Nursing leadership and its relationship with the hospital work environment

Objective: To analyze the nursing work environment considering: autonomy, control, relationships between physicians and nurses, and organizational support; to examine the ideal leadership style in the perception of nurses, and the real leadership style according to evaluation from one of their subordinates; and to correlate the variables work environment and real leadership. Methods: A correlational study was carried out in the healthcare units of a general hospital in the city of Sao Paulo, Brazil. The convenience sample was made up of 62 pairs (nurses and nursing technicians/aides). Nurses responded to three instruments, as follows: 1) characterization; 2) Brazilian Nursing Work Index-Revised (B-NWI-R), which measured autonomy, control, relationships between physicians and nurses, and organizational support; and 3) grid and leadership in nursing, which measured the ideal behavior according to five styles (1.1; 1.9; 5.5; 9.1; and 9.9). Nursing technicians/aides responded to two instruments: 1) characterization and 2) grid and leadership in nursing, which measured the real behavior considering nurses as direct leaders. Data analysis was carried out with the use of variance analysis (ANOVA, p = 0.05). Results: The mean of the B-NWI-R was 2.2. Style 1.1 was considered as ideal by nurses (58.1%), followed by style 9.1 (35.5%). Styles 9.1 and 1.1 were the most pointed out by nursing technicians/aides. No relationship between the work environment and nurses' real leadership (p=0.39) was found. Conclusion: The work environment proved to be favorable to nursing practice. Nurses' ideal leadership style did not present a correspondence with the real leadership style evaluated by nursing technicians/aides, and the work environment was not associated with nursing leadership.