The Association of Toxic Leadership on Nurses’ Well-Being in Saudi Arabia

Background: Nurses are central to achieving Saudi Arabia’s Vision 2030 goals, particularly in improving healthcare quality and workforce well-being. However, their well-being may be influenced by toxic leadership behaviors such as abusive supervision, authoritarianism, and unethical practices. Aim: This study examined the association between toxic leadership and nurses’ well-being in selected hospitals within Riyadh’s Second Health Cluster and the Al-Qassim Health Cluster. Methods: A cross-sectional survey was conducted among 400 staff nurses using two validated tools: the Toxic Leadership Behaviors of Nurse Managers (ToxBH-NM) Scale and the BBC Well-being Scale (BBC-WBS). Toxic leadership was rated on a 1–5 scale (mean = 2.10, SD = 0.74), while well-being was measured similarly (mean = 2.90, SD = 0.61). Correlation and regression analyses were used to examine associations, adjusting for demographic factors. Results: A statistically significant positive correlation (p < 0.01) was found between toxic leadership and well-being scores, indicating that higher perceived toxic leadership was unexpectedly linked with higher reported well-being. This counterintuitive finding may reflect contextual or methodological factors, such as cultural norms, social desirability, or measurement limitations. Demographic variables (age, gender, educational qualification, marital status, nationality, contract type, years of experience, and weekly work hours) also showed statistically significant associations with well-being, but effect sizes were generally small and varied in direction. Conclusion: The observed positive association between toxic leadership and well-being diverges from prior evidence and should be interpreted with caution. Given the cross-sectional design, no causal claims can be made. Future research—preferably longitudinal or mixed-method—should further investigate these dynamics and clarify the contextual influences on nurse well-being in Saudi Arabia.