Optimizing Job Performance: Exploring the Leadership Paradox in Health Care.

Authors

  • Ramish Zafar Bhatti Institute of Management Sciences, University of Balochistan.
  • Beenish Malik Institute of Management Sciences, University of Balochistan.
  • Mariyam Mustafa Ghulam Ishaq Khan Institute of Engineering Sciences and Technology

DOI:

https://doi.org/10.22555/ijelcs.v10i1.1337

Keywords:

Abusive Supervision, Emotional Exhaustion, Servant Leadership, Job Performance

Abstract

Abusive supervision remains a critical challenge in the health care settings, significantly affecting the emotional well-being and performance of nurses. The study investigates how abusive supervision indirectly impacts job performance through emotional exhaustion. This study further examines whether servant leadership can reduce these negative impacts.  Grounded on leadership theories of leadership and occupational stress, the study employed model 7 of the PROCESS macro to analyze a sample data 306 nurses from public hospitals in Quetta. Findings reveal that while abusive supervision does not reduce job performance, it significantly increases emotional exhaustion, which further negatively impacts job performance.  Moreover, servant leadership moderates this relationship by improving the psychological burden caused by abusive supervision, thereby lessening its adverse effects on nurses’ well-being and work outcomes. However, the protective influence of servant leadership is partial it reduces, but does not entirely eliminate, the destructive consequences of abusive supervision. These finding highlights the pivotal role leadership styles in shaping employee resilience and performance, particularly in high stress environments, like health care. By aligning with sustainable development goal 3 on ensuring good health and well-being in workplace, study advocates strategic intervention that prioritize servant leadership that encourage leaders to shift from authoritarian control to a more supportive and empathetic approach can contribute to a healthier, more engaged, and higher performing nursing workforce.

 

References

Al-Hawari, M. A., Bani-Melhem, S., & Quratulain, S. (2020). Do frontline employees cope effectively with abusive supervision and customer incivility? Testing the effect of employee resilience. Journal of Business and Psychology, 35(2), 223–240. https://doi.org/10.1007/s10869-019-09621-2

Alzola, M. (2018). Decent work: The moral status of labor in human resource management. Journal of Business Ethics, 147(4), 835–853. https://doi.org/10.1007/s10551-017-3507-5

Aryee, S., Sun, L.-Y., Chen, Z. X. G., & Debrah, Y. A. (2008). Abusive Supervision and Contextual Performance: The Mediating Role of Emotional Exhaustion and the Moderating Role of Work Unit Structure. Management and Organization Review, 4(3), 393–411. https://doi.org/10.1111/j.1740-8784.2008.00118.x

Babakus, E., Yavas, U., & Ashill, N. J. (2011). Service Worker Burnout and Turnover Intentions: Roles of Person-Job Fit, Servant Leadership, and Customer Orientation. Services Marketing Quarterly, 32(1), 17–31. https://doi.org/10.1080/15332969.2011.533091

Bakker, A. B., Demerouti, E., & Verbeke, W. (2004). Using the job demands?resources model to predict burnout and performance. Human Resource Management, 43(1), 83–104. https://doi.org/10.1002/hrm.20004

Bass, B. M., & Bass Bernard, M. (1985). Leadership and performance beyond expectations. Free Press, https://doi.org/10.1002/hrm.3930250310

Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173

Bavik, A., Bavik, Y. L., & Tang, P. M. (2017). Servant leadership, employee job crafting, and citizenship behaviors: A cross-level investigation. Cornell Hospitality Quarterly, 58(4), 364–373. https://doi.org/10.1177/1938965517719282

Beamish, A. G. (2019). Energised or Exhausted? The Effect of Abusive Supervision and Servant Leadership on Leader Wellbeing. Doctoral dissertation, Monash University.

Bhatti, R. Z., & Malik, B. (2024). Is Ambidexterity A Myth? An Empirical Study Investigating the Impact of Ambidextrous Leadership on The Effect of Innovation Climate on Employee Innovation Performance. International Journal of Management Research and Emerging Sciences, 14(2), 70–86. https://doi.org/10.56536/ijmres.v14i2.605

Bhatti, R. Z., Malik, B., & Nagi, S. (2024). Unlocking Innovation Potentials: The Role of Value Co-Creation and Absorption Capacity. Sarhad Journal of Management Sciences, 10(1), 17–32. https://doi.org/10.31529/2024/1/2

Carlson, D., Ferguson, M., Hunter, E., & Whitten, D. (2012). Abusive supervision and work–family conflict: The path through emotional labor and burnout. The Leadership Quarterly, 23(5), 849–859. https://doi.org/10.1016/j.leaqua.2012.05.003

