Introduction
Nursing team creativity is critical not only for the successful operation and sustainability of new hospitals but also for enhancing patient experiences, optimizing care processes, fostering teamwork, and delivering better healthcare services [1]. Numerous studies have highlighted the importance of nursing team creativity in the establishment and growth of new hospitals [2, 3]. For frontline practitioners, creativity helps address clinical challenges, improve service quality, reduce patient costs, and realize professional value [4].
New hospitals continuously evolve to meet dynamic healthcare demands, particularly in their early stages, rely on creative nursing teams to adapt their workflows and processes to better serve patients. In a complex and ever-changing healthcare environment, maximizing nursing team creativity to ensure high-quality patient care has become a key challenge for nursing managers.
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Entrepreneurial leadership, characterized by entrepreneurial traits [5], enables leaders to guide employees in identifying and leveraging opportunities to strengthen their organization’s competitive advantage and sustainable growth [6]. These leaders value employee diversity, encourage open communication, foster psychological safety, and promote team self-efficacy and creativity [7].
For example, Bagheri [8] found that entrepreneurial leadership significantly enhances nurses’ innovative behaviours in Iranian hospitals. Similarly, other studies have shown that entrepreneurial leadership empowers nurses to think creatively, develop tailored solutions, and improve patient care [9]. Creative nurses often devise innovative solutions to resource shortages, such as developing apps, predictive models, or task management tools [10]. They also enhance patient experiences through initiatives like designing diabetic-friendly recipes that balance taste and dietary requirements [11].
Despite growing interest in the impact of entrepreneurial leadership on nurses’ creativity [12], research on the mechanisms linking the two remains limited. This gap is partly due to the lack of a robust conceptual framework reflecting nursing managers’ and nurses’ experiences, as well as inadequate representation of nursing practices.
To address this, our research team conducted a study from April to July 2023 in a new hospital in Guizhou, China. This hospital was chosen because new hospitals often face unique challenges and opportunities, requiring strong leadership to navigate organizational and management hurdles. Earlier research involving 833 nurses from two new hospitals in Guizhou demonstrated that entrepreneurial leadership positively influences nursing team creativity (β = 0.268, p < 0.001), with factors like innovation climate, self-efficacy, psychological safety, and knowledge sharing acting as mediators (p < 0.001) [13]. However, a detailed conceptual framework exploring the interactive processes and impacts of entrepreneurial leadership on nursing team creativity is still needed.
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Our study used grounded theory to investigate how entrepreneurial leadership styles and behaviours influence nursing team creativity. By interviewing nursing managers and team members, we identified key leadership attributes and behaviours that affect creativity and developed a conceptual framework to guide nursing managers in implementing effective leadership practices.
Methods
Research design
This study used the grounded theory design of Corbin and Strauss [14]. This study investigated how entrepreneurial leaders inspire the creativity of nursing teams by taking the perspectives of nursing managers and nurses into account. These perspectives include their inputs, their perceptions of entrepreneurial leadership, the strategies they pursue and the positive effects of creativity on their work. Given that entrepreneurial leadership and nursing team creativity are social interaction phenomena, grounded theory is deemed appropriate for exploring the topic at hand. This qualitative research method captures key concepts and domains based on rich empirical information [14]. Under this theoretical framework, the researcher does not propose hypotheses before the study and instead collects the primary data, extracts relevant concepts and domains, discovers the logical relationships amongst these domains and eventually builds a theoretical model; in other words, the substantive theory can be obtained from the bottom up with the help of grounded theory [14].
Participants
According to the standards of grounded theory [14], Participants (new hospital nursing managers and nurses) were gradually included in the study, initially using purposive sampling and later using a focused theoretical sampling procedure. The aim was to reach nursing managers and nurses working in different departmental contexts with different field experiences. The theoretical sampling process involved participants from different departmental departments and different ages. This study collected data from 15 nursing managers and 14 nursing team members in a new hospital in Guizhou, China through face-to-face semi-structured interviews. The following inclusion criteria were adopted: ① the nursing managers should have more than three years of management experience; ② the nursing team members should have more than three years of clinical experience; and ③ all participants should engage in this study voluntarily and sign an informed consent form. The nursing management and nursing team members interviewed all had more than three years of work experience, because such employees have already formed a relatively mature skill system and workplace world view and have a certain ability to explore and work experience, which can provide more in-depth and comprehensive insights. This helps to reveal the deep-grounded theoretical mechanism of the role of entrepreneurial leadership attributes and leadership behaviours on the creativity of the nursing team in the new hospital.
