Inclusive Leadership and Intent to Stay in a Midwestern US Nonprofit Faith-Based Hospital - A Cross-Sectional Study of Nursing Staff.
R Wesley Swen, David W Brown, Mary Luallen
Abstract
Open AccessIntroduction: The healthcare industry is facing unprecedented challenges related to nursing shortages and staff retention. In response to escalating turnover rates, particularly after the COVID-19 pandemic, healthcare organizations are seeking evidence-based strategies to support long-term workforce stability. This study explored the gap in evidence linking perceived inclusive leadership and nurses' intent to stay at a single Midwestern faith-based medical center. Inclusive leadership-defined by behaviors that promote fairness, value uniqueness, and foster belonging-has emerged as a potential driver of employee engagement and their intent to stay employed. Methods: A cross-sectional survey using a validated Inclusive Leadership Questionnaire (ILQ) was administered to a convenience sampling of front-line nurses and nurse managers at a single hospital. Nurses rated leadership behaviors; managers assessed organizational support. Seventy-one responses (59 nurses, 12 managers) were analyzed. The ILQ scores were then summarized by ILQ dimension categories. Associations between leadership perceptions, inclusivity and intent to stay were analyzed using one-way analysis of variance of the ILQ scores and nurse self-reported intent to stay. Discussion: Nurses perceived their managers as inclusive, especially in fostering belonging and support. However, weaker scores in team integration highlight ongoing challenges with collaboration. A disconnect between leadership behaviors and organizational support suggests systemic gaps. Inclusive leadership was positively linked to retention, particularly for long-tenured staff, emphasizing its long-term value. Results: Results showed that nurses who perceived higher levels of inclusive leadership were significantly more likely to express an intent to stay (p=0.01), particularly among those with longer tenure. Belonging and individual support were the highest-rated dimensions, while integration and fairness across teams were noted as areas needing improvement. Nurse managers reported moderate organizational support for inclusive leadership. Conclusion: The study concludes that inclusive leadership is associated with a meaningful, actionable strategy for improving nurse intent to stay. Embedding inclusive practices in leadership development and aligning systems to support them may help healthcare organizations foster long-term commitment and address persistent workforce challenges.