Background <p>Nurses’ professional attitudes, as a key component of nursing professionalism, profoundly influences its development. However, empirical studies examining the influence of nursing managers on nurses’ professional attitudes are lacking, and studies exploring how different leadership management styles—through the lens of Balance theory—affect these attitudes remain scarce.</p> Aim <p>To investigate the relationship between nurses’ professional attitudes and nursing managers’ authentic, destructive, and transformational leadership styles, based on the Balance theory.</p> Methods <p>A questionnaire survey was conducted using convenience sampling among 1,154 clinical nurses from 11 hospitals in Tianjin, China. Data from the returned questionnaires were analysed using one-way analysis, correlation analysis, and multiple linear regression to identify factors influencing nurses’ professional attitudes.</p> Results <p>Nurses’ professional attitudes were positively correlated with authentic and transformational leadership (<i>p</i> &lt; 0.01) and negatively correlated with destructive leadership (<i>p</i> &lt; 0.01). Multiple linear regression analysis identified nine influencing factors: gender, monthly income, hospital level, hospital type, whether or not the nurses were specialists, working in obstetrics and gynaecology, authentic leadership, transformational leadership, and destructive leadership (<i>R</i>^<i>2</i> = 69.7%).</p> Conclusions <p>Nurses’ professional attitudes are influenced by the degree to which nursing managers exhibit transformational, authentic, or destructive leadership styles.</p> Clinical trial number <p>Not applicable.</p>