Resonant Leadership of Nurse Managers as determinant of

Empowerment and Organizational Commitment of

Registered Nurses in a District Hospital Basis for the
development of Enhancement Training Program.

Francis Jay N. Enriquez

 INTRODUCTION

• Delivery of the utmost quality and safest care begins with retaining expert nurses. Nurse
Managers are widely accepted as the most significant force in staff contentment and
preservation because of their role in work environments. Responsibilities once
performed by nurse directors have now been integrated into the nurse manager's scope
of practice.
• In the Philippines many of the registered nurses left their work in the hospital to look
for a job abroad some of them tried to look for other jobs that can suit their financial
and personal needs. Based on the report of POEA (Philippine Overseas Employment
Administration) there are almost 20,000 nurses left the country to seek greener Pasteur
at the other countries.
• The researcher chooses this study to have a deeper understanding on how
resonant leadership and structural empowerment can affect the current
trend on exodus of the Philippine nurses. This study will also benefit the
hospitals organization that they can promote organizational commitment
within their institution. This study will also uncover strategies in which
nurse leaders and staff nurse can use to develop a more harmonious and
empowered workplace as a factor for an organizational success.
 Statement of the Problem

• Main Objective:
• The main objective of the study is to know Resonant Leadership of
nurse managers as determinant to empowerment and organizational
Commitment of registered Nurses.
Statement of Specific Problem
• 1. What is the level of resonant leadership of the nurse managers in terms of:
• a. Self-Awareness c. Social Awareness
• b. Self-Management d. Relationship Management
 
• 2. What is the level of empowerment of the registered nurses in terms of:
• a. Access to Opportunity c. Access to Information
• b. Access to Resources d. Access to Support

• 3. What is the level of organizational commitment that is exhibited by the registered nurses in the organization as to:
• a. Affective Commitment c. Normative Commitment
• b. Continuance Commitment
• 4. Is there a relationship between the level of resonant leadership of nurse
manager and level of empowerment of registered nurses?

• 5. Is there a relationship between the level of resonant leadership of nurse

manager and level of organization commitment of registered nurses?

• 6. Based on the findings, what is the enhancement training program that can be
develop?
 Hypothesis
• H01.The hypothesis will be tested at 0.05 level of significance, there is no
significant relationship between resonant leadership of nurse manager and
empowerment of registered nurses.

• H02.The hypothesis will be tested at 0.05 level of significance, there is no

significant relationship between resonant leadership of nurse manager and
organizational commitment of registered nurses.
 Significance of the Study

• This study will be conducted in order to establish understanding about the

Resonant Leadership of Nurse Managers as Determinant to Empowerment
and Organizational Commitment of Registered Nurses in Selected District
Hospital.

• Moreover, this study could be useful to the following:

• Nursing Leaders and Administrators.
• This will enable nurse leaders to have an understanding on resonant leadership style in which
can improved their leadership skills and to establish empowered subordinates in attaining
organizational commitment and achieving organizational goals.

• Registered Nurses
• This will enable the registered to have an understanding about resonant leadership and its
promotion to empowerment and patient care satisfaction. This will minimize job dissatisfaction to
established nurse’s commitment in promoting safe working environment and address this issue
toward organizational commitment and organizational success.
• Nursing Education Research and Development
• The study will create awareness on the Resonant Leadership skills of the nurse
managers. This will in turn, be used as an outline reference for future enhancement
trainings specifically constructed for nurse managers.
 
• Hospital Administration
• The findings of the study can be used as baseline evidence or data to enhance the
leadership abilities of the nurse managers. Thus, cost effective to the organization,
improve nursing care service, advance quality patient care and better patient satisfaction.
• Healthcare patients and clients.
• This study will benefits healthcare patients and clients in achieving optimum health
and quality care delivered by the empowered and committed registered nurses
established by their resonant leader nurse managers.

• Future Nurse Researcher.

