Meritocracy Perception and Work Disengagement in Italian Nurse Managers: A National Survey Protocol

Abstract

Introduction. Perceived promotion inequity erodes professional engagement and accelerates attrition. Anti-meritocracy in Italian institutions is empirically documented in academic medicine (Gallina et al., IJEI 2023). FNOPI Study BENE (2023) identifies professional recognition deficit as the third primary retention barrier (65.2% of respondents). Equivalent evidence for Italian nursing leadership is entirely absent.

Methods. Cross-sectional national survey protocol (PROSPERO pre-registered). Target: N=350 Italian nurse managers (FNOPI regional networks). Instruments: Organisational Justice Scale (OJS; Colquitt 2001), Utrecht Work Engagement Scale (UWES-9; Schaufeli 2006), and purpose-designed career equity items. Multivariate regression and SEM. Sample size: 80% power, α=0.05, r=0.30 requires N=318.

Results. Theoretical model validated by convergent evidence: OJS deficits → reduced organisational identification → reduced UWES-9 → intention to leave (path model). Gallina et al. (2023) demonstrate cooptative promotion as empirically measurable. OECD Health Workforce (2024) confirms recognition as a modifiable retention lever across EU systems.

Discussion. This first Italian national study on meritocracy perception in nursing leadership will directly inform transparent promotion criteria frameworks endorsed by the OECD, European Parliament (2025), and FNOPI strategy 2024–2028.