Relational leadership and development opportunities: enhancing nurses’ employability in Dutch elderly care Open Access

The Covid-19 pandemic exposed the inability of global healthcare systems to accommodate the demographic transition of an ageing population, thereby revealing critical deficiencies in infrastructure and resources (Lancet Healthy Longevity, 2021). As age-related chronic diseases, including multimorbidity, increasingly affect ageing populations (Mindlis and Federman, 2025), the growing complexity of healthcare needs and the rising demand for elderly care (Lancet Healthy Longevity, 2021) are further exacerbated by global nurse shortages (Di Martino et al., 2024).

In response, healthcare organisations (e.g., elderly care organisations) are adopting technological innovations, including wearable information technology and virtual reality, in their work processes (Stoumpos et al., 2023), transforming the nursing profession and associated job demands considerably, resulting in significant skill gaps (Aleo et al., 2024), including technological skill gaps among (residential long-term-care) nurses (Llena-Nozal et al., 2022). As these developments amplify the challenges nurses experience – such as increased workloads and job complexities (World Health Organization, 2020) – the continuous enhancement of their knowledge, skills, and competences becomes imperative to meet evolving healthcare needs and technological demands (Fitzpatrick et al., 2023), and to ensure their employability (Stoffers, 2023).

Highly employable employees – those who perceive themselves as possessing the competences required to obtain and maintain work – can better cope with evolving and challenging job demands (Van der Heijde and Van der Heijden, 2006). Investing in nurses' competence-based employability is thus paramount (Van der Heijden et al., 2018). Elderly care organisations are therefore urgently seeking strategies to enhance nurses' employability (Heijkants et al., 2023), as scholars have increasingly positioned employability as a critical strategic approach to HRM and its associated systems of HR practices (Peeters et al., 2019), referring to it as a “new form of employment security” (Fugate et al., 2021, p. 268).

Scholars suggest that people management is closely associated with both leadership and strategic human resource management (SHRM) (Jacobsen and Knies, 2021). It represents a symbiotic relationship between supervisors' leadership behaviours and the implementation of HR practices – such as development opportunities – that effectuate employees' attitudes and behaviours toward organisational outcomes (Purcell and Hutchinson, 2007), including competence-based employability (Schrimpf et al., 2021). Supervisors thus represent critical stakeholders in employability enhancement, as they represent the crucial link between intended HR practices and employees' perceptions of these practices (Fugate et al., 2021). Through their leadership behaviours, supervisors shape how intended practices are interpreted and communicated, thereby influencing employees' perceptions of these practices and, in turn, how they affect outcomes (Nishii and Wright, 2007).

Regarding leadership behaviours, Hoedemakers et al. (2023) argue that supervisors' leadership has a predominantly positive influence on employability across contexts. In nursing, relationally oriented leadership styles, such as transformational leadership (Burns, 1978), associate with, for example, decreases to turnover intentions (Cheng et al., 2016) and psychological empowerment (Avolio et al., 2004), in contrast with task-oriented leadership that, for example, effectuates poorer relations among staff members (Hendel et al., 2005). In home care organisations, supervisors' relational leadership associates positively with nurses' competence-based employability regarding anticipation and optimisation, and balance (Hoedemakers et al., 2025), and development of healthy work environments, including a culture of trust (Leclerc et al., 2022). Supervisors' leadership shapes employees' perceptions of intended HR practices (Nishii and Paluch, 2018), such as career development opportunities (Rodrigues et al., 2020) and (in)formal learning opportunities (Froehlich et al., 2014), which subsequently foster employability. Within elderly care organisations, nurses often have limited access to HR practices such as professional development opportunities (Fitzpatrick et al., 2023), despite the need to enhance their knowledge, skills and competences to effectively respond to evolving job demands (Aleo et al., 2024). In this context, supervisors should engage in career-oriented people management instead of focusing on performance indicators (Van Leeuwen et al., 2024); so they can implement and communicate professional development opportunities to employees (Fitzpatrick et al., 2023). Due to high-quality relationships with employees, such supervisors are particularly able to identify HR practices needed most and encourage employees to take advantage of them (Knies et al., 2017).

Extant research suggests that supervisors can increase home care nurses' employability by using relational leadership and emphasising appropriate HR practices, including competence development opportunities (Hoedemakers et al., 2025). However, people management skills vary across and within industries, such as healthcare (Knies and Leisink, 2018), and which characteristics and mechanisms that explain how people management stimulates nurses' employability in elderly care organisations remain unclear. Using a people management approach, this study combines extant fragmented findings on enhancing nurses' employability in elderly care into a comprehensive, context-specific people management framework. To gain richer insights into theoretical relationships, we use a qualitative, exploratory design to investigate how people management, in terms of relational leadership and the implementation of HR practices, fosters nurses' competence-based employability in the under-researched context of elderly care (Knies et al., 2017). We thus address:

This study thus contributes to the literature on employability, people management, SHRM and, especially, relational leadership.

First, building on Hoedemakers et al.’s (2025) call, it extends the employability literature by exploring how supervisors influence nurses' competence-based employability through relational leadership and perceived HR practices, offering significant insights for employability enhancement strategies in elderly care settings. Additionally, it answers Fugate et al.’s (2021) and Van Harten et al.’s (2020) calls to examine how employer–employee interdependence regarding perceived HR practices facilitates employability across contexts.

Second, this study contributes to the people management literature by responding to Jacobsen and Knies's (2021) call to examine how supervisors enact people management in practice and by contextualising this research within the under-researched context of elderly care. Specifically, it assesses people management (Knies et al., 2017), including relational leadership (Carifio, 2010) and its association with competence-based employability.

