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Abstract
Background
Autocratic leadership is characterized by centralized decision-making, strict supervision, and limited staff participation. In emergency departments, where rapid decisions and adherence to protocols are critical, this leadership style is commonly employed. However, excessive control may negatively affect nurse performance, increase work-related stress, and reduce job satisfaction, potentially impacting patient care and staff retention.
Aim
The study aimed to examine the effects of autocratic leadership style on emergency nurses’ performance, work-related stress, and job satisfaction in tertiary care hospitals.
Methods
A descriptive cross-sectional study was conducted in the emergency departments of three tertiary care hospitals: Khyber Teaching Hospital (KTH), Hayatabad Medical Complex (HMC), and Lady Reading Hospital (LRH). The total population of emergency nurses was 240, and the sample size was calculated using the Raosoft calculator. 148 nurses were included in the study. A structured, self-administered questionnaire was used to collect data on demographics, perceived autocratic leadership behaviors, nurse performance, work stress, and job satisfaction. Data were analyzed using SPSS version 27. Descriptive statistics summarized the variables, and Chi-square tests were applied to determine associations between autocratic leadership levels and nurses’ performance, stress, and job satisfaction.
Results
High autocratic leadership was reported by 50.7% of nurses. Nurses experiencing high autocratic leadership demonstrated poorer performance (36%), higher stress levels (57.4%), and lower job satisfaction (57.4%) compared to those under low or moderate autocratic leadership. Chi-square analysis revealed statistically significant associations between autocratic leadership and nurse performance (χ² = 11.86, p = 0.018), work stress (χ² = 18.74, p = 0.001), and job satisfaction (χ² = 16.29, p = 0.003).
Conclusion
Excessive autocratic leadership negatively affects emergency nurses’ performance, increases stress, and reduces job satisfaction. Leadership strategies balancing control and support are recommended to optimize nurse well-being and clinical outcomes in high-pressure emergency settings.