Incivility from patients and their families: can organisational justice protect nurses from burnout?

The antecedents, drivers and outcomes of employee family incivility in the workplace: A systematic review and future research avenues

Family Incivility has emerged as an important construct that may impact the employee's mental wellbeing and thus affect various organizational outcomes including financial and market related outcomes. The construct however is nascent stage of scholarly research. Thus through a systematic literature review we organise the scholarship till date on the theories, contexts and methods used to explore the construct We also propose a unique framework for employee family incivility and its impact on workplace that identifies and maps the antecedents, drivers and outcomes of family incivility. These two contributions would help both scholars and practitioners in further development of theory and practice. The study follows the PRISMA method for literature review which is an established and rigorous protocol to minimise the errors and biases. That identified 34 articles for the review that were analysed and synthesised for the findings. The third unique and novel contribution of the study is the identification of specific future research questions with reference to employee family incivility and workplace, based on the analysis done in the review.

Impact of despotic leadership and workplace incivility on innovative work behavior of employees: Application of mediation-moderation model

Innovative Work Behavior (IWB) of employees is one of the essential requirements for organizations to excel in competition in today's dynamic world. Nowadays, organizations can keep the current pace through competitive advantage. But to acquire competitive advantage, employees must be creative and innovative in their work-related behaviors. Small and Medium Enterprises (SMEs) in Pakistan are suffering several challenges in this regard. Therefore, current study is designed to examine the role of negative events and negative leadership on the IWB of the employees with mediating role of Psychological Well-being (PsyWB). Further, the moderating role of Perceived Organizational Support (POS) has also been tested. The negative event used in current research is Workplace Incivility (WPI) and Despotic Leadership (DL) from the negative leadership styles examined. Results of the current study showed that the presence of WPI and DL in organizations damage the IWB of employees as they harm the PsyWB of employees. We find that PsyWB mediated the relationship among DL, WPI, and IWB. POS is helpful for employees to overcome the negative issues prevailing in the organizations. The SMEs need to construct policies to eradicate WPI and must discourage despotic personalities to make the environment favorable for employees to protect their IWB. There must be some events that can increase the positive PsyWB of employees to make them more creative and motivated. Likewise, POS must be at sufficient level so that employees feel safe and healthy in all respects.

When Patient Rudeness Impacts Care: A Review of Incivility in Healthcare

Healthcare workers increasingly face incivility and rude behaviors from patients, families, and visitors. Although these are less severe than other types of mistreatment, studies have documented that they may still impact healthcare worker well-being and patient care. Defining and measuring incivility can be challenging because current research relies on the perceptions of the targets. Furthermore, there is often overlap among different types of mistreatment, and much of it goes unreported by those who experience it. Nevertheless, multiple studies have documented that incivility is common in healthcare and has been associated with burnout and intent to leave. In clinical settings, multiple consequences for patient care have been documented, including adverse consequences in the diagnostic and intervention performance of teams, as well as team processes. One theory is that incivility incidents divert cognitive resources away from the intervention and that these experiences may interfere with higher-order reasoning. Although limited research has been performed in the areas of prevention, response to incidents of incivility, and best practices for ameliorating the effects of incivility, some promising interventions have been reported in the literature.

Coping with Workplace Incivility in Hospital Teams: How Does Team Mindfulness Influence Prevention- and Promotion-Focused Emotional Coping?

Incivility is a growing concern for researchers and practitioners alike, yet we know little about how the team context is related to the way that employees respond to it. In this study, we examined the role of team mindfulness and its direct and buffering effects on individual-level promotion- and prevention-focused emotional coping. We also examined how these forms of coping were related to individual work engagement. In a temporally lagged study of 73 hospital teams (involving 440 team members), multi-level analyses showed that team mindfulness was directly negatively associated with individual-level prevention-focused emotional coping (behavioral disengagement, denial, and venting); however, it was not positively related to individual-level promotion-focused forms of coping (positive reframing and acceptance). In addition, a cross-level interaction effect was identified whereby team mindfulness reduced the positive relationship between incivility and venting, meaning there was less individual-level venting following incivility in the context of higher team mindfulness. These findings may have implications for work engagement, which was shown to be negatively related to venting and behavioral disengagement. Our findings are useful for managers of teams that regularly experience customer incivility as it uncovers how they can develop a team context that discourages ineffective coping responses.