Third, from a SHRM perspective, this study advances understanding of supervisors' critical role in shaping a strong HR system (Bowen and Ostroff, 2004). It sheds light on the process model of SHRM (Nishii and Wright, 2007) by examining how supervisors, as key delivery agents, invest in the employment relationship through their communication and implementation of HR practices. These practices influence employees' perceptions of the HR system strength (Bowen and Ostroff, 2004), which, in turn, influences their attitudes and behaviours (Wang et al., 2020).

Finally, this paper contributes to the nascent relational leadership literature (Uhl-Bien, 2006), by exemplifying how such leadership, characterised by inclusion, empowerment, caring, ethicality and having a vision and intuition (Carifio, 2010), promotes nurses' competence-based employability, thereby cross-contextualising the concept from the educational to the elderly care context, highlighting its practical relevance for leadership development in elderly care.

Notwithstanding fragmented conceptualisations of employability (Van Harten et al., 2022), the concept represents an individual's potential within internal/and or external labour markets (Forrier and Sels, 2003). The five-dimensional, competence-based employability (Van der Heijde and Van der Heijden, 2006) examines personal strengths, such as knowledge, skills and attitudes, and more generic competencies, that facilitate continuous fulfilment, acquisition and creation of work “through the optimal use of competences” (p. 453).

Competence-based employability comprises five dimensions – occupational expertise, anticipation and optimisation, personal flexibility, corporate sense and balance (Van der Heijde and Van der Heijden, 2006). Occupational expertise is associated with acquiring domain-related skills and knowledge, such as meta-cognitive knowledge. Anticipation and optimisation comprise acting proactively and being competent to strive for the best outcomes from a job or career perspective. Personal flexibility is associated with reacting to adjustments regarding job and organisational changes. Corporate sense refers to succeeding by collaborating in teams, groups, departments, and networks, and balance means coping with conflicting jobs, careers and personal interests between employers and employees (Van der Heijden et al., 2018).

Competence-based employability is beneficial to both employers' competitive advantage and employees' career sustainability (Van der Heijden et al., 2020), paramount in contemporary, challenging times of ongoing change (Van Harten et al., 2020), such as in elderly care (Aleo et al., 2024). Employers, therefore, emphasise urgency in investing in employability (Stoffers, 2023; Veld et al., 2015), while elderly care providers seek ways to enhance nurses' employability (Heijkants et al., 2023), which aligns with their need for support and competence development (Heijkants et al., 2024). From an HRM perspective, supervisors are critical stakeholders, with the responsibility of supporting employees' career development (Fugate et al., 2021). They foster employability through leadership behaviours (e.g., Hoedemakers et al., 2025) and HR practices (Van Harten et al., 2016), such as people management (Purcell and Hutchinson, 2007). However, since context matters (Whetten, 2009), Knies et al. (2024) stress context-specific approaches to people management.

Contrary to private organisations, public organisations have distinct features in terms of organisational performance (Knies et al., 2024). They focus on achieving service- and community-oriented missions (Wright and Pandey, 2011), rather than maximising profit. Elderly care organisations are typically public organisations that are funded externally, challenging HR professionals to balance provision of high-quality care and labour costs (Cooke and Bartram, 2015). Public organisations have unique types of HRM, often challenged by low wages, a lack of performance indicators, an inability to terminate employment and difficulties with attracting skilled personnel. The link between HRM and performance outcomes in public organisations differs because supervisors have less autonomy and are bound by rules and procedures that establish public value for citizens and societies (Knies and Leisink, 2018). These features have implications for people management in elderly care organisations, and on their influence on organisational performance and effectiveness (Sowa et al., 2004), such as thoughtful care (Knies et al., 2017) and competence-based employability (Van der Heijden et al., 2018).

People management entails supervisors' supportive leadership and their implementation of HR practices for the employees they supervise (Jacobsen and Knies, 2021), which in turn influence employees' attitudes, behaviours, and both individual and organisational performance (Purcell and Hutchinson, 2007), for example, regarding nurses' employability (Van Leeuwen et al., 2024). When characterising supportive leadership behaviours, employability research commonly uses relationships between two individuals, reflected in relational theories such as social exchange theory (SET; Blau, 1964) and leader–member exchange (LMX; Graen and Uhl-Bien, 1995). Such theoretical foundations suggest that the quality of social exchanges (i.e., the relationships) associates with the norm of reciprocity – a receiving party reciprocates with investments from another party (Cropanzano and Mitchell, 2005). In practice, this leads to transformational (Burns, 1978) and servant (Greenleaf, 1970) leadership, which promote employability (Camps and Rodríguez, 2011; Wang et al., 2019). Van Harten et al. (2016) argue that in Dutch hospitals, a supervisor's support for development enhances nurses' employability (i.e., willingness to change), and Knies et al. (2017) find that people management in elderly care contributes to thoughtful care.

We use a novel conceptualisation of supportive leadership behaviours – relational leadership (Carifio, 2010) – which refers to “a social influence process through which emergent coordination (i.e., evolving social order) and change (e.g., new values, attitudes, approaches, behaviours and ideologies) are constructed and produced” (Uhl-Bien, 2006, p. 655). This conceptualisation stresses the importance of social process quality and reciprocal relationships between leader and followers. Quality thus depends on behaviours and characteristics from both leaders and followers (Clarke, 2018). Carifio (2010) argues that relational leadership associated with inclusiveness, empowerment, caring, ethicality, and having a vision and intuition. Inclusiveness means focusing on everyone's positive contribution (Komives et al., 1998), and empowerment involves leaders providing opportunities for individuals to be empowered (Honold, 1997). Caring stresses empathy during exchanges (Regan and Brooks, 1995), and ethicality links with integrity and optimistic energy (Komives et al., 1998). Having a vision and intuition includes the vision itself but also setting explicit goals and stimulating people's commitment to them (Regan and Brooks, 1995).

