- The paper demonstrates that green transformational leadership and ethical climate significantly predict sustainable clinical behaviors, with green psychological climate partially mediating this relationship.
- The paper details robust SEM analysis of 760 nurses, confirming significant direct, mediating, and moderating effects, with metrics such as β coefficients supporting the findings.
- The paper highlights practical implications for aligning authentic leadership and ethical climates to overcome perceived organizational hypocrisy in resource-constrained healthcare settings.
Overview
"Green Transformational Leadership and Sustainable Nursing Practices: Evidence from the Healthcare Sector" (2606.29056) presents a structural equation modeling (SEM) study on how green transformational leadership (GTL) and ethical climate (EC) predict sustainable clinical behaviors (SCB) among nurses, utilizing green psychological climate (GPC) as a mediator and perceived organizational hypocrisy (POH) as a moderator. The empirical context is Jordanian hospitals, providing insights from a non-Western healthcare system with substantial resource constraints. The study integrates perspectives from social information processing theory and social learning theory to explain the interplay between organizational antecedents and sustainable behavioral outcomes in clinical environments.
Theoretical Contributions
The study makes several explicit contributions:
- Extension of Green Transformational Leadership Theory: While prior GTL research has focused on manufacturing and services, this study centers on the healthcare sector, where direct environmental impacts and the scale of nursing labor multiply the consequences of micro-level green behaviors.
- Integration of Ethical Climate and Environmental Sustainability: The authors position EC as a contextual determinant of SCB, conceptually linking ethical climates (across caring, law and code, and rules subdimensions) to the internalization and enactment of environmental stewardship among nursing staff.
- Boundary Condition: Perceived Organizational Hypocrisy: Incorporating POH as a boundary condition expands the theoretical understanding of negative moderators. Unlike most studies that focus exclusively on positive drivers, this analysis empirically demonstrates how lack of alignment between espoused values and enacted practices undermines the efficacy of GTL and EC.
Empirical Design and Measurement
- Sample & Methodology: Data were collected via cross-sectional survey (N=760) from registered nurses in 11 public and private Jordanian hospitals, using established and contextually adapted scales. SEM with bootstrapping (5,000 subsamples) addressed both direct/indirect effects and moderation pathways. CFA confirmed discriminant/convergent validity and reliability metrics.
- Construct Operationalization:
- GTL measured via context-adapted items from Chen & Chang.
- EC captured through Victor & Cullen's multidimensional instrument.
- GPC via Norton et al.’s framework.
- POH adapted from Dineen et al. to focus on the supervisor level.
- SCB operationalized with both required and discretionary behavior metrics covering conservation, waste management, and proactive green behaviors.
Key Findings
- Direct Effects: Both GTL (β=0.215, p<0.001) and EC (β=0.161, p<0.001) are significant positive predictors of SCB. The model accounted for 35.7% of SCB variance.
- Mediation: GPC partially mediates both GTL→SCB (indirect effect=0.122) and EC→SCB (indirect effect=0.092), consistent with both social information processing and social learning theoretical expectations. Both direct and indirect effects remain significant, indicating complementary partial mediation.
- Moderation: POH significantly attenuates the positive effects of both GTL (β=-0.153, p<0.001) and EC (β=-0.065, p<0.01) on SCB. The moderating effect is more pronounced for the leader-subordinate dyad, reinforcing the salience of perceived authenticity at the unit management level.
- Control Variables: Age is positively associated and tenure negatively associated with SCB, while gender shows no significant effect, emphasizing contextual workforce demography.
No contradictory claims are presented; all hypothesized relationships were statistically supported, and the moderation effects, while negative, align with recent theory and empirical findings regarding greenwashing and organizational trust.
Implications
Practical Implications
- Leadership Development: Healthcare organizations aiming to reduce their environmental footprint should prioritize green-focused transformational leadership training for front-line managers, as leader-driven behavioral cues and role modeling are robust predictors of systemic SCB uptake.
- Ethical and Green Climate Integration: Initiatives to improve environmental sustainability cannot be decoupled from efforts to strengthen ethical climates across professional and administrative domains. Explicit alignment of caring, code/law, and rule-based ethics with environmental objectives should be a strategic priority.
- Authenticity and Resource Alignment: The moderating effects of POH underscore the necessity to synchronize organizational messaging with concrete action, resource allocation, and leadership behavior at all levels. Symbolic or rhetorical sustainability efforts are not only ineffective but counterproductive, eroding staff engagement.
Theoretical Implications
- Multi-level Modeling: The findings support integrated multi-level models wherein leadership and climate effects on sustainability practices are contingent on both psychological mediators and boundary conditions such as POH.
- Expanding Generalizability: The Jordanian context—resource-scarce, non-Western, and with unique gender demographics in nursing—provides valuable comparative data, suggesting the applicability of GTL and climate constructs beyond traditional Western-centric samples.
- Employee-Centric Green Transformation: The large effect sizes for GTL and GPC indicate the high leverage of behavioral and psychological channels, beyond infrastructural or technological interventions.
Limitations and Future Directions
- Single-country Design: While offering valuable context, results warrant replication in other healthcare systems to assess generalizability in varying institutional and cultural environments.
- Focus on Nursing Staff and Supervisor-level POH: Although nurses are central to clinical operations, future research should address interprofessional variation. Additionally, measuring POH at broader organizational (rather than immediate supervisor) levels may capture further variance in SCB.
- Potential Additional Moderators and Mediators: The role of green self-efficacy, personal environmental value alignment, or peer influence could be explored in subsequent studies to complete the nomological network of determinants.
- Temporal Sequencing and Causality: The cross-sectional design precludes causal inference; longitudinal or experimental research could elucidate directionality and durability of effects.
Conclusion
This study demonstrates that both green transformational leadership and ethical climate are significant and partially mediated predictors of sustainable clinical behaviors in the healthcare sector. The moderating role of perceived organizational hypocrisy highlights the absolute necessity of aligned incentives, consistent behavior, and authentic leadership for the effective translation of organizational green values into practice. These findings have immediate practical relevance for healthcare administrators pursuing carbon reductions and broader environmental sustainability, particularly in resource-constrained contexts. Theoretical implications pertain to the integration of leadership, climate, psychological, and authenticity constructs in operationalizing the micro-foundations of organizational sustainability. Future research should expand these insights through multi-professional, cross-cultural, and longitudinal designs to further inform evidence-based sustainability interventions in healthcare and beyond.