Data collection
We conducted individual interviews with the participants. Each interview lasted approximately half an hour on average. All interviews were recorded and transcribed. The interviewer was a female registered nurse who was pursuing a master’s degree at the time of this study. Before the interviews, she received systematic training in qualitative research and had an extensive interviewing experience. By using Chinese (the native language of the participants and the primary researcher) during the interviews, the linguistic and cultural nuances in the interviews were captured, thus avoiding loss of meaning [15]. Writing memos is crucial in interviews. It helps us to instantly capture key information and highlights, record the non-verbal information and emotional responses of the interviewee, as well as record the details of interactions and background information. This provides rich material for subsequent data analysis, helps to extract key concepts, themes and relationships, constructs a theoretical framework, and enriches the research results by comparing the content of notes from different interviewees. To ensure data saturation, we continuously compare and analyse newly collected data with existing data to find commonalities and differences. We consider data to have reached saturation when no new categories for analysis or theoretical insights emerge from the new data. Two rounds of interviews were conducted following this principle. The first round consisted of 23 interviews, and the collected data were used to explore the intrinsic motivation effects of entrepreneurial leadership on the creativity of the nursing team in the selected hospital. The second round consisted of 6 interviews, and the collected data were used to conduct a theoretical saturation test of the model. An interview outline was initially drafted based on a literature review and the objectives of this study. The outline was revised and finalized through pre-interviews with five nursing managers and five nurses. An outline of the interviews with the nursing managers and nursing team members is shown in Tables 1 and 2.
Table 1
Qualitative interview outline for nursing managers
1. Please describe your nursing team in a few words (be as accurate and comprehensive as possible). | |
2. Please talk about how you stimulate creativity amongst your nursing team members. | |
3. Please discuss those factors that promote and hinder the development of creativity in your nursing team (be as specific as possible). | |
4. Do your nursing team members often share constructive ideas about their work (be as detailed as possible about their actual work situation)? | |
5. What are your suggestions for developing creativity in your nursing team? |
Table 2
Qualitative interview outline for nursing team members
1. Please describe the personality attributes of your nursing manager (be as accurate and comprehensive as possible). | |
2. Please give examples of how your nursing manager leads your team to learn new knowledge and methods and to try new ways of working. How effective was it? | |
3. Tell us how your nursing manager talked about the goals and vision of the team. | |
4. How did your nursing manager lead you through difficulties and challenges? | |
5. What type of nursing manager do you find most attractive? What qualities should such a leader possess? | |
6. How does your nursing manager foster creativity in your team? | |
7. What can you tell us about the impact of the new hospital environment on your creativity (whether positive or negative)? | |
8. What are the most critical aspects of fostering team creativity? | |
9. Tell us about the role of the nursing team’s creativity in building a new hospital (whether positive or negative). |
Data analysis
The collection and analysis of the interview data were conducted simultaneously. The audio recordings were transcribed verbatim within 24 h after the interviews were completed. To avoid recall bias, another researcher was asked to listen to the recordings after the transcription was finished and to recheck the transcribed texts to confirm their accuracy. The transcripts were sequentially coded and imported into the NVivo 12 qualitative analysis software. This process of analysing data is in line with the grounded theory methodology [14].
