Background: Healthcare organizations in the south part of Sweden are today vulnerable, since several of them have undergone structural changes. To be "the glue that holds together a healthywork environment" unit leaders need to create a common understanding about the organizational culture "Why we are here". Work overload, changes and shortage of personnel affect the health of the co-workers. This is something that the co-workers often catch up, especially when the leadership becomes unclear and the lack of support results in insecurity. Aim: The aim of the study was to explore health care unit leaders' perceptions of how the organizational culture influence their ability to provide a health promoting leadership. Method: A qualitative study, through interviews with a salutary approach was chosen. The interview material was analysed by using qualitative conventional content analysis. Result: The result showed that, the unit leaders described a frustration to not be able to be visible because of lack of time. They also expressed that the turbulent environment in the organizations created conflicts in their leader role. Likewise, very few of the unit leaders had any knowledge about what the concept of organizational culture actually meant. As a result affected those parts “The coworkership” with less responsibility commitment among all co-workers in the organization. The loss of this commitment showed that many attitudes and behaviours grew fast “in the walls” and becamea problem for all in the organizational culture. With these conflicts around the unit leaders they needed to find a way to be able to be health promotional leaders. One way, according to one unit leader, was the Salutary leadership. Conclusion: The unit leaders need self confidence in their role as a leader as well as knowledge about how the organizational culture affect them and vice versa to become a health promotional leader. There must also be more support from the upper-management and manageable tools from a leader education before entering the unit leader service to have a possibility to become a caring health promotional leader.