Is there a role for ethics in addressing healthcare incivility?

In a healthcare setting, a multitude of ethical and moral challenges are often present when patients and families direct uncivil behavior toward clinicians and staff. These negative interactions may elicit strong social and emotional reactions among staff, other patients, and visitors; and they may impede the normal functioning of an institution. Ethics Committees and Clinical Ethics Consultation Services (CECSs) can meaningfully contribute to organizational efforts to effectively manage incivility through two distinct, yet inter-related channels. First, given their responsibility to promote a humane, respectful, and professional climate, many CECSs and Ethics Committees may assist institutional leadership in evaluating and monitoring incivility policies and procedures. Second, when confronted with individual incidents of patient/family incivility, Ethics Consultants can and often do work with all stakeholders to address and mitigate potentially deleterious impacts. This manuscript presents an overview of the multifaceted ethical implications of incivility in the healthcare environment, discusses the inherent qualifications of Ethics Consultants for assisting in the management of incivility, and proposes specific mitigating actions within the purview of CECSs and Ethics Committees. We also invite healthcare organizations to harness the skills and reputation of their CECSs and Ethics Committees in confronting incivility through comprehensive policies, procedures, and training.

Workplace Incivility and Work Engagement: The Chain Mediating Effects of Perceived Insider Status, Affective Organizational Commitment and Organizational Identification

The intention of this paper was to test the impact of workplace incivility (WPI) on work engagement of faculty members in private universities in China, exploring the correlation between them through chain mediators, which were perceived insider status (PIS), affective organizational commitment (AC), and organizational identification (OID). A quantitative analysis was used on a sample of 465 participants from 68 private universities in China. The conclusions show that WPI decreases faculty members’ work engagement through the chain mediation effects of PIS, AC and OID. This study attempted to establish a three-in-series mediator model to comprehend the influence mechanism of WPI on work engagement, and the results suggest managers in private universities in China to create a working environment with no tolerance for incivility.

Cross-sectional Study of the Relationship between Experiences of Incivility from Staff Nurses and Undergraduate Nursing Students’ Sense of Belonging to the Nursing Profession

AIM

This study examined the frequency of incivility for undergraduate nursing students and the relationship between staff nurse incivility and nursing students' sense of belonging. Factors between program semester and students' body mass index (BMI) to staff nurse incivility and students' sense of belonging were assessed.

BACKGROUND

Sense of belonging enhances belonging development to the profession. However, no studies address the relationship between incivility and nursing students' sense of belonging.

METHODS

A cross-sectional design assessed the relationship between staff nurse incivility and undergraduate nursing students' sense of belonging to the nursing profession. An online survey was administered to 123 pre-licensure junior and senior undergraduate nursing students from February 1, 2021, to May 5, 2021. Correlation coefficient, descriptive statistics, Fisher r-to-z transformation, 95% confidence intervals were calculated.

RESULTS

Staff nurse incivility inversely correlated with undergraduate nursing students' sense of belonging (rs=-.358; p <.001). American Indian or Alaskan Native students reported the highest mean frequency of incivility (1.25 ± .421). There were no significant differences in correlations based on semester or BMI.

CONCLUSION

Staff nurse incivility is inversely associated with sense of belonging in students. Further research is needed to test interventions mitigating the effects of incivility on belonging.