To clarify the direction to be studied and the problem to be solved, an open, axial and selective coding was performed on the collected data. First, open coding was used to identify keywords or phrases that formed the initial categories. These initial categories were then used in the subsequent coding process to construct a more specific coding structure to more fully analyse the research data. Second, to find the interrelationships between the categories, this study used axial coding to compare and analyse the initial categories obtained, find the relationships between them, and organize and group repetitive concepts into major categories. Finally, to further extract the mechanism based on entrepreneurial leadership and the creativity of the care team, these main categories were further refined, and core categories were identified and refined using selective coding to form a conceptual framework. Two independent coders (the first author and a qualitative expert) conducted stepwise data analyses. Two experts with a doctoral degree (one with a PhD in nursing, and the other with a PhD in English) were also invited to do independent translations of the interview recordings. Although all the participants were native Chinese speakers, given the jargon and cultural backgrounds involved in the interviews, we invited an expert with a PhD in English, which was crucial to ensure the accuracy of the translation. This expert not only helped us to ensure that the language was fluent and grammatically correct but also ensured that the participant’s statements were accurately and completely conveyed during the translation process from Chinese to English, ensuring the quality of the translation and the rigour of the study. The researcher then compared these two translations and came up with the first draft after discussions. The researcher then asked two academics fluent in Mandarin and English, one of whom was an expert in the field of nursing, to review the audio recordings, check the transcripts line by line and conduct backward translation from English to Chinese. The researcher then contrasted these back-translations with the actual statements of the participants and, if necessary, discussed and adjusted these translations along with the back-translators to ensure that they were consistent with the participants’ original statements in terms of meaning and context.
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The analysis was carried out based on well-established coding procedures and comprised three stages, namely, open coding, axial coding and selective coding [14]. These codes were based on the actual statements of the participants and extracted by the researchers. All participants were kept anonymous; instead of using the actual names of the participants, they were given a unique number (e.g. NM1 or N1, where NM stands for nursing manager, and N stands for nurse).
Theoretical saturation
Pandit [16] suggested that after the model of grounded theory is constructed, the theoretical model should be subjected to a theory saturation test. In this test, the theory reaches saturation when no new concepts, categories and relationships reappear when the three-level coding is performed again using another part of the collected empirical data. To ensure clarity in the process, we followed a systematic approach to the saturation test. First, we selected nursing managers as interviewees due to their leadership positions within the team and their overarching perspective. Their interviews provided valuable insights into team operations, management strategies, and challenges. Next, we selected nursing team members for interviews. These interviews offered a grassroots perspective on teamwork, which helped validate and supplement the insights gained from the nursing manager interviews.
To maintain consistency, we used a standardized interview outline, ensuring that each interviewee addressed the same key questions, allowing for comparability across responses. During the interviews, we made detailed notes, capturing not only the verbal responses but also non-verbal cues such as tone of voice and facial expressions, which were important for the subsequent data analysis and coding process. After the interviews, we transcribed the data into a text format suitable for analysis.
We then performed three levels of coding. In the first level, we identified and extracted key concepts and events from the data; in the second level, we categorized these concepts and events into broader categories; and in the third level, we refined and integrated the categories to construct the theoretical model. Once the three-level coding was completed, we conducted a theoretical saturation test. In this step, we applied the same coding procedure to a new subset of the data and checked whether any new concepts or categories emerged. The results showed that no new information emerged, indicating that theoretical saturation was reached. This confirms that our theoretical model is stable and comprehensive, as no further refinements were needed.
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Ethical considerations
This study was approved by the Medical Ethics Committee of the selected new hospital (No. YXLL(KY)-2022-002). Before the start of the interview, we obtain the explicit consent of the interviewee, inform them of the purpose, process, possible risks and benefits of the research, as well as how their personal information will be used and stored, and ensure that the interviewee fully understands and agrees to participate in the research by signing a consent form. The real names and identifiers of the interviewees were omitted during the recording of the interviews. The researcher also emphasised that their participation was purely voluntary and that they could terminate their participation at any time without any adverse consequences. During the data processing and analysis stage, sensitive information was desensitized, such as replacing personal information such as real names and ID numbers with meaningless codes or symbols, to ensure that the privacy of the interviewees was not disclosed. The number of people and institutions authorized to access the data was limited to ensure that only the necessary members of the research team had access to the raw data and analysis results to prevent illegal access and use of the data.
