Empowerment experiences of registered nurses and the role of nurse managers in Ghana: a qualitative descriptive study

Background: Nurses constitute the largest segment of the healthcare workforce, yet they are frequently undervalued within health systems and society. This study explored how nurse managers empower registered nurses and how such empowerment shapes nursing practice, professional identity and care delivery within a resource-constrained Ghanaian hospital. Methods: A qualitative descriptive exploratory design was used. Seventeen registered nurses were purposively sampled. Data were collected through semi-structured, face-to-face interviews and analysed using qualitative content analysis, supported by reflexivity, peer debriefing and data saturation. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guided the reporting of the study. Results: Two themes were identified: (1) Nurse Empowerment in Low-Resource Clinical Settings and (2) Organisational and Leadership Influences on Empowerment. Empowerment enhanced retention, advocacy, autonomy and quality care. Supportive leadership, recognition, training and shared decision-making facilitated empowerment; whereas autocratic leadership, favouritism, limited resources and gender-related challenges hindered empowerment. Conclusion: Nurse manager-led empowerment strengthens nurses' confidence, autonomy and care quality. Culturally responsive leadership, equitable recognition, staff development and inclusive decision-making are essential for sustaining the nursing workforce and improving patient outcomes through advocacy, high-quality care and error reduction in Ghana.