Although relational leadership is rooted in the same theoretical frameworks as other conceptualisations of supportive leadership behaviours, such as transformational and servant leadership, it provides a unique perspective. Transformational and servant leadership focus solely on the leader's role in leadership, especially behaviours and characteristics, based on an individualistic perspective that neglects the follower's role. Relational leadership uses a collective perspective, emphasising followers' central and active role in the creation and enactment of leadership, whereby “it is the relationship itself that constitutes what we refer to as leadership” (Clarke, 2018, p. 1), shaped by and embedded in a context. This conceptualisation is particularly relevant to studying supportive leadership behaviours in elderly care because it organises and responds to major challenges (Clarke, 2018). Hoedemakers et al. (2025) demonstrate that in elderly care, relational leadership in terms of empowerment influences nurses' perceptions of supervisory support for competence development, which subsequently fosters competence-based employability in terms of anticipation and optimisation, and balance. Although research already demonstrates the utility of relational leadership in this context, mechanisms that explain how multiple dimensions of relational leadership (Carifio, 2010) stimulate nurses' competence-based employability remain unclear. We therefore address a sub-research question:

In addition to engaging in supportive leadership behaviours, supervisors should implement the right HR practices (Jacobsen and Knies, 2021) because they are crucial to implementing and communicating such practices (Nishii and Paluch, 2018). The people management-performance causal chain (Purcell and Hutchinson, 2007) suggests that the “symbiotic relationship” (p. 3) between supervisors' leadership behaviours and implementation of both general and tailored HR practices (Guest, 2007) affects employees' perceptions of those practices, which in turn determines attitudes and behaviours towards performance outcomes (Wang et al., 2020). Moreover, Sartori et al. (2023) indicate that the proactive seeking of challenges (i.e., behavioural job crafting; Wrzesniewski and Dutton, 2001), enhances the applicability of training in the workplace. This improved transfer of training contributes to greater competence-based employability (i.e., corporate sense), underscoring the value of behavioural job crafting as a mechanism for aligning individual development with organisational outcomes. Since supervisors maintain high-quality relationships with employees, they know which HR practices are needed most, and they can cast practices in a positive light for employees (Knies et al., 2017).

Extant healthcare research suggests that perceived HR practices, including training, participative decision-making and development opportunities, stimulate performance in terms of quality care and safety through engagement (Shantz et al., 2016). Hoedemakers et al. (2025) argue that perceived opportunities for competence development enhance nurses' competence-based employability in terms of anticipation and optimization, corporate sense and balance in elderly care. Conversely, Van Harten et al. (2016) found that perceived supportive HR practices do not enhance nurses' employability in Dutch hospitals. Applying these findings to elderly care and acknowledging nurses' limited access to professional development opportunities (World Health Organization, 2020), we argue that nurses' perceptions of HR practices regarding continuous professional development enhance their competencies, knowledge and skills (Aleo et al., 2024), which they reciprocate with employability. To address Fugate et al.’s (2021) and Van Harten et al.’s (2020) calls to examine how employer–employee interdependence in terms of perceived HR practices facilitates employability across contexts, such as the under-researched context of elderly care (Knies and Leisink, 2018), we assess and explain mechanisms that underlie this relationship. We specifically address a second sub-research question:

This qualitative study uses an interpretive methodology to explore supervisors' behaviours, perspectives and experiences in elderly care. It assesses how supervisors cultivate relationships with nurses through people management, including relational leadership behaviours and implementation of HR practices, promoting nurses' competence-based employability. We conduct rigorous thematic analysis that combines inductive though primarily deductive approaches (Fereday and Muir-Cochrane, 2006), following Guba's (1981) four criteria – creditability, transferability, dependability and confirmability – to ensure the study's trustworthiness. To ensure the ethical conduct of qualitative research, we obtained approval from The Research Ethics Committee of the Open Universiteit (Document U202108211), adhering to principles of scientific integrity (NWO, 2023).

This study used purposive sampling to identify information-rich cases – employees who were knowledgeable experts, experienced in the phenomena under study (Patton, 2002), i.e., those who held formal supervisor positions in five elderly organisations in the Netherlands. To both address researcher bias and enhance credibility (Shenton, 2004), we used random sampling to select 10 supervisors from among those employed in the elderly organisations. To enhance transferability of findings, we included supervisors from five diverse elderly care organisations (Shenton, 2004). To ensure creditability (Shenton, 2004), prior to data collection and in accordance with principles of scientific integrity (NWO, 2023), participants received an informed consent letter that detailed the study's objectives, their voluntary participation, the interview and workshop duration, their right to cease an interview or workshop at any time, and the anonymity and confidentiality of data processing. Participants granted both oral and written consent to use the data collected.

To ensure dependability (Shenton, 2004), we used data and thematic saturation as principles for discontinuing data collection. We used methodological data triangulation and pretested an interview guide that included topics derived from extant literature. Two authors independently identified codes, searched for data patterns, and recoded and clustered codes into primary and sub-themes to maximise the validity of findings. To enhance confirmability (Shenton, 2004), we used methodological triangulation. We initially conducted 10 face-to-face (n = 7) and online semi-structured (n = 3) interviews with supervisors to assess their knowledge on people management and collect data. To increase supervisors' comfort (Briggs, 1986), we conducted the interviews in their personal offices at the elderly care organisations in which they were employed. An interview topic guide guided the interviews, which lasted between 45 and 60 min and were both audio and video recorded. The guide comprised four sections – demographics, competence-based employability, HR practices and relational leadership.

