Explore the vast range of titles available.

Background Perceived overqualification is an emerging challenge in the nursing workforce, influencing job satisfaction, psychological well-being, and overall retention. This study aims to examine the relationships among perceived overqualification, covert narcissism, workplace alienation, and role ambiguity among nurses using path analysis to explore their interactions. Methods A cross-sectional study was conducted with 446 nurses from various Egyptian healthcare settings. Data was collected through structured face-to-face interviews using four validated instruments: the Scale of Perceived Overqualification (assessing subjective overqualification), Hypersensitive Narcissism Scale (measuring covert narcissism), Role Ambiguity Scale (evaluating clarity in job responsibilities), Work Alienation Scale (assessing workplace alienation), Additionally, a researcher-developed Demographic Questionnaire was used to collect participants’ background characteristics. Path analysis was conducted using AMOS 26.0 to test direct and indirect relationships among variables, with model fit assessed using standard indices. Results Direct effects revealed that perceived overqualification significantly predicted workplace alienation (B = 0.401, 95% CI [0.311, 0.490], p  <.001), covert narcissism (B = 0.430, 95% CI [0.193, 0.423], p  <.001), and role ambiguity (B = 0.603, 95% CI [0.150, 0.463], p  <.001). Additionally, workplace alienation showed positive direct associations with role ambiguity (B = 0.268, 95% CI [0.195, 0.443], p  <.001) and covert narcissism (B = 0.191, 95% CI [0.293, 0.426], p  <.001). Mediated effects were also observed: perceived overqualification indirectly influenced workplace alienation via covert narcissism (B = 0.367, 95% CI [0.131, 0.273], p  <.001) and via role ambiguity (B = 0.228, 95% CI [0.183, 0.513], p  <.001). Conclusion Perceived overqualification significantly contributes to workplace alienation among nurses, with covert narcissism and role ambiguity acting as mediators. To mitigate these effects, healthcare organizations should implement targeted interventions such as structured role clarification, career development programs, and leadership strategies that enhance nurses’ sense of professional fulfillment. These strategies can improve job satisfaction, reduce turnover, and support workforce sustainability in healthcare settings. Clinical trial number Not applicable.

Background Achieving sustainable performance in healthcare organizations has become a pressing necessity, driven by environmental challenges and the imperative for enhanced efficiency. Within nursing leadership, the integration of green absorptive capacity, green intellectual capital, and green knowledge management has emerged as a strategic approach to fostering sustainability. However, empirical research on the interplay of these green competencies in the nursing sector remains limited. Aim This study aims to examine the mediating role of green knowledge management (GKM) in the relationships between green absorptive capacity, green intellectual capital, and sustainable performance among nursing managers. It explores how GKM processes translate environmental competencies into sustainable leadership outcomes. Methods A cross-sectional descriptive correlational study was conducted among 207 nursing managers at Zagazig University Hospitals, Egypt. Data was collected using five validated instruments, including the Green Absorptive Capacity Questionnaire, Green Intellectual Capital Questionnaire, Sustainable Performance Questionnaire, and Green Knowledge Management Scale. Structural equation modeling and path analysis were performed to test the study hypotheses. Results The findings revealed significant positive associations between green absorptive capacity (β = 0.123, p  < 0.001), green intellectual capital (β = 0.064, p  = 0.016), and sustainable performance among nursing managers. Green knowledge management exhibited the strongest direct effect on sustainable performance (β = 0.727, p  < 0.001). Additionally, green knowledge management significantly moderated the relationships between green absorptive capacity and sustainable performance (β = 0.256, p  < 0.001) as well as between green intellectual capital and sustainable performance (β = 0.359, p  < 0.001). These results underscore the pivotal role of knowledge-driven sustainability strategies in nursing leadership. Conclusion This study highlights the importance of integrating green absorptive capacity, green intellectual capital, and green knowledge management into nursing leadership to enhance sustainability outcomes. The findings provide empirical evidence for the need to embed green competencies within nursing management, advocating for policies and training programs that reinforce environmental responsibility in healthcare institutions. Clinical trial number Not applicable.