The Moderation of Perceived Comfort and Relations with Patients in the Relationship between Secure Workplace Attachment and Organizational Citizenship Behaviors in Elderly Facilities Staff

This study focuses on caregivers who work in residential facilities (RFs) for the elderly, and specifically on their organizational citizenship behaviors (OCBs) in relation to their interaction respectively with the overall context (workplace attachment dimension), the spatial-physical environment (perceived environmental comfort), and the social environment (relationship with patients). A sample of health care workers (medical or health care specialists, nurses, and office employees, n = 129) compiled a self-report paper-pencil questionnaire, which included scales measuring the study variables. The research hypotheses included secure workplace attachment style as independent variable, OCBs as the dependent variable, and perceived comfort and relations with patients as moderators. Results showed that both secure workplace attachment and perceived comfort promote OCBs, but the latter counts especially as a compensation of an insecure workplace attachment. As expected, difficult relationships with patients hinder the relationship between secure workplace attachment style and OCBs. In sum, our study highlights the importance of the joint consideration of the psychological, social, and environmental dimensions for fostering positive behaviors in caregivers employed in elderly care settings.

Hospital nurses experiencing day-to-day workplace incivility: A diary study on the benefits of daily social support

AIM

The present study investigated the adverse effects of daily experienced incivility and the positive role of daily social support during the workday in predicting daily emotional exhaustion after work and vitality and positive affect at bedtime.

BACKGROUND

Despite the broad knowledge of the impact of experienced incivility in different occupations, little is known about day-to-day nurse incivility, much less in the hospital context.

METHOD

After completing a general questionnaire, hospital nurses (n = 96) completed a diary questionnaire twice a day for five consecutive workdays (n = 480 diary observations). The diary design had two levels: 5-day repeated measures (Level 1, day level) nested in persons (Level 2, person level) using an experience-sampling methodology.

RESULTS

Multilevel hierarchical analyses showed that incivility during the workday increased emotional exhaustion after work (t = 3.00, p = <0.05) and reduced vitality (t = -2.48, p = 0.05) and positive affect (t = -2.23, p = 0.05) at bedtime. However, daily social support during the workday was a crucial job resource that directly benefited hospital nurses' daily wellbeing (t = 5.19, p = 0.01 vitality; t = 4.89, p = 0.01 positive affect) and buffered the adverse effects of daily workplace incivility (t = -2.33, p = 0.05).

CONCLUSION

The within-person approach of our findings suggests that supportive practices can reduce day-to-day incivility spirals.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can promote a civility culture within their units using in service training programmes at work.

Registered Nurses' Experiences With Incivility During the Early Phase of COVID-19 Pandemic: Results of a Multi-State Survey

Background:

Incivility among workers in the health sector is recognized as an occupational hazard. The COVID-19 outbreak brought sudden and profound changes to many health care settings, many of which have been identified as antecedents to workplace incivility. The purpose of this retrospective study was to explore the experiences of registered nurses with workplace incivility, cyber-incivility, and incivility outside of work during the early phase of the COVID-19 pandemic.

Methods:

This mixed-methods study used convenience sampling. Data were collected from June to September 2020 via an online survey, which consisted of both closed- and open-ended questions. Participants were recruited from national nursing organizations and unions. Data were analyzed using descriptive statistics and thematic analysis for open-ended responses.

Findings:

A total of 526 nurses’ responses were included in the analysis. More than one third experienced greater incivility at work during the COVID-19 outbreak than before the pandemic (37.4%), and almost half (45.7%) said they witnessed more incivility than before the pandemic. Cyber-incivility and incivility outside of work were also issues. Qualitative results indicated that respondents felt they were on edge during this period. Other themes included leadership failure, fractured co-worker relationships, heightened incivility from patients and families, and hostility and ostracism from the general public

Conclusion/Application to practice:

Occupational health nurses, nursing leaders, and staff nurses need to work to restore relations that were fractured by incivility during the pandemic. In the future, improved preparedness, including establishing clear channels of communication, may lessen incivility by decreasing role stress and organizational chaos.

