Abstract

Purpose: Grounded in Social Exchange Theory (SET), this study investigates the impact of Ethical Leadership (EL) on nurses’ Organizational Citizenship Behaviors (OCB) and Employee Commitment (EC) toward patients. Despite the high-stakes nature of healthcare, the psychological mechanisms linking leadership ethics to extra-role behaviors remain under-researched in non-Western clinical settings. This research examines the nexus between EL, Employee Commitment (EC), and OCB within the Ghanaian public healthcare. Design/methodology/approach: A quantitative, cross-sectional design was employed, surveying 159 nurses across three hospitals in the Kumasi Metropolis, Ghana. Data were collected via structured scales and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) via SmartPLS v4 and SPSS v28. This approach allowed for a robust assessment of the structural pathways and the predictive relevance of the proposed model. Findings: The results provide empirical evidence that EL is a robust antecedent of both nurse commitment and OCB. Structural path analysis reveals that ethical supervisors cultivate an environment of trust, which significantly enhances nurses’ emotional attachment to their institutions. Furthermore, the study identifies Employee commitment as a vital conduit that transmits the influence of ethical leadership into pro-social, patient-centered behaviors. This suggests that OCB is not merely an individual trait but a reciprocated response to ethical governance. Originality/Value: This research contributes to the “nursing-management” literature by offering rare empirical insights from a sub-Saharan African context. It demonstrates that in resource-constrained environments like Ghana, ethical leadership acts as a critical non-material resource that drives service excellence. The study provides a mandate for healthcare administrators to integrate ethical competency into leadership development to reduce turnover and improve patient care quality through enhanced employee engagement EC and OCB.