Results
Demographic profile
A total of 29 participants were recruited in 2 rounds (23 in the first round and 6 in the second round). These participants had a mean age of 33 years and clinical experience of 22 years. They included 15 nursing practitioners and 14 registered nurses working across different departments, namely, internal medicine, surgery, oncology, obstetrics and gynaecology and intensive care unit. All participants had bachelor’s degrees and reported some knowledge of entrepreneurial leadership and nursing team creativity. The interviews with the nurse manager and nursing team members lasted for a total of 480 min. The detailed characteristics of the participants are shown in Table 3.
Table 3
Characteristics of participants in the two rounds (n = 29)
Characteristics | Profile | Number (%) |
|---|---|---|
Position | Nursing managers | 15(51.7%) |
Nurses | 14(48.3%) | |
Gender | Male | 2(6.9%) |
Female | 27(93.1%) | |
Age (Years) | 20–30 | 14(48.3%) |
31–40 | 12(41.4%) | |
41–50 | 2(6.9%) | |
51–60 | 1(3.4%) | |
Nursing services (Years) | 0–10 | 13(42.9%) |
11–20 | 14(55.1%) | |
21–30 | 1(3.4%) | |
31–40 | 1(3.4%) | |
Entering the team time (Years) | <1 | 1(3.4%) |
1–3 | 27(93.2%) | |
>3 | 1(3.4%) |
Fig. 1
Sankey diagram of the coding process of the entrepreneurial leadership model. Note This study used the grounded theory research method. In-depth interviews were conducted with the nursing managers and nursing team members of the new hospital. The interview data were systematically analysed using a three-level coding technique to extract multiple categories and main categories of entrepreneurial leadership attributes and leadership behaviours, and to identify core categories. Subsequently, we quantified the frequency of occurrence of each category in the data and finally presented these quantitative ratios visually in the form of a Sankey diagram
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Entrepreneurial leadership attributes
Entrepreneurial leadership attributes are those demonstrated in entrepreneurial environments, typically including a drive for organizational creativity, leadership attitude, and the motivation and management of teams. Participants defined entrepreneurial leadership as a style applicable at any stage of a hospital’s development. This style emphasizes the continuous pursuit of entrepreneurial activities, identifying opportunities by creatively addressing patient needs, fostering innovation among nurses, and turning opportunities into actionable outcomes. In essence, entrepreneurial leadership enables new hospitals to thrive. From the interviews, five key attributes were identified: achievement orientation, flexibility and patience, concerns and questions, communication and sharing, and execution and support.
Achievement orientation
This study defined achievement orientation as a personality trait that reflects the motivation that nurses aim to achieve and influences their cognition, behaviours and emotions. In the dynamic development of new hospitals, nursing team creativity results from complex team process formation and needs to be driven by a robust motivational engine. Achievement goal orientation is an essential motivational factor that can stimulate nurses’ creativity [17].
N3: The manager should act as a guide; their mindset directly influences the team’s ability to learn and innovate. Their attitude toward learning and innovation shapes the team’s direction.
Flexibility and patience
Flexibility and patience refer to the ability to quickly adjust strategies, methods and resource allocation in the face of different situations, patient needs or team challenges. And when training members of the nursing team, they can remain calm and patient, giving enough time and space to solve problems or promote growth. The interviewed nursing managers and nursing staff pointed towards differences amongst nursing staff and argued that individual diversity should be considered. The nursing managers respect the nurses’ personalities and values, identify and develop their strengths and give them a sense of complete trust and frequent encouragement to increase their willingness to do their jobs and their likelihood of learning something new in the process. Meanwhile, the nurses believed that nursing leaders should have some work management skills and should be patient, understanding and supportive of their subordinates because apart from work issues, the life challenges faced by their staff warrant consideration [18].
N1: Each nurse has unique strengths. If managers can patiently identify these and adapt their approach, we can build a highly effective team.
Concerns and questions
Concerns and questions mean that nursing managers should pay attention to the personal characteristics and strengths of nurses, and at the same time dare to question mainstream logical thinking. Understanding the nurses’ skill levels, personal attributes and work status will help nursing managers in new hospitals manage their teams better and provide the needed support and resources. Moreover, instead of blindly following the traditional or prevailing ideas, nursing managers in new hospitals should keep an open mind and be willing to challenge these established ideas and practices. By doing so, they can drive innovation and improvement and bring new ways of thinking to their teams. Combining these attributes can stimulate the creativity of nursing teams, and by focusing on the abilities and status of nurses, managers can provide the necessary support and guidance that can help their team members realise their full potential. Questioning the prevailing ideas also promotes creativity and innovation in nursing teams by facilitating the nurses’ thinking and encouraging them to find new solutions and ideas [19].