Explaining the negative impact of workplace incivility on work and non-work outcomes: The roles of negative rumination and organizational support

Research studies have shown that workplace incivility is associated with numerous negative work and non-work outcomes. The underlying mechanisms explaining why workplace incivility is associated with these outcomes, as well as contextual buffers of these relationships, have received less attention. This study extends workplace incivility research by examining the mediating role of negative rumination as a potential factor undergirding the relationship between experiences of incivility from colleagues at work and detrimental outcomes. We also investigated perceived organizational support and family supportive work environment as potential mitigators of the indirect relationship between incivility and negative outcomes. Data were collecfrom 154 university faculty members on two occasions. The results showed that negative rumination mediated the relationships between workplace incivility and both work (job satisfaction, burnout) and non-work (work-to-family conflict, life satisfaction) outcomes. Furthermore, results from the moderated mediation analyses revealed that perceived organizational support buffered the mediated effect of negative rumination and job satisfaction and a family-supportive work environment buffered the mediated effect of negative rumination on work-to-family conflict. Overall, the results demonstrate that negative rumination helps explain why workplace incivility negatively affects both work and non-work outcomes and underscores the important role of organizational context as buffers for these relationships.

Family incivility, burnout and job satisfaction: examining the mediation effect

Purpose

Drawing from the work-home resources model and the conservation of resources theory, this study examines the potential of family incivility in instigating burnout and reduced job satisfaction.

Design/methodology/approach

This study employed structured questionnaires to collect data from a sample of 290 doctors working in tertiary care hospitals across India. Measurement modeling was done using IBM AMOS 23.0 and PROCESS macro was employed for hypothesis testing.

Findings

The study revealed that family incivility has a positive spillover effect on burnout, subsequently leading to lowered levels of job satisfaction. Furthermore, burnout mediated the aforementioned relationship.

Research limitations/implications

This study is cross-sectional, and a longitudinal study will help test more rigorously; the causal relationships between the focal variables are recommended. Self-report data pose limitations concerning common method bias. Data collected from different occupations and cultures would help with further generalizability of the results.

Practical implications

This study establishes that incivility within the family can negatively affect various vital work outcomes. Accordingly, it is recommended for organizations to support employees to achieve improved work-family integration. Further research should explore various coping strategies that will help with mitigating these spillover effects.

Social implications

This study offers a new perspective on the negative effect of family interactions on work-domain outcomes.

Originality/value

The paper extends the scholarly literature on stress and work-family interface by demonstrating that family incivility has spillover effects. This is the pioneering study that examines family incivility as a home demand causing long-term severe damages at work.

Nurse Educators' Perspectives on Implementing Culturally Sensitive and Inclusive Nursing Education

BACKGROUND

Nurse educators must be equipped to teach diverse students using culturally sensitive and inclusive nursing education (CSINE). The purpose of this study was to explore associate degree nurse educators' perceptions on implementing CSINE.

METHOD

This was a descriptive exploratory study. Associate degree nurse educators in a midwestern state completed an open-ended question survey that included dichotomous response questions to help participants self-reflect and respond. Follow-up interviews added further depth to the findings.

RESULTS

Four major categories emerged that helped answer the research questions: personalize approaches, consider resources, promote cultural diversity broadly, and use active teaching methods and strategies. In addition, participants provided descriptive comments about beginning benefits and outcomes of CSINE and gaining needed education regarding CSINE.

CONCLUSION

Participants indicated that learning about CSINE was an ongoing and necessary process for nurse educators. Categories emerging from the data provide guidance for educators in developing and sharing CSINE educational resources to promote positive outcomes for students and their patients. [J Nurs Educ. 2020;59(3):126-132.].

Organizational Justice, Professional Identification, Empathy, and Meaningful Work During COVID-19 Pandemic: Are They Burnout Protectors in Physicians and Nurses?