Chen, Z., Zhu, J., & Zhou, M. (2015). How does a servant leader fuel the service fire? A multilevel model of servant leadership, individual self-identity, group competition climate, and customer service performance. Journal of Applied Psychology, 100(2), 511–521. https://doi.org/10.1037/a0038036

Chi, S.-C. S., & Liang, S.-G. (2013). When do subordinates' emotion-regulation strategies matter? Abusive supervision, subordinates' emotional exhaustion, and work withdrawal. The Leadership Quarterly, 24(1), 125–137. https://doi.org/10.1016/j.leaqua.2012.08.006

Chughtai, A. A. (2016). Servant leadership and follower outcomes: Mediating effects of organizational identification and psychological safety. The Journal of Psychology, 150(7), 866–880. https://doi.org/10.1080/00223980.2016.1170657

Cochran, W. G. (1953). Sampling Techniques (1st ed.). John Wiley & Sons.

Cropanzano, R., & Mitchell, M. S. (2005). Social exchange theory: An interdisciplinary review. Journal of Management, 31(6), 874–900. https://doi.org/10.1177/0149206305279602

Demeke, G. W., van Engen, M. L., & Markos, S. (2024). Servant leadership in the healthcare literature: a systematic review. Journal of Healthcare Leadership, 16,1–14. https://doi.org/10.2147/JHL.S440160

Eisenbeiß, S. A., & Brodbeck, F. (2014). Ethical and unethical leadership: A cross-cultural and cross-sectoral analysis. Journal of Business Ethics, 122(2), 343–359. https://doi.org/10.1007/s10551-013-1740-0

Eisenberger, R., Stinglhamber, F., Vandenberghe, C., Sucharski, I. L., & Rhoades, L. (2002). Perceived supervisor support: contributions to perceived organizational support and employee retention. Journal of Applied Psychology, 87(3), 565. https://doi.org/10.1037/0021-9010.87.3.565

Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods, 41(4), 1149-1160). https://doi.org/10.3758/BRM.41.4.1149

Fu, J., Long, Y., He, Q. Y., & Liu, Y. (2020). Can ethical leadership improve employees’ well-being at work? Another aspect of ethical leadership is rooted in organizational citizenship anxiety. Frontiers in Psychology, 11, 1478. https://doi.org/10.3389/fpsyg.2020.01478

Goodman, S. A., & Svyantek, D. J. (1999). Person–organization fit and contextual performance: Do shared values matter? Journal of Vocational Behavior, 55(2), 254–275. https://doi.org/10.1006/jvbe.1998.1682

Greenleaf, R. K. (2013). Servant leadership: A journey into the nature of legitimate power and greatness. Paulist press. https://www.urbanleaders.org/620Leadership/92Readings/articles/Greenleaf-Servant%20Leadership.pdf

Haar, J. M., de Fluiter, A., & Brougham, D. (2016). Abusive supervision and turnover intentions: The mediating role of perceived organisational support. Journal of Management & Organization, 22(2), 139–153. https://doi.org/10.1017/jmo.2015.34

Han, G. H., Harms, P. D., & Bai, Y. (2017). Nightmare bosses: The impact of abusive supervision on employees’ sleep, emotions, and creativity. Journal of Business Ethics, 145(1), 21–31. https://doi.org/10.1007/s10551-015-2859-y

Hanse, J. J., Harlin, U., Jarebrant, C., Ulin, K., & Winkel, J. (2016). The impact of servant leadership dimensions on leader–member exchange among health care professionals. Journal of nursing management, 24(2), 228–234. https://doi.org/10.1111/jonm.12304

Harris, K. J., Kacmar, K. M., & Zivnuska, S. (2007). An investigation of abusive supervision as a predictor of performance and the meaning of work as a moderator of the relationship. The Leadership Quarterly, 18(3), 252–263. https://doi.org/10.1016/j.leaqua.2007.03.007

Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd ed.). The Guilford Press.

Hobfoll, S. E. (1989). Conservation of resources: a new attempt at conceptualizing stress. American psychologist, 44(3), 513. https://doi.org/10.1037//0003-066x.44.3.513

Huang, L.-C., Lin, C.-C., & Lu, S.-C. (2020). The relationship between abusive supervision and employees' reaction: the job demands-resources model perspective. Personnel Review, 49(9), 2035–2054. https://doi.org/10.1108/pr-01-2019-0002

Huang, L.-C., Su, C.-H., Lin, C.-C., & Lu, S.-C. (2019). The influence of abusive supervision on employees' motivation and extra-role behaviours: The daily-basis investigation. Chinese Management Studies, 13(3), 514–530. https://doi.org/10.1108/cms-04-2018-0495

Imran, M. K., Nadeem, M., Fatima, T., Sarwar, A., & Shabeer, S. (2024). I am a Performer Because of Self-control! A Canvas Among Abusive Supervision, Silence, Voice, Self-control , and Performance. Global Business Review. https://doi.org/10.1177/09721509241251979

Ja'afaru Bambale, A. (2014). Relationship between servant leadership and organizational citizenship behaviors: Review of literature and future research directions. Journal of Marketing & Management, 5(1).