N3: Entrepreneurial leaders should question mainstream ideas. Innovations often emerge from overlooked areas, and challenging norms can spark new thinking.
Communication and sharing
Communication and sharing refer to the clear, accurate and timely exchange of information between the nursing manager and members of the nursing team, patients, their families and other medical professionals, as well as the transfer of knowledge to promote teamwork, improve the quality of patient care and grow the nursing team. The participants talked about the increasing importance of communication and sharing in hospitals as a typical knowledge-intensive organisation [20]. Communication and sharing are essential components of nursing practice, and knowledge sharing amongst nurses is vital for improving their job competency, strengthening their workforce and providing quality nursing care.
N14: Our head nurse shares the latest geriatric nursing trends and encourages nurses to communicate and share. For example, when our team is working on a nursing project, she will organise the communication and sharing of ideas amongst the members to find an optimal path to achieve the best possible outcomes from this project.
Execution and support
Execution and support refer to the process of effectively carrying out a plan or project, coupled with the provision of necessary assistance, resources, and encouragement to ensure its successful implementation and completion. Most of the participants regarded performance incentives as essential. Nurses who achieve an excellent performance tend to feel energised and have a sustained enthusiasm for their work. By encouraging nursing staff to look beyond existing routines and take a creative view and by giving them the necessary resources to do their jobs, they can improve their business skills and innovative spirit. In this process, they can achieve professional growth and provide quality patient care [21].
N3: Entrepreneurial leaders guide nurses to discover new directions and pursue innovative opportunities, such as establishing pain-free or rapid rehabilitation wards.
Entrepreneurial leadership behaviours
Entrepreneurial leadership behaviours refer to a range of motivational, supportive and encouraging measures taken by leaders to stimulate creativity and innovation amongst their team members [22]. These behaviours differ from traditional management attributes given their focus on stimulating the potential of team members, encouraging them to try out new ideas and approaches and pushing them to continue developing. This study extracted two broad categories of entrepreneurial leadership behaviours, namely, positive and negative leadership behaviours, from the interview data. The framework for investigating how entrepreneurial leadership fosters creativity in nursing teams was established via multilevel coding and constant comparison, and the coding process is shown in Fig. 1.
Positive entrepreneurial leadership behaviours
Positive entrepreneurial leadership behaviors refers to leadership attributes that effectively promote team development and creativity [23]. Nursing managers engage in certain nurturing actions to enhance nursing team creativity, including innovative talent development, advantage seeking, mobilise subordinates, psychological empowerment, inwardly following, exemplary management, observing team member traits and job reinvention.
NM12: I encourage nurses to consult information, form their own ideas, and collaborate, often leading to unexpected solutions.NM15: Assigning tasks that demand collaboration, and emotional sharing helps build team cohesion and a shared sense of accomplishment.NM10: Creating a warm, supportive environment and empowering nurses to make decisions enhances their engagement.NM15: Continuous learning and self-development as a manager inspire nurses to grow.
Negative entrepreneurial leadership behaviours
Nursing managers may perceive a lack of organisational flexibility and workplace capital, inherent thinking and blurred sense of boundaries, all of which hinder nursing team creativity [24]. Lack of managerial resilience means that these nursing managers may be too stuck in traditional management attributes and mindsets that prevents them from trying out new approaches or responding to change. Lack of social capital means that nursing managers are unable to build good relationships with other leaders, experts or resource providers. Those managers who are influenced by built-in thinking and have fuzzy cognitive boundaries around certain concepts or areas may struggle in understanding and supporting the creativity of their nursing teams. As a result, these managers may become sceptical of the new ideas and innovative approaches proposed by their team members or fail to provide them the adequate support and guidance, thus limiting the development of their teams’ creativity and innovation.
