Leaders and their followers share the work environment; they live the same challenges, and face the same problems (Baker, 2007; Uhl-Bien et al., 2014). However, in nursing little is known about the effect of the quality of the manager – follower relationship and work engagement in formulating a follower’s perception of leadership and its impact on job satisfaction. In a country such as Lebanon that has the eighth lowest nurse density in the Eastern Mediterranean Region (EMR) and suffers from excessive nurse migration and low nurse satisfaction and retention rates (El-Jardali, Dimassi, Dumit, Jamal, & Mouro, 2009) understanding the factors influencing nurse satisfaction becomes a priority. It is also important for clinical nurse leaders to be associated with engaged and committed followers in order to achieve positive outcomes. Followers are direct care nurses who practice in acute care in the capacity of registered nurses and under the first level supervision of a nurse manager. Effective and engaged followers are those who show intelligence, commitment, integrity, independence, and courage (Kelley, 1988). The relationship between the leader and followers is not unidimensional, but it is rather an interdependent relationship. Followers expect their leaders to be reachable, honest, empathic, visionary, and to be involved in employee development (Sherman, 2012).

Follower-centric relational predictors that impact nurses’ job satisfaction in acute care was the focus of this study. Using a predictive correlation design, this study examined the association between the registered nurses’ (RNs’) (a) quality of relationship with the nurse manager and (b) work engagement and how these variables impact the registered nurses’ (followers) perception of leadership effectiveness and job satisfaction. Findings of the study supported that better work engagement and positive follower-nurse manager relationship will impact an enhanced perception of leader effectiveness and increase RNs job satisfaction.

Date of publication

Summer 8-30-2016

Document Type




Persistent identifier


Committee members

Beth Mastel-Smith, Ph.D (Chair); K. Lynn Wieck, Ph.D.; Sally Northam, Ph.D.; Nuhad Dumit, Ph.D.


Doctor of Philosophy in Nursing