Jahanzeb, S., & Fatima, T. (2018). How Workplace Ostracism Influences Interpersonal Deviance: The Mediating Role of Defensive Silence and Emotional Exhaustion. Journal of Business and Psychology, 33(6), 779–791. https://doi.org/10.1007/s10869-017-9525-6

Karatepe, O. M., & Olugbade, O. A. (2009). The effects of job and personal resources on hotel employees' work engagement. International Journal of Hospitality Management, 28(4), 504–512. https://doi.org/10.1016/j.ijhm.2009.02.003

Keijzers, B. (2012). The Relationship between Organizational Culture Differences and Employee Performance in Mergers.

Kensbock, J. M., & Boehm, S. A. (2016). The role of transformational leadership in the mental health and job performance of employees with disabilities. The International Journal of Human Resource Management, 27(14), 1580–1609. https://doi.org/10.1080/09585192.2015.1079231

Kim, S. L., Lee, S., & Yun, S. (2020). The trickle-down effect of abusive supervision: The moderating effects of supervisors’ task performance and employee promotion focus. Journal of Leadership & Organizational Studies, 27(3), 241–255. https://doi.org/10.1177/1548051820933321

Kish, L. (1994). Multipopulation survey designs: five types with seven shared aspects. International Statistical Review, 62(2), 167–186. https://doi.org/10.2307/1403507

Kloutsiniotis, P. V., & Mihail, D. M. (2020). Is it worth it? Linking perceived high-performance work systems and emotional exhaustion: the mediating role of job demands and job resources. European Management Journal, 38(4), 565–579. https://doi.org/10.1016/j.emj.2019.12.012

Kül, S., & Sönmez, B. (2021). The effect of nurse managers' servant leadership on nurses' innovative behaviors and job performances. Leadership & Organization Development Journal, 42(8), 1168–1184. https://doi.org/10.1108/LODJ-07-2020-0318

Labrague, L. J. (2024). Abusive supervision and its relationship with nursing workforce and patient safety outcomes: a systematic review. Western Journal of Nursing Research, 46(1), 52–63. https://doi.org/10.1177/01939459231212402

Walter, F., Lam, C. K., van der Vegt, G. S., Huang, X., & Miao, Q. (2015). Abusive supervision and subordinate performance: Instrumentality considerations in the emergence and consequences of abusive supervision. Journal of Applied Psychology, 100(4), 1056–1072. https://doi.org/10.1037/a0038513

Lee, R. T., & Ashforth, B. E. (1996). A meta-analytic examination of the correlates of the three dimensions of job burnout. Journal of Applied Psychology, 81(2), 123–133. https://doi.org/10.1037/0021-9010.81.2.123

Liden, R. C., Wayne, S. J., Meuser, J. D., Hu, J., Wu, J., & Liao, C. (2015). Servant leadership: Validation of a short form of the SL-28. The Leadership Quarterly, 26(2), 254–269. https://doi.org/10.1016/j.leaqua.2014.12.002

Lin, W., Wang, L., & Chen, S. (2013). Abusive supervision and employee well?being: The moderating effect of power distance orientation. Applied Psychology: An International Review, 62(2), 308–329. https://doi.org/10.1111/j.1464-0597.2012.00520.x

Liu, D., Liao, H., & Loi, R. (2012). The dark side of leadership: A three-level investigation of the cascading effect of abusive supervision on employee creativity. Academy of Management Journal, 55(5), 1187–1212. https://doi.org/10.5465/amj.2010.0400

MacKinnon, D. P., & Fairchild, A. J. (2009). Current directions in mediation analysis. Current directions in psychological science, 18(1), 16–20.