Burnout has been recognized as a serious health problem. In Portugal, before COVID-19 Pandemic, there were strong indicators of high prevalence of burnout in physicians and nurses. However, the Portuguese Health Care Service was able to efficiently respond to the increased demands. This study intends to understand how psychosocial variables might have been protective factors for burnout in physicians and nurses in Portugal. Specifically, we considered several psychosocial variables that have been found to be protective factors for burnout in previous research and we compared their predictive and unique impact in the prediction of burnout. These variables are perceptions of justice (distributive, procedural, justice from colleagues, justice from patients, and their families), professional identification, meaningful work and empathy. We also included workload, as a risk factor, and controlled other variables that can be confounds for burnout, such as socio-demographic variables, ideological variables (religiosity, political orientation), and specific variables related with COVID-19 pandemic. The sample of the present study is composed by 229 physicians (aged between 23 and 70 years old, M = 36.54; SD = 10.72; 48% male and 52% female) and 268 nurses (aged between 22 and 69 years old, M = 34.96; SD = 9.52; 27% male and 73% female). An online survey was created using Qualtrics and participants were recruited via Facebook and LinkedIn. The data were collected during 29 days (between the 45th and the 74th days after the first diagnosed case of COVID-19 in Portugal). The results showed that workload was a significant risk factor, except for disengagement in physicians. The most consistent protectors across samples were procedural justice (for both dimensions of burnout, both in physicians and nurses) and professional identification (for disengagement, both in physicians and nurses; for exhaustion only in physicians). This study suggests that decreasing workload and promoting procedural justice and professional identification are key factors that might be simultaneously and independently addressed in interventions for reducing the risk of burnout or preventing it from occurring in the first place.

A national study of personal accomplishment, burnout, and satisfaction with work-life integration among advance practice nurses relative to other workers

BACKGROUND

There is a high prevalence of burnout among health care professionals, but little remains known about burnout and satisfaction with work-life integration (WLI) among advance practice nurses (APNs).

PURPOSE

To evaluate burnout and satisfaction with WLI among APNs compared with other US workers.

METHODS

A national sample of APNs and a probability-based sample of US workers completed a survey that measured burnout and satisfaction with WLI.

RESULTS

Of the 976 (47%) APNs who completed the survey 64% had high personal accomplishment, 36.6% had symptoms of overall burnout, and 60.6% were satisfied with their WLI. In multivariable analysis, work hours (for each additional hour odds ratio [OR] 1.03, 95% confidence interval [CI] 1.02-1.04, p < .001) and working in an outpatient setting (overall p = .03; referent hospital: outpatient, OR 1.80, 95% CI 1.17-2.18; other/unknown, OR 1.41, 95% CI 0.90-2.22, p = .13) were independently associated with having higher odds of burnout. Work hours were also independently associated with lower odds of satisfaction with WLI (for each additional hour OR 0.94, 95% CI 0.94-0.95, p < .001). Advance practice nurses were not more likely to have burnout or have greater struggles with WLI than other workers.

IMPLICATIONS FOR PRACTICE

Findings from this study suggest APNs have high levels of personal accomplishment and a favorable occupational health profile. Advance practice nurses do not appear at higher risk of burnout or dissatisfaction with WLI than other US workers.

The relationship amongst nurses' perceived organizational justice, work consciousness, and responsibility

BACKGROUND

Nurses' perceived organizational justice is one of the factors influencing their social responsibility and conscientiousness. Social responsibility and conscience are major requirements for providing high-quality and standardized care.

OBJECTIVE

The aim of the present study is to investigate the relationship of perceived organizational justice with work consciousness and the social responsibility of the nurses.

METHODS

The present cross-sectional study was performed on 380 nurses who had at least 1 year of job experience and willingness to participate in the study. The study was conducted in Zanjan province, Iran, in 2018. The study subjects were selected via stratified random sampling. The data were collected using an organizational justice scale, corporate social responsibility scale, and consciousness scale. Questionnaires were completed through self-reporting. The data were analyzed using partial correlation coefficient and linear regression analysis.

ETHICAL CONSIDERATIONS

Research ethics approval (with the code of IR.ZUMS.REC.1397.47) was obtained from Zanjan University of Medical Sciences.

