Job demands, authentic leadership, job satisfaction, and intention to leave in public healthcare

Abstract

The public health sector faces major challenges to produce, recruit and retain skilled nurses and doctors. Budgetary constraints further exacerbate this situation affecting the healthcare environment and skills shortage. This leaves an already fragile health system even more vulnerable by adding to the pressure on the remaining workforce to meet the country’s ever-growing healthcare demands. In a bid to retain brilliant medical professionals, nurses and doctors are often fast tracked into senior positions by management. This practice not only strips these capable individuals of clinical expertise and the opportunity to specialise, but it also thrusts them into leadership positions they are not appropriately skilled to manage. Poor leadership practices cause burnout and decrease job satisfaction, ultimately affecting quality of care, customer service, attrition, intention to leave, turnover and patient satisfaction. The need for authentic leadership is critical as it contributes to the growth and development of a healthy work environment through leaders who are transparent, support followers, are objective in decision-making and are guided by ethical values. An authentic leader-follower relationship allows followers to be inspired and develop due to the interaction with the leader, and is essential to increase job satisfaction levels and retention of nurses, doctors and other public healthcare workers. The objective of this study was to investigate the relationships between job demands, authentic leadership, job satisfaction, and intention to leave. A cross-sectional survey design with a non-probability convenient sample (n = 633) was obtained. The measuring instruments are the Questionnaire on Experience and Assessment of Work (QEEW), the Authentic Leadership Inventory, the Job Satisfaction Scale, and the Intention to Leave Scale. Structural equation modelling was used for developing measurement and structural models to test the study hypotheses. The measurement models were used to determine correlations and factor analysis, whilst the structural model was used to determine regression amongst the variables, as well as moderating and indirect effects. The results confirm correlations in the expected directions between the variables. Authentic leadership did not have a moderating effect on the relationship between job demands and job satisfaction. Authentic leadership did not have a moderating effect on the relationship between job demands and intention to leave. The indirect effects were significant as job demands had a significant effect on intention to leave through job satisfaction. Findings suggest that public healthcare institutions can focus on developing authentic leadership skills within the organisation, fostering a values-based climate and further, seek to understand those variables that promote employee motivation towards job satisfaction