Green Transformational Leadership and Sustainable Nursing Practices: Evidence from the Healthcare Sector

The healthcare sector contributes approximately 4.4% of global greenhouse gas emissions, yet research on the organizational determinants of sustainable behaviors among healthcare workers remains limited. This study examines how green transformational leadership and ethical climate influence sustainable clinical behaviors among registered nurses, with green psychological climate as a mediator and perceived organizational hypocrisy as a moderator. Data were collected from 760 nurses across 11 public and private hospitals in Jordan using a cross-sectional survey design. Structural equation modeling with bootstrapping was employed to test the hypothesized relationships. The results revealed that both green transformational leadership (β = 0.215, p < 0.001) and ethical climate (β = 0.161, p < 0.001) positively predicted sustainable clinical behaviors. Green psychological climate partially mediated both relationships. Perceived organizational hypocrisy significantly weakened the positive effects of green transformational leadership (β = −0.153, p < 0.001) and ethical climate (β = −0.065, p < 0.01) on sustainable behaviors. The model explained 35.7% of the variance in sustainable clinical behaviors. These findings highlight that fostering sustainability in healthcare requires not only supportive leadership and ethical organizational environments but also authenticity and consistency between stated values and actual practices. The study extends green transformational leadership theory to healthcare settings, integrates ethical climate research with environmental sustainability, and introduces perceived organizational hypocrisy as a critical boundary condition. Practical implications for healthcare administrators seeking to reduce their environmental footprint are discussed.