Association Between Nurse Managerial Leadership and Nurse Retention: A Cross-Sectional Study at a Tertiary Hospital in Saudi Arabia

Abstract

Background: Retaining experienced nurses is a major priority for healthcare organizations because workforce stability is essential for delivering safe, effective, and high-quality patient care. Nurse managers play a critical leadership role in shaping the work environment, influencing job satisfaction, and encouraging nurses to remain within their organizations. Despite growing international evidence, research examining this association in Saudi Arabian tertiary hospitals remains limited. Aim: The study aimed to identify the relationship between nurse managers' leadership skills and staff retention among registered nurses working in a tertiary healthcare hospital in Saudi Arabia. Methods: A quantitative cross-sectional correlational study was conducted among 506 registered nurses recruited through convenience sampling. Data were obtained using a self-administered questionnaire that included demographic characteristics, the 12-item Nurse Managerial Leadership Scale, and the 6-item Nurse Retention Instrument. Data were analyzed using IBM SPSS Statistics version 29. Descriptive statistics summarized participant characteristics and study variables, while Pearson's correlation and simple linear regression were used to examine the association between nurse managers' leadership skills and staff retention. Statistical significance was set at p < 0.05. Results: Participants perceived nurse managers' leadership skills (M = 2.899, SD = 1.076) and staff retention (M = 2.873, SD = 1.111) at moderate levels. Nurse managers' leadership skills were positively and statistically significantly related to staff retention (r = 0.648, p < 0.001). Linear regression analysis demonstrated that leadership skills significantly predicted staff retention (β = 0.648, B = 0.661, SE = 0.039, t = 16.949, p < 0.001), explaining 42.0% of the variance in retention (R² = 0.420). Conclusion: The findings indicate that stronger nurse managerial leadership is associated with greater staff retention among registered nurses. Enhancing leadership competencies among nurse managers may improve nurse retention, strengthen workforce stability, and support the long-term sustainability of tertiary care healthcare institutions.