NM8: Heavy workloads and stress, if unaddressed, can stifle creativity.N6: A lack of social networks and openness in managers can hinder team progress.N12: ‘Fuzzy boundary perceptions in decision-making can limit the team’s potential.
Theoretical model
We have finally constructed a theoretical model that explains how entrepreneurial leadership attributes and leadership behaviours can positively influence the creativity of the new hospital care team. We have also paid attention to those negative leadership behaviours that should be avoided. This framework represents the core attributes, behaviours and aims of entrepreneurial leadership as shown in Fig. 2.
Fig. 2
A theoretical model of the mechanism of entrepreneurial leadership on the influences of nursing team creativity
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Discussion
This study explores the impact of entrepreneurial leadership on creativity and innovation within nursing teams in new hospitals. The research identifies key entrepreneurial leadership attributes and behaviours that contribute to nursing team development. Entrepreneurial leadership attributes are fundamental to stimulating the creativity of nursing teams in new hospitals. Nursing managers in these hospitals guide nurses in recognising the value of opportunities and help them achieve their goals. Meanwhile, nurses demonstrate their sense of responsibility through their positive behaviours, such as seeking advantages and developing novel and practical ideas. The interview data suggest that nursing managers should flexibly respond to the challenges and situations in a changing healthcare environment. They may need to adjust their teams’ work schedule to accommodate unexpected situations, such as medical emergencies and staff shortages, to cope with the complexity of the changing nursing work environment and to maintain the effective functioning of their teams. Nursing work in hospitals is inherently stressful and demanding, necessitating that nursing managers maintain a patient and composed demeanor. Such patience not only mitigates workplace conflicts and alleviates stress but also enhances job satisfaction and boosts productivity among team members [25]. Building on this, paying attention to team members allows managers to identify individual strengths and needs, enabling tailored support and guidance. This fosters trust, belonging, and the maximization of each member’s potential [26]. Furthermore, by encouraging questioning and challenging conventional thinking, managers can help nurses explore new perspectives, identify innovations, and propose creative solutions, ultimately stimulating nursing team creativity [27, 28].
Nursing managers in new hospitals play a dual role as effective organizers and supportive leaders to ensure high-quality nursing services. To achieve this, they should establish positive communication channels to facilitate timely information sharing, clarify team goals and tasks, and improve collaborative efficiency. Encouraging knowledge sharing among team members not only helps nurses adapt to new environments and master skills quickly but also fosters a culture of continuous learning and innovation, benefiting both individual growth and team development [29].As strong executives, nursing managers must develop clear work plans and objectives, ensuring tasks are completed on time and standards are met. Simultaneously, they should act as supportive leaders by providing technical, professional, and emotional support to help nursing team members overcome challenges, realize their potential, and achieve personal and team goals. This combination of organizational and supportive leadership fosters a sense of belonging and enthusiasm among nurses, motivating them to apply their knowledge creatively and drive innovation in clinical practice [30].
The active implementation of positive entrepreneurial leadership behaviors is essential for fostering creativity in nursing teams. Nursing managers in new hospitals can boost creativity by adopting leadership qualities such as flexibility, motivation, and empowerment, which help nurses generate new ideas and solutions [31]. Innovative talent development, cultivating innovative talents sparks creativity and imagination, enabling team members to develop new solutions and drive innovation in nursing services [32]. Advantage seeking, nursing managers can help team members identify and leverage their strengths, enhancing creativity and competitiveness [33]. Mobilizing subordinates, positive leadership and motivation from nursing managers encourage nurses to engage in team innovation activities, unlocking their creative potential and promoting development. Psychological empowerment: By granting autonomy and decision-making power, nursing managers boost team members’ confidence, encouraging them to propose new ideas and stimulate creativity and innovation [34]. Supporting inner motivation and passion inspires team members to actively participate in innovative initiatives, contributing to continuous improvement in nursing services [35]. Exemplary management, leading by example fosters team organization, improves efficiency, and solves problems, all while inspiring creativity [36]. Observing team member traits, understanding individual team members’ strengths allows managers to organize work effectively, maximizing potential and fostering innovation across the team [37]. Job reinvention, encouraging team members to experiment with new methods and optimize work processes enhances both nursing efficiency and service quality [38]. The positive leadership behaviours adopted by nursing managers can effectively enhance the creativity of nursing teams and promote their development in new hospital environments. These initiatives help team members give full play to their potential, enhance the overall quality of their teams and positively contribute to the enhancement of hospital nursing services.