• This will enable future nurse researchers to continually study the influence of
resonant leadership to empowerment and organizational factor, such as the adaptability
of this leadership style in the changing health care system.
 Scope and Limitation of the Study

• The researcher’s study focused on the resonant leadership of nurse managers as determinant to empowerment
and organizational commitment of registered nurses in a district hospital in Sablayan, Occidental Mindoro. The
scope of the study involves the resonant leadership of nurse managers, empowerment and organizational
commitment of staff nurses.
• This study utilized descriptive correlational type of research design. There will be 20 registered nurses and
3 nurse managers with at least one year in service in the nursing and patient care service of a selected district
hospital. The participants will be selected using non-probability purposive sampling.
• The study is limited to one specific location which is a district hospital in Sablayan Occidental Mindoro
and no other institution will be involved. Approval of the conduction of the study was sought from the head of
divisions concerned through a formal letter. The researcher used three questionnaires, two of them are adapted
questionnaires and will be subjected for reliability and validity testing. The questionnaire will be distributed to
the respondents and will be given 10-15 minutes to finish. The study will be conducted on April – May 2020
 Definition of Terms

• Access to Information – refers to the ability to access and mobilize resource

information and support from one’s position in the organization.
• Access to Opportunity – refers to growth, mobility and the chance to increase
knowledge and skills.
• Access to Resources – refers to the ability to acquire necessary materials,
supplies, money and personnel needed to meet organizational goal.
• Access to Support – refers to guidance and feedback received from
subordinates, peers and supervisors to enhance effectiveness.
• Affective Commitment – refers to employee’s emotional attachment to, identification with
and involvement in the organization.
• Continuance Commitment – refers to employee’s awareness of the cost associated in
leaving the organization.
• Empowerment – refers to given freedom and responsibility to decide about their own
work. These decisions can be small or big depending on the power the superior bestowed.
• Normative Commitment – refers to the feeling and obligation to continue employment.
• Nurse Manager – refers to the unit manager of 1 year in nursing care units in selected
tertiary hospital.
• Organizational Commitment – refers to an attachment to the organization,
characterized by an intention and obligation to remain in it.
• Registered Nurses – refers to the staff nurses who are 1 year in service in the nursing
care units in selected tertiary hospital.
• Relationship Management – refers to ability to maintain a good relationship with
others.
• Resonant Leadership – refers to a type of relational leadership skill that uses
emotional and social intelligences to renew themselves, create good relationships and
develop a healthy working environment to engage others towards a common goal.
• Self-Awareness – refers to ability of person to know one self.
• Self-Management – refers to ability of person to control emotions and
make right decision for oneself.
• Social Awareness – refers to ability to know and understand the emotion
of society.
 Conceptual Framework

RESONANT LEADERSHIP EMPOWERMENT

of Nurse Manager of Registered Nurses
ORGANIZATIONAL COMMITMENT of
Registered Nurses

LEADERSHIP ENHANCED
TRAINING PROGRAM

SOCIO-DEMOGRAPHIC
PROFILE
-Nurse Manager
-Registered Nurse
• In the paradigm, the socio-demographic profile of both nurse managers and
registered nurses have a direct relationship to resonant leaderships of nurse
managers and to empowerment and organizational commitment of registered nurses.
This is signified by a single ended arrow. The single ended arrow signifies the
resonant leadership as determinant to empowerment and organizational commitment
that both empowerment and organizational commitment of registered nurse are
affected by the resonant leadership of the nurse manager. An enhanced training
program will be the output based on the relationship between resonant leadership to
empowerment and resonant leadership to organizational commitment.
 REVIEW OF RELATED LITERATURE AND STUDIES