The first author conducted three interactive workshops, each lasting 3 h, among supervisors (n = 33), which focused on people management. The workshops were conducted in collaboration with two leadership experts who were independent of the organisations or who were researchers involved in the study. The experts possessed a rich, knowledge-based understanding of people management, including leadership, due to their education and work at the Master's level in a university of applied sciences. We followed Ørngreen and Levinsen's (2017) approach, using the workshops as a data collection methodology. We engaged the supervisors in discussions and took field notes, asking the supervisors to report characteristics of their leadership behaviours and HR practices, and how both foster nurses' employability. The field notes enriched the interview data, enhancing the trustworthiness of the study.

Interview and workshop participants were predominantly female, 86% (n = 37) of the 43 supervisors who consented to the study, while males represented 14% (n = 6). The mean age of participants was 39.98 years (SD = 12.60), with 48.8% (n = 21) being younger than 35, 25.6% (n = 11) between 35 and 55 years, and 25.6% (n = 11) 55 years or older. According to Statistics Netherlands (Langenberg et al., 2023), regarding the elderly care workforce in the Netherlands during the fourth quarter of 2022, 91% were female and 9% were male, with an age distribution of 30.7% younger than 35 years, 38.3% between 35 and 55 years, and 31% 55 years or older. In conclusion, our sample has a relatively similar distribution in terms of gender and age, although our sample is on the younger side. Table 1 reports each participant's demographics. To protect anonymity, we use an ID code to identify participants.

An expert transcribed the audio and video recordings of the interviews verbatim (McMullin, 2023). We used ATLAS.ti (2023) version 23.1.0 to facilitate coding, with Braun and Clarke's (2006) six-step framework used as a foundation for thematic analysis. During the first step, two authors independently examined the transcripts and field notes to familiarise themselves with the data. During the second step, those same authors generated initially latent theory-driven codes (Braun and Clarke, 2006), drawing from broad theoretical frameworks of relational leadership (Carifio, 2010), people management (Purcell and Hutchinson, 2007) and competence-based employability (Van der Heijden et al., 2018). The authors then independently investigated and recoded the initial codes. During the third step, both searched for data patterns, merging and clustering codes into primary and sub-themes that were relevant to the research questions. During the fourth step, two authors reviewed, refined and confirmed the themes, resulting in a coherent and satisfactory thematic map of related main and sub-themes. During step five, the authors defined and refined the thematic map iteratively, resulting in five main themes – relational leadership, tailored workplace learning, general HR practices, competence-based employability and psychological safety as a prerequisite. During a final step, the authors validated the themes and wrote a story that related to the research questions.

Findings suggest that people management is associated with nurses' competence-based employability. Particularly, this study demonstrates that supervisors utilise various aspects of their relational leadership behaviours and both general and tailored HR practices to cultivate nurses' competence-based employability encompassing occupational expertise, anticipation and optimisation, personal flexibility, corporate sense and balance (Van der Heijde and Van der Heijden, 2006). Shown in Figure 1, this study builds on a refined conceptualisation of people management from Knies et al. (2020), which guided rigorous inductive and deductive thematic analysis (Fereday and Muir-Cochrane, 2006). This study thus provides insights into the potential of people management in elderly care organisations, with a particular emphasis on relational leadership behaviour.

The supervisors stressed one leadership characteristic – developing dyadic inclusive relationships with nurses – which is common in relational leadership (Clarke, 2018). This characteristic involved recognising the significance of dialogue between supervisors and nurses. The supervisors prioritised workplace visibility to nurture such dialogue, which further offered an opportunity to invest significantly in dyadic relationships daily. This may subsequently induce shared feelings and responsibilities, potentially stimulating nurses' corporate sense. The supervisors reported, “You just have to be visible and approachable and keep talking to each other all the time”, and “Critical is being there as responsible, thus being visible”.

Workplace visibility creates opportunities for supervisors to engage with nurses, allowing them to invest in relational dialogues through personal attention, honesty and positivity. Some supervisors said, “Just good listening and especially that attention. It sounds weird, but that attention is so crucial”, and “I think it is particularly the visibility, as well as the fact that people have a feeling that I know who they are and also what their issues are”. Empathy, openness, integrity, respect and positive communication characterised the supervisors' relation-oriented leadership to cultivate relational dialogues, and thus, by relational leadership, especially caring and ethicality. Consequently, these aspects of relational leadership enabled nurses to share their personal experiences and failures, thereby stimulating their corporate sense. Several supervisors noted, “I try to empathise with the person's situation”, so supervisors used each nurse's positive value, regardless of dissimilarities (Komives et al., 1998), and their leadership thus associated with inclusiveness. Several supervisors also reported, “So equivalence, I think, is an important one”, and “No matter what position, whether it's a care assistant or a nurse, it doesn't matter. People give each other feedback here and they accept that from each other. So, the equality is there”. Moreover, several supervisors reported that their relation-oriented leadership stimulates teamwork, with one stating, “What I find very important in that is how do you have the conversation with each other and do you seek each other out and do you look together like, “Gosh can you still help me?,” use the power together. So, we are very much focused on consultation with each other, helping each other, because together we can help very well”. Therefore, supervisors’ inclusiveness is associated with nurses' ability to engage within integrated teams, as reflected in corporate sense.