Avoiding negative entrepreneurial leadership behaviors is also essential for the healthy development of nursing teams in new hospitals. For example, a lack of flexibility and workplace capital can limit nursing staff’s ability to exercise their creativity. In a healthcare environment where innovation and change are increasingly important, the creativity of nursing teams is crucial to driving progress in care delivery. However, without flexibility, nurses may be reluctant to adopt new approaches or engage in innovation [39]. Nursing managers in these hospitals may also be constrained by traditional management practices and mindsets, making them less adaptable to change. This lack of managerial flexibility can hinder the ability to respond to new challenges, reducing the resilience of teams and stunting their development [40]. Additionally, nursing managers who cannot effectively network with other leaders, experts, or resource providers may lack necessary social capital. Collaboration and communication with external stakeholders are vital in healthcare to help teams access resources, share experiences, and overcome obstacles. Without social capital, teams may struggle with collaboration and communication, limiting their development [41]. Nursing managers must avoid these negative entrepreneurial leadership behaviors to promote creativity and achieve continuous improvements in nursing services.
Implications for nursing management
This study offers practical insights for nursing management in new hospitals, with an emphasis on fostering creativity and innovation within nursing teams. Nursing managers should create an achievement-oriented environment by setting clear, measurable goals, aligning teams with hospital objectives, and maintaining motivation. Flexibility and patience are key to adapting to challenges such as medical emergencies and staffing shortages. Effective communication and knowledge-sharing foster team cohesion and competency. Additionally, providing both professional and emotional support enhances job satisfaction and reduces turnover. Empowering nurses with autonomy fosters innovation, while focusing on talent development and continuous learning ensures teams stay adaptable in a dynamic healthcare environment. Avoiding negative behaviors, such as inflexibility and poor external networking, is vital for promoting creativity and collaboration. Lastly, understanding and leveraging team members’ diverse strengths allows managers to tailor leadership strategies, improving both team performance and innovation. By implementing these strategies, nursing managers can cultivate an environment conducive to creativity, which ultimately enhances healthcare delivery and organizational success.
Limitations
This study provides a framework that can aid nursing managers in new healthcare facilities in China in nurturing the creativity of their nursing teams. To ensure trustworthiness, the researchers collected data from the nursing managers and nurses separately. Although entrepreneurial leadership is especially beneficial for dynamic new hospitals, such effect may not be generalisable to other cultures even though the Chinese culture has a considerable influence. The conclusions of this work provide a theoretical model of entrepreneurial leadership that fosters creativity in nursing teams in a Chinese cultural context. However, the attributes identified in this study only refer to the perceptions of Chinese nursing managers and nurses regarding entrepreneurial leadership and are not representative of the perceptions of nursing professionals in other countries. We will continue to strive to expand the sample size as conditions permit in subsequent research to further improve the scientific nature and accuracy of the research.
Conclusions
Nursing managers in new hospitals can leverage entrepreneurial leadership qualities, such as flexibility, patience, and communication, to enhance nursing team creativity. Attributes like empowerment and support are also essential for fostering innovation. Avoiding negative behaviors, such as rigidity and poor networking, ensures continuous team growth. These leadership behaviors contribute to both team cohesion and the overall quality of nursing services in new hospitals.
Acknowledgements
We sincerely thank all nursing managers and nurses who participated in the interviews. We sincerely thank the Second Affiliated Hospital of Zunyi Medical College for your support. We thank the Science and Technology Bureau of Zunyi City and Zunyi Medical College for the funding.
Declarations
Ethics approval and consent to participate
This study was approved by the Institutional Review Committee of the Second Affiliated Hospital of Zunyi Medical University (YXLL(KY)-2022-002) on January 28, 2022. The research was carried out adhering to the Declaration of Helsinki. Written informed consent was obtained from each participant after proper orientation regarding the study’s objectives. Data confidentiality and informants’ identities were maintained throughout the study.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
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