• In recent studies, relational leadership on individual nursing units directly

affects nursing staff emotional and intellectual satisfaction. Employees are
fascinated in managers who can lead in a positive and encouraging
manner. Nurses who are satisfied in their positions correlate to a decline
in staff turnover and improve retention. When the nursing staff are
satisfied with their employment, patient satisfaction also produce.
• Cummings (2010), resonant leadership is a positive relational leadership style and
existing literature supports the importance of relational leadership for effective work
outcomes. It supports a leadership view that directly intervene with individuals own
emotion intellect and behavior. Resonant Leaderships is a type of leadership that is
rooted from the emotional intelligence of the leaders. It is also a type of relational
leadership wherein the nurse manager are affecting his/her staff within their emotional
and intellectual capacity. Resonant Leader who are able to develop resonance are
defined to be effective in their organizations relatively because it increases the
satisfaction levels of the workers, resonant leaders are mostly linked in the jobs wherein
emotional and intellectual aspect are taken into action.
• Empowerment is one of the factor in gaining growth within the work and achieving the
goal of the company. It eliminates the barrier that prevent the staff in attaining the
desired goals. With empowerment the staff and the whole team are motivated in
achieving their vision and goals and also their psychological morale is on a positive
note, thus empowerment help in the maturity and development of the staff output and
outlook. According to Laschinger and Finegan (2005), Employees who lack access to
these structures of empowerment in their organizations may experience a sense of
powerlessness and may be less motivated, committed and productive. Employee needs
to be motivated and empowered to be more productive and to develop the sense of job
satisfaction and organizational commitment
• Organizational commitment it is the forte of an individual's identification with and association in a organization.
Accentuates the affection to an engaging organization, including its goals and values and thereby define it as an
outlook. Organizational commitment can decrease staff’s absenteeism and turnover. Commitment is the energy
that connects an individual to a development of achievement of relevance to one or more objectives. Commitment
is like the develop stability of an organization and of every employee and individual working on it. According to
Cohen (2003) commitment is a force that binds an individual to a course of action of relevance to one or more
targets. Commitment is like the building strength of an organization and of every staff and individual working on
it. Arnold (2005) stated that it is the relative strength of an individual’s identification with and involvement in an
organization. Organizational commitment relates to organization vision and mission and also on its goal. Miller
(2003,) also states that organizational commitment is a state in which an employee identifies with a particular
organization and its goals and wishes to maintain membership in the organization. Organizational commitment
also relates to employees’ attitude and behavior. It will be its basis on his/her own judgement and outlook in their
own organization,
 METHODOLOGY

• 3.1 Research Design

• This study will utilize a descriptive non-experimental correlational design. Macnee(2004) stated that,
descriptive design functions to portray as accurately as possible some phenomenon of interest and used to
answer research question that seek to describe while correlation studies use a descriptive design to
describe as accurately as possible interrelationships among variable and are used to answer questions that
seek or link to connect. It is Non-experimental research because the researcher collected data without
introducing an intervention. A comparative research is a type of research that explores the difference
among variables of interest without any active intervention by the researcher (Polit and Beck, 2006).
• The researcher will use this design in order to describe and interrelate the relationship of resonant
leadership to empowerment and how it can influence organizational commitment among its subordinates.
• 3.2 Research Locale
• The study will be conducted in a district hospital in salaam, occidental mindoro, Philippines.
Being a level 1 government hospitals in sablayan, occidental mindoro. The hospital has been
known to have 25 beds capacity and the only government hospital in the municipality of sablayan.
• The nursing and patient care service is one of the biggest divisions in the institution in terms of
number of populations. There are almost twenty five employees working as a healthcare front liner,
this include the clinical department manager, nurse managers, charge nurses and staff nurses.
• Data gathering will be conducted specifically at the nursing and patient care division. Most of
the participants are nurse managers and staff nurses that has an experience of 1 year in service
working in nursing unit.
• 3.3 Sample and Sampling Technique
• The participants will be chosen using non-probability purposive sampling in which decisions
concerning the individuals to be included in the sample are taken by the researchers based upon a
variety of criteria which may include specialist, knowledgeable of research issue or capacity and
willingness to participate in the research (Oliver, 2006). A non-probability type of sampling is a
selection process wherein the probability that one individual may be selected is not equal to the
probability that one individual may be chosen. A purposive type of sampling is when the researcher
institute a certain criterion considered to represent the target population and purposely selects a
sampling unit based on those criteria.
• The eligibility criteria set by the researcher will be registered nurses and nurse manager with at
least one year in service at the nursing and patient care service in a selected district hospital.
• 3.4 Instrumentation
• There are three instrument that will be use by the researcher on this study.
Two of the instruments that will be use is inspired by the survey questionnaire
made by the previous researchers these are the instrument for resonant leadership
and organizational commitment. The only instrument that will be use that is not
adapted will be the instrument for empowerment. There will be 2 versions of the
instrumentation in the study, one for the Registered Nurses which are the
instrument for empowerment and organizational commitment and one for the
Nurse Managers which is the instrument of resonant leadership.
• The instrumentation has 2 parts. The first part of the instrumentation will be the socio-demographic variables of the
respondents, which can help in the analysis of the study. The socio demographic is limited to age, gender, unit, length of
service in the unit, educational attainment and number of years in service of the nurse manager and staff nurse in the unit.
 