RESULTS

The results indicated that nurses felt injustice in all dimensions of organizational justice (2.66 ± .753). They feel the most sense of injustice in distributive justice (2.19 ± .798). In three dimensions, except the ethic dimension, the social responsibility was in a desirable range (2.79 ± .703). In two dimensions, work consciousness was in a desirable range. The results showed a significant and positive relationship between all dimensions of social responsibility and all dimensions of organizational justice (r = .072). However, no statistically significant relationship was observed between the dimensions of organizational justice and conscience (r = -.002).

CONCLUSION

Based on the obtained results, social responsibility and the work consciousness of the nurses are affected by organizational justice. Therefore, nursing managers are suggested to change their management styles to reduce the sense of organizational injustice in nurses and have long-term productivity.

Professional Recognition at Work: The Protective Role of Esteem, Respect, and Care for Burnout Among Employees

OBJECTIVE

The present research systematically investigates the role of recognition experiences at work as a protective factor for burnout.

METHOD

In two cross-sectional studies (N = 328 and N = 220) with employees we measured via online questionnaires three forms of recognition (achievement-based social esteem, equality-based respect, and need-based care) from coworkers and supervisors as predictors and burnout among employees as outcome.

RESULTS

Using multiple regression analyses, Study 1 provided initial evidence that both supervisor and coworker recognition were negatively associated with employees' burnout. Study 2 further demonstrated that whereas respect experiences were especially crucial for lowering emotional exhaustion, care was primarily linked to reduced depersonalization and esteem to heightened personal accomplishment.

CONCLUSION

We discuss how positive recognition experiences can be fostered in organizations in order to buffer the negative effects burnout can cause.

The voice of nurses as a means to promote job engagement

Objective:

The objective of this study was to establish the factors that induce nursing professionals to present engagement with their work environment.

Method:

Qualitative study, using the communicative methodology, with nursing professionals from public and private centers in the city of Huesca. The statements were collected through communicative stories and discussion groups.

Result:

The methodology used has allowed the establishment of a set of engagement promotion measures in the studied environment. These measures are framed in the three main categories analyzed: the systemic or structural variables, the subject-oriented variables, and those that refer to the relationships between the subjects.

Conclusion:

Knowledge of the situation regarding engagement among professionals, and the issues that encourage or hinder its appearance, is essential in establishing measures that contribute to its development. The use of qualitative techniques has allowed for the discovery of situations that would have gone unnoticed. After analyzing the interviews and the discussion groups, the following were present: an important lack of recognition that the participants experience, and that contribute, in their opinion, to the appearance of burnout syndrome, and, the lack of cohesion as a collective.

Empathy and cultural competence in clinical nurses: A structural equation modelling approach

BACKGROUND

Forgiveness has the potential to resolve painful feelings arising from nurse-patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness.

AIM/OBJECTIVE

The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence-forgiveness association among nurses using structural equation modeling.

RESEARCH DESIGN

The research applied a cross-sectional correlational design.

PARTICIPANTS AND RESEARCH CONTEXT

The study included 380 nurses eight hospitals in southern Iran.

ETHICAL CONSIDERATIONS

The Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed.

FINDINGS

Most of the participants were married and female and fell in the 20- to 30-year-old category. Most of them (89.5%) had a working experience of 1-10 years. The proposed model showed that nurses' empathy intermediated the association between nurses' cultural competence and forgiveness which has fitted the data acceptably (root mean square error approximation = 0.070; comparative fit index = 0.993; goodness-of-fit index = 0.983; and χ²/df = 2.85).

CONCLUSION

Empathy skills and cultural competence training were essential for interventions aimed at increasing the tendency to forgive patients. In such interventions, planners should aim at increasing nurses' cultural competence in order to enhance their empathy toward patients, which can, in turn, lead to a greater wish to forgive patients.