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113. https://doi.org/10.1002/job.4030020205

Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual review of psychology, 52(1), 397–422. 10.1146/annurev.psych.52.1.397

Mirza, N. S., Haider, A., Taj, T., & Bilal, H. (2020). The impact of workplace ostracism on job performance with the mediating role of emotional exhaustion: Evidence from public sector universities of Pakistan. Review of Economics and Development Studies, 6(3), 651–659. https://doi.org/10.47067/reads.v6i3.253

Mitchell, M. S., & Ambrose, M. L. (2007). Abusive supervision and workplace deviance and the moderating effects of negative reciprocity beliefs. Journal of Applied Psychology, 92(4), 1159–1168. https://doi.org/10.1037/0021-9010.92.4.1159

Moin, M. F., Wei, F., & Weng, Q. (2020). Abusive supervision, emotion regulation, and performance. International Journal of Selection and Assessment, 28(4), 498–509. https://doi.org/10.1111/ijsa.12301

Montano, D., Reeske, A., Franke, F., & Hüffmeier, J. (2017). Leadership, followers' mental health and job performance in organizations: A comprehensive meta?analysis from an occupational health perspective. Journal of Organizational Behavior, 38(3), 327–350. https://doi.org/10.1002/job.2124

Namie, G. (2021). 2021 WBI U.S. Workplace bullying survey. Workplace Bullying Institute. https://workplacebullying.org/wp-content/uploads/2021/04/2021-Full-Report.pdf

United Nations. (2016, November 29). United Nations Statistics Division: SDG indicators – Official list of SDG indicators. https://unstats.un.org/

World Health Organization. (2021). WHO/ILO joint estimates of the work-related burden of disease and injury, 2000–2016: Technical report with data sources and methods. World Health Organization. https://www.who.int/publications/i/item/9789240034925

Palanski, M., Avey, J. B., & Jiraporn, N. (2014). The effects of ethical leadership and abusive supervision on job search behaviors in the turnover process. Journal of Business Ethics, 121(1), 135–146. https://doi.org/10.1007/s10551-013-1690-6

Peterson, S. J., Galvin, B. M., & Lange, D. (2012). CEO servant leadership: Exploring executive characteristics and firm performance. Personnel psychology, 65(3), 565–596. https://doi.org/10.1111/j.1744-6570.2012.01253.x

Pircher Verdorfer, A., Belschak, F., & Bobbio, A. (2024). Felt or thought: Distinct mechanisms underlying exploitative leadership and abusive supervision. Journal of Business Ethics, 192(2), 363–383. https://doi.org/10.1007/s10551-023-05543-5

Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879

Priesemuth, M., & Schminke, M. (2019). Helping thy neighbor? Prosocial reactions to observed abusive supervision in the workplace. Journal of Management, 45(3), 1225–1251. https://doi.org/10.1177/0149206317702219

Quinn, R. W., Spreitzer, G. M., & Lam, C. F. (2012). Building a sustainable model of human energy in organizations: Exploring the critical role of resources. Academy of Management Annals, 6(1), 337–396. https://doi.org/10.5465/19416520.2012.676762

Reb, J., Narayanan, J., Chaturvedi, S., & Ekkirala, S. (2017). The mediating role of emotional exhaustion in the relationship between mindfulness and turnover intentions and job performance. Mindfulness, 8(3), 707–716. https://doi.org/10.1007/s12671-016-0648-z

Rhee, S. Y., Hur, W. M., & Kim, M. (2017). The relationship of coworker incivility to job performance and the moderating role of self-efficacy and compassion at work: The job demands-resources (JD-R) approach. Journal of Business and Psychology, 32(6), 711–726. https://doi.org/10.1007/s10869-016-9469-2

Rodwell, J., Brunetto, Y., Demir, D., Shacklock, K., & Farr?Wharton, R. (2014). Abusive supervision and links to nurses' intentions to quit. Journal of Nursing Scholarship, 46(5), 357–365. https://doi.org/10.1111/jnu.12089

Rotenstein, L. S., Brown, R., Sinsky, C., & Linzer, M. (2023). The association of work overload with burnout and intent to leave the job across the healthcare workforce during COVID-19. Journal of General Internal Medicine, 38(8), 1920–1927. https://doi.org/10.1007/s11606-023-08153-z

Seidman, G. (2017). Does SDG 3 have an adequate theory of change for improving health systems performance? Journal of Global Health, 7(1), 1–7. https://doi.org/10.7189/jogh.07.010302

Semmer, N. K., & Beehr, T. A. (2013). Job control and social aspects of work. An introduction to contemporary work psychology, 169–195. https://doi.org/10.1002/9781394259564.ch7

Tariq, H., & Ding, D. (2018). Why am I still doing this job? The examination of family motivation on employees’ work behaviors under abusive supervision. Personnel Review, 47(2), 378–402. https://doi.org/10.1108/pr-07-2016-0162

Tepper, B. J. (2000). Consequences of abusive supervision. Academy of Management Journal, 43(2), 178–190. https://doi.org/10.2307/1556375

