Understanding Nurse Supervisor Legitimacy of Authority as Perceived by Subordinate Staff Nurses: An Exploratory Sequential Mixed-Method Study

Abstract

The study of perceived legitimacy of authority is a relatively new area of study in the field of nursing administration. An attribute of a manager or person of authority that makes people believe that a person deserves to be obeyed (Tyler, 1997), the study of perceived legitimacy of authority at an individual level may help nurse managers to understand how subordinate staff nurses provide voluntary deference in the workplace.

The primary objective of this study was to understand the phenomenon of nurse supervisor legitimacy of authority as perceived by their subordinate staff nurses through an exploratory sequential mixed-method study.

A qualitative investigation was conducted on ten (10) staff nurses of East Avenue Medical Center (EAMC). After analyzing the interview transcripts using MAXQDA Analytics Pro 2022, six thematic dimensions, which include professional and academic advancement, communication and managerial competence, relational perspective, knowledge transfer abilities, supervisor’s leadership characteristics, and moral perspective emerged from 18 contextual categories. Development of survey instrument was derived from the themes and contextual categories, with good content validity and reliability scores (S-CVI= 1.00, 0.92, k* =1.00, α=0.976, ICC= 0.976; 95% CI: 0.960 – 0.988; p-value < 0.001). In the third phase of the study, a quantitative investigation was conducted on 242 staff nurses of EAMC using the Perception of Nurse Supervisor Legitimacy of Authority Scale (SN-PNSLAS) which revealed a highly acceptable level of nurse supervisor legitimacy.

The study provided an understanding of the factors that affected subordinate staff nurses' perception of nurse supervisors' legitimacy of authority. The results of the qualitative and quantitative investigation, as well as the creation of SN-PNSLAS, will provide nurse leaders with a method to assess and strengthen voluntary deference given by subordinate staff nurses. It may result in the enhancement of work dynamics, achievement of organizational goals, and improvement of patient outcomes.