• The questionnaire for resonant leadership is a 12 item Likert scale questionnaire related to resonant leadership skills of
nurse manager is research made instrument inspired from the four resonant leadership style theorized by Goleman. The
questionnaire consists of statements regarding the four components of resonant leadership. Statements from number 1 to 3
pertains to visionary type, statements from number 4 to 6 refers to coaching type, statement from number 7 to 9 refers to
affiliative type, and the last 3 statements will pertain to democratic type. Nurse Manager will be asked to indicate the
degree to which they agree or disagree with the opinion expressed by the statement. The likert scale is a five-point rating
where respondents will have to choose from 5 as strongly agree, 4 as agree, 3 as undecided, 2 as disagree and 1 as strongly
disagree. After nurse manager respondents completed the Likert scale, their responses will be scored using weighted mean.
• Second instrument that the researcher will use is The Conditions for Work
• Effectiveness Questionnaire-II (CWEQ-II), which was developed by Laschinger (2001), was used
to measure the four main dimensions of structural empowerment (Laschinger 2001). The CWEQ-
II has 12 items each of which is rated on a 5-point Likert scale ranging from a low of 1 (= very
minimal level of empowerment) to a high of 5 (= very high level of empowerment). The four
structural empowerment subscales measured include access to opportunities, support, resources
and information. Statements from number 1 to 3 refers to access to opportunity, Statements from
number 4 to 6 refers to access to information, statements from number 7 to 9 refers to access to
support, and the last 3 statements refers to access to information. After the registered nurse
respondents completed the Likert scale, their responses will be scored using weighted mean.
• Third instrument that the researcher will use for the organizational commitment is
researchers made inspired from the TCM Employee Commitment Survey. The
questionnaire is consisting of 18 items statements regarding the three dimensions of
organizational commitment. Statements from number 1 to 6 pertains to affective,
statements from number 7 to 12 refers to normative, and statement from number 13 to 18
refers to continuance. Registered nurse will be asked to indicate the degree to which they
agree or disagree with the opinion expressed by the statement. The likert scale is a five-
point rating where respondents will have to choose from 5 as strongly agree, 4 as agree,
3 as undecided, 2 as disagree and 1 as strongly disagree. After staff nurse respondents
completed the Likert scale, their responses will be scored using weighted mean.
• 3.5 Reliability and Validity
• Before the actual data gathering a pilot, test will be conducted together with the approval of two
clinical department manager and the vice president for nursing services. 10 selected participants
who will meet the criteria but will not be part of the data gathering procedure will undergo the pilot
test. After which, a retest reliability test will be done, wherein the test will be taken twice on two
separate occasions by the same respondents, with a 4 days interval. This is to assess the stability of
the tool. Afterwards, the computation of the test-retest reliability coefficient will be computed using
Cronbach’s Alpha of Statistical Package of Social Science (SPSS), IBM version. Cronbach’s alpha
is the most common measure of internal consistency (“reliability”). It is most commonly used when
you have multiple Likert questions in a survey / questionnaire that form a scale and you wish to
determine if the scale is reliable (Galang, 2016).
The results of the Cronbach alpha will be based on the table below:

Cronbach Alpha (a) Internal Consistency

≥ 0.9 Excellent

0.9 > a > 0.8 Good

0.8 > a > 0.7 Acceptable

0.7 > a ≥ 0.6 Questionable

< 0.5 Unacceptable

• 3.6 Data Gathering Procedure
• In order to conduct this study, the researcher will attain a consent letter from Vice
President of Nursing and Patient Care Services of the selected district hospital stating the
process flow of the study and the benefits the study will conceive. This is to secure an
administrative permission in conducting the study. The study will also undertake an
Institutional Review Board (IRB) panel in order to obtain approval for data gathering in
the hospital and ensure ethical considerations are secured. The researcher will request a
copy of all the registered nurses and nurse manager under the nursing and patient care
division, minimum of 1 years in service, from the Nursing Workforce Management,
Budget and Informatics Department in order to acquire the target population.
• Before the actual data gathering, the researcher will conduct a pilot study at the selected
tertiary hospital to authenticate if the questionnaire needs modification and to have a primary
assessment of the data gathering process.

