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Mitigating the Impact of Hospital Restructuring on Nurses

The Responsibility of Emotionally Intelligent Leadership

Cummings, Greta; Hayduk, Leslie; Estabrooks, Carole


Background A decade of North American hospital restructuring in the 1990s resulted in the layoff of thousands of nurses, leading to documented negative consequences for both nurses and patients. Nurses who remained employed experienced significant negative physical and emotional health, decreased job satisfaction, and decreased opportunity to provide quality care.

Objective To develop a theoretical model of the impact of hospital restructuring on nurses and determine the extent to which emotionally intelligent nursing leadership mitigated any of these impacts.

Methods The sample was drawn from all registered nurses in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (N = 6,526 nurses; 53% response rate). Thirteen leadership competencies (founded on emotional intelligence) were used to create 7 data sets reflecting different leadership styles: 4 resonant, 2 dissonant, and 1 mixed. The theoretical model was then estimated 7 times using structural equation modeling and the seven data sets.

Results Nurses working for resonant leaders reported significantly less emotional exhaustion and psychosomatic symptoms, better emotional health, greater workgroup collaboration and teamwork with physicians, more satisfaction with supervision and their jobs, and fewer unmet patient care needs than did nurses working for dissonant leaders.

Discussion Resonant leadership styles mitigated the impact of hospital restructuring on nurses, while dissonant leadership intensified this impact. These findings have implications for future hospital restructuring, accountabilities of hospital leaders, the achievement of positive patient outcomes, the development of practice environments, the emotional health and well-being of nurses, and ultimately patient care outcomes.

Greta Cummings, PhD, RN, is Assistant Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada

Leslie Hayduk, PhD, is Professor, Department of Sociology, University of Alberta, Edmonton, Alberta, Canada

Carole Estabrooks, PhD, RN, is Associate Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada

Corresponding author: Greta Cummings, PhD, RN, Faculty of Nursing, University of Alberta, 3-120 Clinical Sciences Bldg, Edmonton, Alberta, Canada T6G 2G3 (e-mail:

The authors acknowledge the Canadian Institutes for Health Research (CIHR), the Alberta Heritage Foundation for Medical Research (AHFMR), and the University of Alberta for doctoral fellowships to Dr. Cummings that supported this work and the CIHR career award support for Dr. Estabrooks.

Editor's Note: Additional information provided by the author expanding this article is on the editor's Web site at http://nursing-research-editor.

Accepted for publication August 25, 2004.

© 2005 Lippincott Williams & Wilkins, Inc.