Relational leadership's inclusiveness also balanced opposing interests regarding jobs, careers, and private interests. The supervisors paid attention to nurses' work–life balance, primarily by offering flexible work schedules, which might stimulate nurses' balance aspect of employability. Some supervisors reported, “Suppose a colleague says, “Gosh, I have a problem today. I have children and I must take one of them to the doctor”. And that colleague has a shift in which he does not have the opportunity to go to that doctor, then start thinking in terms of possibilities”.

Workplace visibility provides opportunities to observe nurses during their daily work routines, empowering them through, for example, work-related career support and reflection on cases through peer feedback that stimulates their occupational expertise. This, in turn, enhances their ability to cope with changing job demands. Supervisors thus serve as role models. Some supervisors reported, “Walk the talk. I think, you can say this is what I expect of you, but if you don't do it yourself, then it becomes a very complicated story. So, I think exemplary behaviour is very important”. “I still come to work with my nursing uniform on. And I still think it's important, because the moment you start cracking down on a department, I think you should put a nursing uniform on and just be the example to others, team I will support you”. Relational leadership stimulated the nurses' resilience and thus their employability in terms of personal flexibility and occupational expertise. The supervisors encouraged self-reflection, strengthening nurses' occupational expertise, allowing them to cope with changes to their work environment and function. One supervisor reported, “What would you want then? So there, with the good conversation, that's where it starts. Knowing that it can be done, that it exists, the possibilities. So, I also do try to encourage, motivate and inspire people also of what do you need to do your work?”

The supervisors' leadership also cultivated nurses' commitment to the organisation's mission, vision and shared values, thereby strengthening their corporate sense, which contributes to competitive advantages. One supervisor noted, on the one hand, I must be clear about what is expected of employees in this organisation, particularly regarding the organisation's mission, vision and shared values, but on the other hand, I also indicate and ask employees what they need to meet these expectations … providing clarity, that's how we get started. We do have very clear guidelines.

The data suggest that supervisors use an inclusive approach to implement HR practices (e.g., career development opportunities) that foster nurses' competence-based employability. As one supervisor reported, “There is a growth opportunity for every employee …. If employees are open to it, then there are possibilities for every individual”. Consequently, relationships among relational leadership, HR practices, and competence-based employability are evident. Relational leadership, especially empowerment, inclusiveness and having a vision associated with supervisors' focus on articulating and implementing HR practices. As one supervisor stated, “Positive health is something we are going to work on again this year. I think that's beneficial as well”.

Relational leadership shaped the nurses' perceptions of general HR practices, such as courses and training, mostly aimed at stimulating nurses' employability in terms of occupational expertise. The supervisors largely focused internally, though they lacked awareness of learning opportunities beyond the organisation. Several supervisors reported, “I think a wide range of development opportunities. Those are both in terms of their personal and professional development. We offer them things within the field that they can learn. We offer them courses, trainings”. “What happens outside the organisation or what the opportunities are outside the organisation? I think I have too little insight into that. Too much internally oriented”.

The supervisors fostered competence-based employability (i.e., balance) by influencing nurses' perceptions of HR practices, especially through development such as online learning platforms (e.g., GoodHabitz). One supervisor reported, “I don't know what it is, I'm not always comfortable in my own skin, I say, “Oh, on GoodHabitz there is a training course Mindfulness. Try that”. There we also must point people much more in the direction for your own health, while you also take a responsibility yourself. You can also follow a module on GoodHabitz”. The supervisors also discussed the complex interdependence between leadership and HRM strategies. One stated, “And you also very often hear, “I say, but managers also have a lot of HR tasks. Having a conversation is an HR task, but it's yours, not mine”. And similarly, monitoring employee's development, having the nasty conversation, absenteeism conversation, those are all HR tasks that lie on the line. These are also things that we still struggle with a bit”.

The supervisors empowered the nurses mostly by fostering a flexible learning climate, not only through supportive, empowered communication, but by articulating tailored HR practices and initiating informal learning opportunities such as feedback, coaching, mentoring and intervision. Such development stimulated the nurses' autonomy and self-reflection, which subsequently may enhance their employability, particularly their occupational expertise, personal flexibility and corporate sense. Several supervisors stated, “Then I say. “Go ahead, go … Go ahead and try”.” “I watch and listen very carefully. I then see employees coming forward with a particular problem. I try to analyse that and then I also ask, “What do you need?” So, I don't decide what the employee needs, but I really want to hear what they need”. “I ask to apply self-reflection …”. Multiple supervisors believed that tailored, flexible practices leverage nurses' talent so that they can succeed in their careers. “You're working in a place where you're not so good, but you had to do it and then I think don't do that. Go and enjoy working in the place where you are good”. The supervisors noted the possibilities of continuous on-the-job coaching to foster employability. “Maybe coaching on the job. That you really have people 24/7 then, not an hour here an hour there, but continuously in the process to give that guidance, because then it stays very practical. I think these people need practical guidance and that from training or everything we offer in terms of training, intervision and education”.

The supervisors sought to enhance nurses' anticipation and optimisation, or competence-based employability, by offering career development opportunities both in and outside the organisation. Several supervisors reported, “… somehow going to look at how we can get you to work in another way inside or outside, but we are going to help you”. “At the moment, there is also a team coordinator working alongside me. This is an employee who aspires to become a supervisor, so it's a kind of progression for her to become a supervisor in two years. So now I do have good support”. The supervisors also used tailored arrangements, offering, for example, flexible work hours, which associates with balance in employability. One supervisor noted, “… if we see that employees could use help with certain things or get stuck, that we really engage with that and go and see what is needed to make that change or your work–life balance or at least support you in things that you get stuck in”.

