Effects of ethical leadership on nurses' service behaviors

Background: Nurses' service behaviors have critical implications for hospitals. However, few studies had adequate ethical considerations of service behaviors and accounted for how organizational or individual antecedents can induce nurses to engage in service behaviors. In addition, they mainly focused on the one side of role-prescribed or extra-role service behavior. Objective: This study aims to explore the chained mediation effect of ethical climate and moral sensitivity on the relationship between organizational ethical leadership and nurses' service behaviors and to examine the relationship, from a comparative view, of the role-prescribed service behavior and extra-role service behavior. Methods: In all, 476 nurses from three tertiary hospitals were investigated with the Ethical Leadership Scale, Ethical Climate Scale, Moral Sensitivity Questionnaire and Service Behavior Questionnaire. Structural equation modeling was adopted to analyze the data. SPSS and Mplus statistical software was used in the data analysis. Ethical considerations: Approval was obtained from the Ethics Committee at School of Nursing, Hebei Medical University. Data privacy and confidentiality were maintained and assured by obtaining subjects' informed consent to participate in the research before data collection. Results: The effects of ethical leadership on nurses' service behaviors are mediated by two variables in turn: ethical climate and nurses' moral sensitivity. Ethical climate and moral sensitivity partially mediated the relationship between ethical leadership and nurses' role-prescribed service behavior and fully mediated the relationship between ethical leadership and nurses' extra-role service behavior. Conclusion: Organizational ethical leadership positively affected ethical climate, which positively affected nurses' moral sensitivity and affected both their role-prescribed service behavior and extra-role service behavior.