Ethical leadership of head nurses perceived by nurses and its relationship with nurses’ organizational justice

Abstract Background: Ethical leadership is an altruistic-centered, ethical norm-driven leadership style that can help foster positive work attitudes among nurses. However, the relationship between ethical leadership by nurse leaders and nurses' sense of organizational justice has not been adequately studied. Objective: To investigate the level of ethical leadership among head nurses and its relationship with organizational justice among nurses. Method：This cross-sectional study was conducted with a convenience sample of 501 clinical nurses from four tertiary-level hospitals in Zhengzhou, Henan Province of China in May 2023. The Ethical Leadership at Work Questionnaire and the Organizational Justice Scale were used as data collection instruments. Multiple stratified linear regression was used to analyze the relationships. Results：The mean score of ethical leadership of head nurses was 4.13±0.46, which is at a high level. Marital status, department, and monthly income were the influencing factors of nurses’ perceived ethical leadership. Head nurses’ ethical leadership was positively correlated with nurses’ organizational justice (r = 0.513, P < 0.01). Stratified linear regression analysis showed that the people orientation, power sharing and sustainability dimensions explained 23.0% of the variance in nurses’ organizational justice (P< 0.05). Conclusions: The subscales of people orientation, power sharing and sustainability significantly influence nurses’ organizational justice. Therefore, nurse managers need to pay more attention to nurses’ personal development and needs, give them more opportunities to participate in decision-making, and strengthen their organizational justice.