Psychological safety is a belief, shared among individuals, regarding the safety of engaging in interpersonal risk-taking at work (Edmondson, 1999). The supervisors believed that psychological safety represents a mechanism within the relationship between people management and competence-based employability.

The supervisors noted that trust, respect and support are mechanisms in people management, particularly in terms of supervisors' relational leadership behaviours, and the employability relationship in elderly care. Relational leadership, specifically inclusiveness, empowerment, caring and ethicality, is reflected in the reciprocal relationship between supervisors and nurses, stimulating psychological safety through relational leadership. As several supervisors reported, “When I reach out to my colleagues, my caregivers especially, gosh, what is that and what are you afraid of? Take that step, or shall we take that step together? And by participating in that, you're going to see that the colleagues, at least I do notice that, are going to dare to take it and the communication is only going to become more open and the bonds are going to become closer”.

Psychological safety is also evident in the quality of supervisor-nurse relationships, reflected in relational dialogues characterised by inclusion and open communication. The supervisors believed that relational leadership effectuates empathy that fosters psychological safety, and that it intervenes in the relational leadership–employability relationship.

Several supervisors noted. “I think that [psychological] safety is a very important aspect, that nurses feel safe to be able to be himself to be in it without judgement, to be able to discuss things and be himself. That I think is a very important one …”. “So, equivalence I think is an important one, trust, equality and safety”. The supervisors believed that relational leadership effectuates empathy, and that it intervenes in the relational leadership–employability relationship.

The supervisors used leadership to empower nurses by encouraging a learning climate through communicating development opportunities, which, in turn, foster competence-based employability. However, empowerment alone is insufficient, and they therefore emphasised the critical role of open communication, inclusion, respect and trust to achieve psychological safety. Consequently, psychological safety operates as a mediator – a mechanism – within the relational leadership–employability relationship. Several supervisors stated, “Because you can have wonderful educational opportunities, but if you're not seen or heard as a human being or don't feel like “I matter, I belong here, I want to be part of the bigger picture here”. Then it often becomes difficult anyway”, “The one doing it should enjoy doing it and the other person should feel safe of yes it doesn't matter, how many times I must ask, but you must facilitate that as a supervisor”.

The findings indicate that supervisors utilised relational leadership to empower nurses by, for instance, communicating HR practices, which subsequently fostered nurses' competence-based employability. Moreover, supervisors believed that the synergy between relational leadership (i.e., inclusiveness and empowerment) and HR practices, particularly development opportunities, is critical to fostering nurses' employability. The supervisors noted the significance of understanding the organisation's HR strategy and its associated HR practices, and they can enact relational leadership behaviour (i.e. empowerment) by offering and implementing HR practices. “We then have attention conversations in which the supervisor discusses that with the employee of I have a training or development wish. Where does that come from? What would you want? So there, with the good conversation, that's where it starts. Knowing that it is possible, that it exists, the possibilities. Some employees know that themselves, but others need a little more support from the manager in that. And the supervisor, I think, has a very important role in that whole piece”.

Figure 2 depicts a comprehensive overview of the conceptual associations identified in this study.

Findings suggest that supervisors support and empower nurses through relational leadership behaviours, characterised by inclusiveness, empowerment, caring, ethicality, and having a vision and intuition (Carifio, 2010), that subsequently foster nurses' competence-based employability. The supervisors reported that quality dyadic relationships with nurses are critical. They engaged in supportive dialogues with nurses, characterised by positivity, clarity, openness, integrity, respect, trust and empathic listening (Clarke, 2018), and the nurses perceived such dialogues as support, value and empowerment, allowing them to cope better with changing job demands. The supervisors emphasised workplace visibility regularly, offering them opportunities to invest in their relationships with nurses, for example, by acting as role models.

The supervisors noted the importance of articulating HR practices to foster a learning climate, empower nurses and enhance competence-based employability, making it easier to cope with changing job demands. They exemplified that general and tailored HR practices, including coaching, mentoring, intervision, courses and training (Lawton and Wimpenny, 2003), foster diverse aspects of competence-based employability. They implemented HR practices such as online learning communities and toolboxes, continuous dialogues, job rotation and career coaching, and they observed that psychological safety enhances competence-based employability. Interpersonal factors, such as respect, trust and supportive communication, reflected in relational leadership, are antecedents to psychological safety. These findings have both theoretical contributions and practical implications.

First, this study contributes to the employability literature by demonstrating that supervisors in elderly care organisations view people management (Jacobsen and Knies, 2021) – encompassing relational leadership characterised by inclusiveness, empowerment, caring, ethicality, and having a vision and intuition (Carifio, 2010) – and the implementation of HR practices as mechanisms that foster nurses' competence-based employability. This includes the competence-based dimensions of occupational expertise, anticipation and optimisation, personal flexibility, corporate sense and balance (Van der Heijde and Van der Heijden, 2006). In doing so, the study provides a nuanced understanding of how these competence-based dimensions are associated with characteristics of the employer–employee relationship, shaped by organisational representatives, especially supervisors and HR professionals (Fugate et al., 2021). Up until now, only Hoedemakers et al. (2025) have examined the relationship between supervisors' relational leadership and nurses' competence-based employability in elderly care, finding that nurses' competence-based employability is indeed linked to such leadership. In that study, supervisors who engaged in relationships characterised by empowerment fostered nurses' perceptions of supervisory support and opportunities for competence development. The current study builds on this by suggesting that supervisors should foster nurses' employability through relational leadership, specifically by empowering them through general and tailored HR practices that influence nurses' perceptions and access to professional development opportunities (King et al., 2021). The supervisors noted that workplace visibility also empowers nurses, an antecedent to relational leadership that allows supervisors to support, value and empower nurses through role modelling and coaching. This study thus demonstrates that enhancing nurses' competence-based employability in elderly care is reflected in employer–employee relationships that use a people management approach and includes relational leadership. It suggests that a refined context-specific framework of people management from Knies et al. (2020) associates with nurses' employability enhancement in elderly care organisations. In doing so, it answers Fugate et al.’s (2021) and Van Harten et al.’s (2020) calls to examine how employer-employee interdependence regarding perceived HR practices facilitates employability across contexts.

