Bridging Leadership Competency Gaps to Enhance Nurse Retention: Insights from a Cross-Sectional Study

Background: /Objectives: Nurse managers’ competencies are central to workforce stability and high-quality patient care. Gaps in nurse leadership may contribute to staff nurses’ turnover intentions, which threaten organizational sustainability and care continuity. Despite global recognition of leadership importance, few studies have examined the misalignment between nurse managers’ self-perceptions and staff nurses’ perceptions in relation to retention, especially in the Middle East. This study explored perceived competency gaps in nurse leadership, examined their association with staff nurse turnover intentions, and evaluated the influence of demographic characteristics. Methods: A cross-sectional, descriptive-correlational design was conducted with 225 staff nurses and 171 nurse managers from two tertiary governmental hospitals in Riyadh and Dammam, Saudi Arabia. Competencies were measured using the Nurse Manager Competency Inventory (NMCI), and turnover intention was measured using the Expanded Multidimensional Turnover Intention Scale (EMTIS). Comparative analyses assessed differences between managers’ self-perceptions and staff nurses’ perceptions, correlations examined associations with turnover intentions, and regression analyses assessed demographic influences. Results: Staff nurses reported lower scores in staff recruitment, retention strategies, and supervisory responsibilities compared to managers’ self-assessments. Lower perceived competencies were significantly associated with higher intentions to turnover. Demographics, including age, experience, and education, influenced perceptions and turnover intention. Conclusions: Leadership competency gaps among nurse managers are critical determinants of staff nurse retention. Addressing these gaps through structured leadership development programs can enhance workforce stability, support quality patient care, and contribute to healthcare transformation globally.