• On the day of actual data collection, the researcher will make a courtesy call to the Clinical
Department Manager then researcher will ask the unit for the most suitable time to gather data
that will not interrupt the patient care activities of the Registered Nurses. The research will
give first the informed consent form and explain to the respondents the objectives of the study
and the confidentiality of information then after getting the approval from the informed
consent the researcher will give survey questionnaires to the Nurse Managers and registered
nurses for them to answer. A control number will be indicated in the questionnaires achieve the
desired number of patients. 3 days will be allotted to provide considerable amount of time to
complete the questionnaires. Respondents’ confidentiality and ethical considerations will be
strictly observed during data gather collection.
• Upon retrieval of the questionnaires, the results will be analyzed and
interpreted by using the standard statistical tools through SPSS. The
researcher will be able to produce tabulated reports, descriptive statistics,
and conduct complex statistical analyses.
• 3.7 Statistical Treatment
• These are the following statistical tools that the researchers used in order to analyze all the responses on their
inspired research-made structure questionnaire.
•  
• Weighted Mean
• To answer the first, second and third minor problems about the level resonant leadership of nurse
manager, empowerment and organizational commitment of registered nurses, the statistical method that will
be use is weighted mean where there is some variation in the relative contribution of individual data values to
the mean. Each data value has a weight assigned to it. Data values with larger weights contribute more to the
weighted mean and data values with smaller weights contribute less to the weighted mean (Children mercy,
2008).
Table 1. Level of nurse manager’s resonant leadership

Mean Score Qualitative Interpretation

4.6 – 5.0 Very High Level of resonant leadership
 
3.7 – 4.5 High Level of resonant leadership
 
2.8 – 3.6 Moderate Level of resonant leadership
 
1.9 – 2.7 Minimal Level of resonant leadership
 
1.0 – 1.8 Very Minimal Level of resonant leadership
Mean Score Qualitative Interpretation

4.6 – 5.0 Very High Level of empowerment Table 2.

 

3.7 – 4.5 High Level of empowerment

Level of
 
registered
2.8 – 3.6 Moderate Level of empowerment
  nurse
1.9 – 2.7 Minimal Level of empowerment
 
empowerment
1.0 – 1.8 Very Minimal Level of empowerment
 Mean Score Qualitative Interpretation
4.6 – 5.0 Very High Level of organizational
commitment
 
3.7 – 4.5 High Level of organizational
Table 3. commitment
 
Level of  
registered 2.8 – 3.6 Moderate Level of organizational
nurse commitment

organizational  
commitment 1.9 – 2.7 Minimal Level of organizational
commitment
 
 
1.0 – 1.8 Very Minimal Level of
organizational commitment
 
•  
• Pearson R.
• To answer problem number. 4 and 5 minor problem which aims to determine the relationship
between resonant leadership and empowerment, resonant leadership and organizational
commitment, nurse managers and registered nurses working in a tertiary hospital , Pearson product
will be used. The formula will be:
• 

• Where,
r = Pearson correlation coefficient
x = Values in first set of data
y = Values in second set of data
n = Total number of values.

• The correlation coefficient is always been -1 and +1. The closer the correlation is to +1, the closer
to perfect linear relationship.
 Value of R Qualitative Interpretation

0 No Correlation

+0.01 - +0.19 Negligible Correlation

+0.20 - +0.39 Low Correlation

+0.40 - +0.59 Moderate Correlation

+0.60 - +0.79 Moderately High Correlation

+0.80 - +0.99 High Correlation

+1 Perfect Correlation
• Decision Rule
• To understand the computed value, the decision rule states that if the
calculated that if the computed p-value test is greater than 0.05 level of
significance, the null hypothesis of no significance will be rejected.
However, if the computed p-value is lesser than the level of significance
set at 0.05, the null hypothesis of significant relationship will be accepted.