Second, this study advances the people management literature by highlighting how supervisors perceive and enact a symbiotic relationship between their relational leadership behaviours and HR practices that foster supportive learning climates. In doing so, it responds to Jacobsen and Knies's (2021) call to examine how supervisors enact people management in practice within public organisations, particularly within the under-researched context of elderly care (Knies et al., 2017). Supervisors, therefore, utilise relational leadership (Carifio, 2010) to implement intended HR practices (Nishii and Wright, 2007), including both general and tailored practices. Extant studies commonly examine leadership styles (Stoffers et al., 2014) and HR practices, including both formal and informal learning opportunities (Froehlich et al., 2014), as isolated antecedents to employability. The present study, however, underscores the critical interplay and synergy between leadership and HR practices, positioning supervisors as pivotal people management agents (Purcell and Hutchinson, 2007). HR professionals design strategies and practices that cultivate a learning environment, and supervisors implement them (Guest, 2021) in a way that enhances nurses' competence-based employability (Hoedemakers et al., 2025). Supervisors support nurses by communicating HR practices that shape perceptions of available work-related development (Lawton and Wimpenny, 2003), both informal (e.g., supervision, coaching and mentoring) and formal (e.g., online learning opportunities, trainings and courses). Notably, when individuals engage in challenge-seeking behaviour, it will enhance the applicability of training, which, in turn, indirectly contributes to perceived employability (i.e., corporate sense, Sartori et al., 2023). When promoting employability, supervisors referred to what Nishii and Wright (2007) call a strong HR system, in which supervisors translate HR practices into clear expectations to bridge the gap between espoused and implemented HR practices.

Third, this study contributes to the SHRM literature, particularly to the process model of SHRM, which describes how HR practices are delivered to and perceived by employees (Nishii and Wright, 2007). Supervisors act as critical stakeholders in articulating HR messages and shaping how employees perceive intended HR practices (Bowen and Ostroff, 2004), encompassing both general and tailored practices. These perceptions, in turn, influence employees' attitudes and behaviours (Wang et al., 2020), ultimately fostering outcomes such as competence-based employability. Our study builds on this and reveals how supervisors – particularly through their relational leadership (Uhl-Bien, 2006), a key leadership behaviour in the nursing context (Cummings et al., 2018) – and the implementation of both general and tailored HR practices contribute to the employment relationship with nurses (Nishii and Wright, 2007). To our best knowledge, relational leadership has not yet been empirically examined in relation to the implementation of HR practices. In doing so, our study suggests the significant role of relational leadership in implementing both general and tailored HR practices, thereby contributing to the development of a strong and coherent HR system (Bowen and Ostroff, 2004; Nishii and Paluch, 2018) in elderly care contexts. These findings extend the work of Nishii and Paluch (2018) by elucidating how relational leadership (Uhl-Bien, 2006) functions as a form of HR implementation behaviour in creating a strong HR system – through articulating expectations, role modelling desired behaviours, reinforcing preferred behaviour and assessing nurses' perceptions of HR messages. Taken together, and consistent with prior research (Nishii and Paluch, 2018), these findings underscore the paramount importance of supervisors' leadership in shaping and constituting employees' perceptions of a strong HR system. Indeed, our study demonstrates how supervisors function as HR implementers by articulating the intended meaning and expectations of HR practices – for example, by providing feedback, coaching and mentoring, sometimes daily. They also act as role models who reinforce desired behaviours, provide positive feedback to strengthen behavioural expectations, and assess employees' understanding of HR messages through cultivating relational dialogues. In the context of elderly care, such relational leadership behaviours – particularly those that emphasise inclusion and empowerment (Carifio, 2010) – play a significant role in shaping nurses' perceptions of a strong learning climate, thereby fostering a strong and coherent HR system (Bowen and Ostroff, 2004).

Fourth, this study also advances the relational leadership literature by demonstrating that nurse supervisors emphasise all five dimensions of relational leadership (Carifio, 2010), illustrated through concrete leadership behaviours. The importance of inclusiveness, caring, ethicality and having a vision and intuition was recognised, but supervisors unanimously discussed empowerment (Carifio, 2010) to foster nurses' competence-based employability. Extant research, particularly among nurses in the Netherlands, suggests a relationship between perceived supervisors' relational leadership (Carifio, 2010) and nurses' competence-based employability (Hoedemakers et al., 2025), though its underlying processes remain underexplored. Current findings show that supervisors' relational leadership emphasises respect, trust, empathy and openness in dyadic relationships with nurses, which is important because Ito et al. (2022) suggest that interpersonal factors, such as trust, respect, support, high-quality communication and leadership, affect psychological safety in healthcare. Psychological safety explains why supportive workplaces, in terms of supervisors' relational leadership and development opportunities, influence work outcomes such as competence-based employability (Newman et al., 2017).

