Purpose This study identified the influence of self-leadership, managers’ authentic leadership, and nurses’ organizational culture relationships on hospital nurses‘organizational silence. Methods An explanatory sequential mixed-method study was conducted. For the quantitative portion, 138 nurses from seven hospitals participated. For the qualitative portion, ten nurses with high organizational silence scores were interviewed. Quantitative data were analyzed with SPSS/WIN 26.0. Qualitative data were analyzed by content analysis using NVivo 12.0. Results Quantitative results indicated that self-expectations and a relation-oriented culture explained 14.0% of the variance in acquiescent silence. The combined effect of rehearsal, constructive thought, and relational transparency associated with managers’ authentic leadership on prosocial silence was 15.0%. Qualitative results revealed eight primary themes related to organizational silence: 1) being unable to voice my opinion because I feel insignificant, 2) things that middle managers cannot say, 3) earnest managers, 4) receptive managers, 5) indifferent managers, 6) feeling of camaraderie, 7) selective silence based on performance, and 8) mandatory following of directives. Conclusion Programs to improve managers’ leadership skills and reduce hospital nurses’ organizational silence should be implemented consistently. Hospitals should strive to foster a positive and equitable organizational culture.