Tepper, B. J., Simon, L., & Park, H. M. (2017). Abusive supervision. Annual Review of Organizational Psychology and Organizational Behavior, 4(1), 123–152. https://doi.org/10.1146/annurev-orgpsych-041015-062539

Thompson, M. J., Carlson, D. S., Hackney, K., & Vogel, R. M. (2022). Vicarious abusive supervision and turnover in expectant working mothers: Does financial dependency trigger emotional disconnect? Journal of Organizational Behavior, 43(3), 448–464. https://doi.org/10.1002/job.2579

Thoroughgood, C. N., Sawyer, K. B., Padilla, A., & Lunsford, L. (2018). Destructive leadership: A critique of leader-centric perspectives and toward a more holistic definition. Journal of Business Ethics, 151, 627–649. https://doi.org/10.1007/s10551-016-3257-9

Tropello, P. D., & DeFazio, J. (2014). Servant leadership in nursing administration and academia is shaping future generations of nurses and interdisciplinary team providers to transform healthcare delivery. Nurse Leader, 12(6), 59–66. https://doi.org/10.1016/j.mnl.2014.09.010

United Nations. (2016, November 29). SDG indicators: Official list of SDG indicators. United Nations Statistics Division. http://unstats.un.org/

Wang, G., Van Iddekinge, C. H., Zhang, L., & Bishoff, J. (2019). Meta-analytic and primary investigations of the role of followers in ratings of leadership behavior in organizations. Journal of Applied Psychology, 104(1), 70. https://doi.org/10.1037/apl0000345

Wang, I. A., Tsai, H. Y., Lee, M. H., & Ko, R. C. (2021). The effect of work–family conflict on emotional exhaustion and job performance among service workers: The cross-level moderating effects of organizational reward and caring. The International Journal of Human Resource Management, 32(14), 3112–3133. https://doi.org/10.1080/09585192.2019.1651373

Whitman, M. V., Halbesleben, J. R. B., & Holmes, O., IV. (2014). Abusive supervision and feedback avoidance: The mediating role of emotional exhaustion. Journal of Organizational Behavior, 35(1), 38–53. https://doi.org/10.1002/job.1852

World Health Organization. (2021). WHO/ILO joint estimates of the work-related burden of disease and injury, 2000–2016: Technical report with data sources and methods. World Health Organization.

Wright, T. A., & Bonett, D. G. (1997). The contribution of burnout to work performance. Journal of Organizational Behavior, 18(5), 491–499. https://doi.org/10.1002/(SICI)1099-1379(199709)18:5

Wu, T. Y., & Hu, C. (2009). Abusive supervision and employee emotional exhaustion: Dispositional antecedents and boundaries. Group & Organization Management, 34(2), 143–169. 10.1177/1059601108331217

Wu, W. Y., Tsai, C. C., & Fu, C. S. (2013). The relationships among internal marketing, job satisfaction, relationship marketing, customer orientation, and organizational performance: An empirical study of TFT?LCD companies in Taiwan. Human Factors and Ergonomics in Manufacturing & Service Industries, 23(5), 436–449. https://doi.org/10.1002/hfm.20329

Xie, J., Ma, H., Zhou, Z. E., & Tang, H. (2018). Work-related use of information and communication technologies after hours (W_ICTs) and emotional exhaustion: A mediated moderation model. Computers in Human Behavior, 79, 94–104. https://doi.org/10.1016/j.chb.2017.10.023

Yang, F., & Lu, M. (2024). When humor masks abuse: Employee responses to abusive supervision through the lens of relational energy. Personnel Review, 53(7), 1805–1822. https://doi.org/10.1108/PR-02-2022-0087

Zampetakis, L. A. (2024). Using indirect survey techniques to investigate the relationship between employee personal experience of abusive supervision and job performance. International Journal of Manpower. 45(7): 1309–1325. https://doi.org/10.1108/IJM-10-2023-0595

Zhou, S., Li, X., & Gao, B. (2020). Family/friends support, work-family conflict, organizational commitment, and turnover intention in young preschool teachers in China: A serial mediation model. Children and Youth Services Review, 113. https://doi.org/10.1016/j.childyouth.2020.104997

Downloads

Published

2025-09-16

Issue

Section

Articles

How to Cite

Bhatti, R. Z., Malik, B., & Mustafa, M. (2025). Optimizing Job Performance: Exploring the Leadership Paradox in Health Care. International Journal of Experiential Learning & Case Studies, 10(1), 33-59. https://doi.org/10.22555/ijelcs.v10i1.1337

Similar Articles

1-10 of 37

You may also start an advanced similarity search for this article.