and Economics, North Carolina Agricultural and Technical State University, Greensboro. E-mail:

This research was presented at the Academy of Management, 2008, Anaheim, California, and received the "Best Theory to Practice Award" in the Healthcare Division; Health Care Management Review sponsored the award.

No funding was received for this work from the National Institutes of Health, the Wellcome Trust, the Howard Hughes Medical Institute, or other funding sources.

Receipt of approval from the North Carolina Agricultural and Technical State University institutional review board for human subjects research was obtained for conducting this research.

© 2010 Lippincott Williams & Wilkins, Inc.