Abstract: Nurses require greater autonomy and participation in decision making, nurse participation in
decision making in an organization varies depending on many factors, including the influence of nurse manager
leadership and collaboration with physicians. Aim. The aim of the current study was to assess dominant
leadership styles , level of decision making autonomy among critical care nurses and relationship between
leadership style and decision making autonomy. Design. A descriptive cross-sectional correlation research
design was utilized in this research. Setting .The current study was carried out at two hospitals' namely; King
Fahd Hospital of the University (KFHU) in Saudi Arabia and at Tanta Main University Hospital in Egypt in
Intensive Care Units (ICUs). Subjects. The study subjects encompassed all full time nursing staff convenient
sample in previous settings (n = 27) Head nurses 16 from Egypt, 11 from KSA, and Critical Care nurses ( n=
74 ) divided as the following ; 35 from Egypt and 39 from KSA . Tools. Two tools were used in this study. Tool
I. It was structured questionnaire , assessed decision making autonomy . It included two parts ; part one was
demographic data (7 items), part two was autonomy issue (18 items). The autonomy domain comprised 18 items
( knowledge 6, action 6, value 6 ). Tool II Assessed leadership styles , it included two parts ;part one was
demographic data (6 items) ; age, sex, experience (general and specific in the unit), last education, type of
hospital, type of unit , part two: Leadership styles Questionnaire this questionnaire was designed to measure
three common styles of leadership: authoritarian, democratic, and laissez –fair. It composed of 18 statements.
The respondents were presented with a five point likert scale, the number indicates the degree to which the
respondents agree or disagree [5-1]. Results. In KSA studied nurses had the highest mean score. for total
autonomy scale. A s well as, there are statistical significant difference for two bases of autonomy knowledge,
and action bases also total autonomy. Conclusion. Overall, results of the present study revealed head nurses
applied situational leadership theory in both countries. As well as, in KSA nurses had higher decision making
autonomy than nurses in Egypt. Recommendation. ICU nurse managers should foster nurses' autonomy by
enabling them to exercise clinical decision-making, and Actively supporting nursing decisions and nursing
accountability.