Breaking the silence in the health-care sector: the relationship between empowering leadership and nurses’ silence toward patient safety via psychological empowerment

Recently, an increasing stream of research has investigated the effect of leadership on employee silence in health care organizations. Drawing upon self-determination theory, this study aims to examine the unexplored relationship between empowering leadership and nurses' silence toward patient safety via psychological empowerment. Data were collected from a sample of 271 nurses working in two Greek private hospitals. PROCESS macro was used to test the authors' hypotheses. The results supported that empowering leadership is associated with psychological empowerment, and the latter is related to nurses' silence toward patient safety. Combined results indicated that psychological empowerment mediates the relationship between empowering leadership and nurses' silence toward patient safety. To the best of the authors' knowledge, this is one of the first studies that investigates the effect of empowering leadership on employee silence in the health-care sector. Furthermore, it highlights the underlying mechanism that accounts for this relationship. In doing so, it also provides novel insights into the effect of psychological empowerment on nurses' unfavorable behavior, such as nurses' silence toward patient safety. Theoretical and practical implications are also discussed.