The impact of nurses’ perfectionistic self-presentation and toxic leadership of nurse managers on workplace incivility: a cross-sectional study

BACKGROUND: Unlike overt bullying or violence, incivility refers to subtle and recurring behaviors that undermine others’ dignity. As a pervasive yet frequently overlooked problem in nursing workplaces, incivility has been linked to nurses’ well-being and the quality of patient care, underscoring the need to clarify its dynamics and antecedents. This study aimed to explore the impact of nurses’ perfectionistic self-presentation and the toxic leadership of nurse managers on workplace incivility, from the perspectives of both the victim and the perpetrator, among nurses. METHODS: In this cross-sectional study, data from 319 hospital nurses were collected through an online survey from November 18 to December 6, 2024. Multiple regression analysis was performed to identify the impact of the perfectionistic self-presentation and nurse managers’ toxic leadership on workplace incivility. RESULTS: Victim-related factors had the most significant impact on workplace incivility. These factors included nurse managers’ toxic leadership, nurses’ perfectionistic self-presentation, and working in an intensive care unit, listed in descending order of significance. The factors that significantly affected the perpetrator aspect of workplace incivility included the experience of being a victim of workplace incivility and nurses’ perfectionistic self-presentation. Nurses’ perfectionistic self-presentation and the toxic leadership of nurse managers were shown to affect both the victim and the perpetrator aspects of workplace incivility. CONCLUSIONS: Proactive organizational interventions are required to address workplace incivility. Emotional support should be provided to help nurses recognize and manage perfectionistic self-presentation tendencies related to both victim and perpetrator roles. Educational programs must also be established to mitigate toxic leadership among nurse managers. Additionally, senior executives should foster an organizational culture that encourages mutual respect and positive leadership among nurses.