BACKGROUND: In critical care departments, the clinical leadership of nurses who specialize in critical care nursing significantly influences care quality and clinical outcomes. The leadership styles of head nurses are closely associated with clinical nurse leadership. Ambidextrous leadership, which integrates transactional and transformational leadership, is a common leadership style. AIM: This study was conducted to determine whether psychological empowerment mediates the relationship between ambidextrous leadership and clinical nurse leadership among critical care nurses. STUDY DESIGN: A cross-sectional descriptive design was employed. Critical care nurses were recruited from five tertiary hospitals in Zhengzhou, China, using convenience sampling. Measures were the socio-demographic characteristics of participants, the Chinese version of the clinical leadership survey, the ambidextrous leadership style scale and the psychological empowerment scale. Data were analysed using IBM SPSS v. 21.0. IBM AMOS v. 24.0 was used to construct a structural equation model and bootstrap to test the mediating effect of psychological empowerment. RESULTS: The results of the structural equation model analysis show that the direct effects of ambidextrous leadership on clinical nurse leadership were 0.173, p = .001, and the total effects were 0.225, p = .001
the indirect effects were 0.052, p = .035 (95% confidence intervals = 0.126-0.223), respectively. Furthermore, psychological empowerment moderated the relationship between ambidextrous leadership and clinical nurse leadership. CONCLUSION: The mediating effects of psychological empowerment on ambidextrous leadership and clinical nurse leadership were found among critical care nurses. RELEVANCE TO CLINICAL PRACTICE: This study contributes to clinical nurse leadership among critical care nurses. By adopting ambidextrous leadership, head nurses in critical care departments can improve nurses' clinical leadership. Training is recommended for head nurses' ambidextrous leadership in critical care. In addition, head nurses should give critical care nurses more psychological empowerment to improve their clinical leadership.