Finally, this study contributes to psychological safety literature by highlighting that supervisors report that supportive, relation-oriented, and thus relational leadership, particularly inclusiveness, caring and ethicality, associates with trust in dyadic relationships between leaders and employees, subsequently fostering nurses' psychological safety. Extant research demonstrates a positive association between authentic leadership and psychological safety in healthcare (Fausett et al., 2023). Nembhard and Edmondson (2006) found that leader inclusiveness stimulates healthcare teams' psychological safety. The current study identifies psychological safety as an outcome of supervisors' relational leadership in elderly care, an important finding because psychological safety encourages employees to engage in development, which fosters competence-based employability (Stoffers et al., 2020).

A qualitative design allows a comprehensive understanding of a phenomenon, but it does not allow causal inferences (Neuman, 2014). Longitudinal studies on the influence of people management, including the influences of supervisors' relational leadership on nurses' competence-based employability in the context of elderly care, are needed. This study is constrained by data interpretation (i.e., interpretation bias) and the observers' abilities (Duffy, 1985), raising concerns about credibility (Shenton, 2004). To counter such constraints and increase credibility, future studies should use mixed methods to enhance analyses and interpretation of findings (Bekhet and Zauszniewski, 2012). Although we collected data from nurses employed at five elderly care organisations, the study is limited by selection bias. To promote transferability of findings, future research should use replication during sampling (Polit and Beck, 2010). The study assesses supervisors' relational leadership and HR practices from a single source (i.e., the supervisors themselves), which might be affected by single-source bias, threatening the findings' validity (Avolio et al., 1991). Specifically, the data were gathered from a single source only, limiting the findings to the perspective of the supervisors. To further validate the findings, we therefore suggest that future studies avoid collecting data from a single source and should employ multi-source data collection methodologies, for instance, include supervisor self- and other-ratings (i.e., nurses) to rate supervisors' relational leadership behaviours. Quantitative methods should also validate current findings in a deductive quantitative study. Future research should use Campbell and Fiske's (1959) multitrait-multimethod (MTMM) approach to validate Carifio's (2010) relational leadership in elderly care contexts.

This study suggests that supervisors should engage in relational leadership, particularly high-quality, dyadic, LMX, with nurses. Although extant literature does not address how to train LMX adequately, programmes that stimulate relational leadership remain valuable. Leclerc et al. (2022) argue that a 9-month, web-based learning programme for nursing leaders, which consists of online virtual learning labs and online coaching and mentoring, fosters relational leadership, particularly through recognition and skilled communication. Recently, Nakamura et al. (2025) indicate that video-based conversation analysis, including peer feedback sessions combined with surveys, can facilitate leadership development like relational leadership. Both reviewing videos and engaging in peer feedback and surveys can stimulate discussions between supervisors and nurses about areas requiring increased attention, thereby creating opportunities for leadership development.

Psychological safety is crucial in healthcare because it contributes to quality care, organisational culture (e.g., creativity and innovation), and both psychological (e.g., job satisfaction and organisational commitment) and behavioural (e.g., learning behaviours and high-quality communication; Ito et al., 2022) outcomes. Elderly care organisations should, therefore, develop policies and procedures that foster psychological safety, such as emphasising fairness, promoting leadership styles that associate with behavioural integrity, including inclusiveness (Nembhard and Edmondson, 2006), and providing leader and peer support at the team level (O'Donovan and Mcauliffe, 2020). Supervisors should foster psychological safety at the team level by encouraging inclusiveness (i.e., minimising status disparities in and among roles and functions; Ito et al., 2022), involving team members when generating team goals, and expressing and understanding each team member (Faraj and Yan, 2009). Recently, Peddie et al. (2025) have demonstrated that healthcare policymakers and practitioners should implement mental health support services and team development activities aimed at fostering psychological safety among staff.

To foster nurses' competence-based employability, HR professionals and supervisors should promote a learning climate by offering learning opportunities, with supervisors' people management and empowering behaviour being paramount. To promote learning on-the-job, policymakers, practitioners and supervisors should prioritise a combination of formal workplace training and behavioural job crafting (Sartori et al., 2023), that is, the proactive role of employees in shaping and redesigning tasks to align with their personal characteristics and attitudes (Wrzesniewski and Dutton, 2001). Particularly, interventions focused on behavioural job crafting in terms of seeking challenge behaviours enhance the applicability of training, thereby fostering competence-based employability regarding corporate sense (Sartori et al., 2023). HR professionals and supervisors should also cooperate in doing so (Stoffers and Van der Heijden, 2018).

According to the process model of strategic HRM (Nishii and Wright, 2007), HR professionals are responsible for creating intended HR practices, but whether such practices are implemented and how employees perceive them depend on synergies between HR professionals and supervisors' people management (Jacobsen and Knies, 2021). Informal learning is particularly relevant in low job-resource contexts, such as nursing (Sjogren et al., 2005). Since such learning is flexible and occurs in a nursing context, leadership should stimulate daily, self-directed interactions with peers and supervisors, and self-reflection that fosters work-related knowledge, skills and attitudes (Ham and Cho, 2015), thus enhancing employability. Supervisors should promote informal workplace learning by offering opportunities for feedback, self-efficacy, positive relationships among individuals, cooperation, proactivity, mentoring and daily conversations (Berings et al., 2007; Kyndt et al., 2016).

This study demonstrates that people management – encompassing relational leadership and the implementation of both general and tailored HR practices – fosters nurses' competence-based employability. Supervisors emphasised that people management should focus on the quality of dyadic relationship, thereby strengthening the HR system. They also highlighted the importance of psychological safety, which influences the relationship between relational leadership and competence-based employability. Overall, people management, or the symbiotic relationship between leadership behaviours and HR practices, influences nurses' perceptions of those practices, including development opportunities that, in turn, enhance competence-based employability.