Does incivility impact the quality of work-life and ethical climate of nurses?

Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial

Background

Witnessing or experiencing of incivility affected the nurses’ perception of the ethical climate and quality of their work life. The aim of this study was to investigate the effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses.

Method

This study was conducted as a randomized controlled parallel group clinical trial. Eighty emergency nurses participated in this study and were randomly assigned to intervention and control groups during December 2019—March 2020. Cognitive rehearsal program (include of definitions of incivility, ten common incivilities and appropriate practice methods for responding to each and role-plays) was delivered in five two-hour sessions over three weeks on different working days and shifts. The control group received only written information about what incivility is and how to deal with it before the implementation of intervention and one month after the completion of the training sessions, the demographic information form and the incivility scale were completed by the nurses.

Results

The results showed that there was a significant effect on overall incivility, general incivility, and supervisor incivility between the intervention and control groups. However, these significant reductions were seen in control group who received only written education. There were no significant differences in nurse's incivility towards other nurses, physician incivility, and patient/visitor incivility between the two groups.

Conclusion

The cognitive rehearsal program did not decrease perceived incivility among emergency department nurses in the short term.

Trial registration

Our research was registered on clinicaltrials.gov. Registration number: IRCT20200714048104N1, first registration 16/07/2020.

Helping others not always helps ourselves: the relationship between victim incivility and emergency workers' burnout through work-to-family conflict

Purpose

This study aims to analyse whether and when victim incivility may be related to work-to-family conflict and then burnout among emergency workers.

Design/methodology/approach

A total of 304 Italian emergency workers from five firehouses and six emergency rooms completed questionnaires, examining: victim incivility, work-to-family conflict, social support seeking and burnout symptoms. Descriptive analyses, confirmatory factor analyses and structural equation models were conducted.

Findings

Victim incivility was positively associated with burnout symptoms, both directly and indirectly, as mediated by work-to-family conflict. Additionally, social support seeking exacerbated (rather than mitigated) the impact of work-to-family conflict on burnout symptoms.

Practical implications

Organisations can greatly benefit from implementing family-friendly practices and providing their workers with training programmes on how to deal with difficult victims.

Originality/value

This study contributes to the existing literature on workplace incivility and work–life interface by supporting for the first time the notion that victim incivility can spill over into emergency workers' family domain and by clarifying how and when victim incivility is related to burnout symptoms.

Relationship between quality of work life and caring behaviors among emergency nurses

Purpose

This study aimed to determine the relationship between quality of nurse work life (QNWL) and caring behaviors among emergency nurses.

Design/methodology/approach

In this cross-sectional study, a total of 168 emergency nurses were selected from eight hospitals in the metropolitan of Tabriz, East Azerbaijan Province, Iran. Data were collected in the first six months of 2018 by Brooks' QNWL questionnaire and Wolf's Caring Behaviors Inventory. Multiple linear regression analysis was used to analyze the data.

Findings

The overall QNWL scores were low to moderate. The highest scores were related to the work design and home/ life dimensions. Nurses' care behaviors were focused on the physical aspect of care, so that the highest scores for dimensions of caring behaviors belonged to the professional knowledge and skill followed by the attentiveness to the others' experience and the lowest belonged to the positive connectedness. The results of the multiple linear regression analysis showed that the model with the three variables of work context, male gender, and age group 51–60 years was significant.

Research limitations/implications

This study used cross-sectional data for analysis, which limits the ability to establish causality. It is therefore suggested that future studies should use longitudinal designs to strengthen the acceptability of causality. Longitudinal designs will also help to assess changes of QNWL within units of observation over time. Moreover, this study was conducted in the educational treatment centers of Tabriz. Therefore, further studies should be carried out on nurses in the ED of East Azerbaijan and the northwestern provinces of Iran to allow generalization of the research results concerning macro-policymaking to improve the QNWL of these nurses and their caring behaviors.

Practical implications

For providing high quality care to patients, it is necessary to pay more attention to the communication and emotional aspects of patient care. Nurses' QWL, especially in the work context dimension, should be enhanced to improve the caring behaviors of nurses.

Social implications

Also considering that the work world dimension had the lowest score in QNWL, policymakers' efforts should continue for changing public attitudes toward the nursing profession and balancing the nurses' income based on their performance in the healthcare system to maintain the social prestige of the profession among the community. The media, political and public support can play a pivotal role in improving the image of nursing in society, increasing motivation among Iranian nurses and promoting the QNWL, which will result in higher levels of quality of care as well as greater patient satisfaction.

Originality/value

The results of this study show a positive correlation between the work context and caring behaviors and suggest that the use of strategies for improving the features of work context may be able to improve nurses' caring behaviors. In order to provide holistic care for our patients, we need changes in the conditions and work context of nurses so that nurses can like the physical aspect of care, pay attention to its psychological aspect.