Burnout symptoms in forensic psychiatric nurses and their associations with personality, emotional intelligence and client aggression: A cross-sectional study

WHAT IS KNOWN ON THE SUBJECT?: Client aggression in forensic psychiatry is associated with burnout symptoms in nursing staff. It is unclear what mechanisms contribute to this relationship. The type and severity of aggression might be of importance in the association between client aggression and burnout symptoms, but also the personality characteristics and emotional intelligence of nursing staff. It is unknown whether wearable devices that measure arousal can be used to detect chronic stress and burnout symptoms. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Especially, physical aggression as experienced by nursing staff is associated with staff's burnout symptoms (e.g., emotional exhaustion and depersonalization). Further research on the aggression questionnaire is necessary. The stress management skill of nursing staff is an important factor to consider in the association between burnout symptoms and client aggression. The wearable device was not useful for detecting burnout symptoms. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing staff who experience (physical) aggression should be carefully monitored and should receive social support from their management to aid their well-being. Contrary to intuition, nurses who reported a higher number of stress management skills might have to be monitored more closely if necessary.

ABSTRACT

Introduction Aggressive behaviour of forensic clients is associated with burnout symptoms in nursing staff. The role of staff characteristics as moderators is unclear. Aim We explored the association between type and severity of aggressive behaviour as experienced by nursing staff and staff's burnout symptoms. In addition, the moderating roles of personality characteristics and emotional intelligence (EI) were studied. Moreover, the usefulness of ambulatory skin conductance assessments in detecting arousal related to burnout symptoms was studied. Method A total of 114 forensic nursing staff members filled out questionnaires and wore an ambulatory device. Results Experiencing physical aggression was positively associated with staff's burnout symptoms. Stress management skills, a subscale of EI, but not personality, moderated this relationship. Skin conductance was not associated with burnout symptoms. Remarkably, the association between aggression and burnout symptoms was highest for staff reporting a higher number of stress management skills. Discussion Longitudinal research is necessary to establish causality between client aggression and staff burnout symptoms. In addition, further research is necessary on the validity of the aggression measure used in the current study. Implication for practice Nursing staff who experience physical aggression frequently should receive social support for this, and staff who report high stress management skills should be monitored more carefully after having been confronted with aggression.

Perception of ethical climate and turnover intention among nursing staff: does organizational cynicism mediate?

Purpose

The purpose of this paper is to explore the mediating effect of organizational cynicism between the relationship of perception of ethical climate and turnover intention among nurses working in public sector hospitals.

Design/methodology/approach

A quantitative approach was utilized and 870 questionnaires were distributed to collect data from nursing staff working in Punjab region of Pakistan by using non-probability multistage sampling technique. A total of 711 questionnaires were returned out of which 668 questionnaires were scrutinized. Additionally, confirmatory factor analysis and structural equation modeling were applied to analyze the data.

Findings

The results revealed a full mediating effect of organizational cynicism between the relationship of perception of ethical climate and turnover intention.

Research limitations/implications

The current study has adopted a multistage non-probability sampling technique to collect data because the management of hospitals restricted researcher access to personal information about the nurses. Therefore, at the first stage, the researcher used convenience sampling and at the second stage, the researcher utilized quota sampling to collect the data. Moreover, the findings of the current study are based on cross-sectional data because of the limited time and resources.

Practical implications

The current study fosters the ongoing debate in organizational studies related to cynicism and it is noteworthy for the nursing managers to understand the significant factors which directly or indirectly affect the nursing attitude.

Originality/value

The current study explored the mediating role of organizational cynicism between perception of ethical climate and turnover intention in nursing profession to fill the research gap.

The Impact of Workaholism on Nurses’ Burnout and Disillusion

Background:

The literature has shown that workaholism acts at the root of burnout, but research regarding these constructs in the nursing profession is scant. Similarly, little attention has been paid to the impact of workaholism on disillusion, which is a dimension of burnout linked to professional vocation.

Objectives:

Contribute to the ongoing research on the relationship between workaholism and burnout among nurses. Moreover, this study considers disillusion as a dimension to be considered when investigating the relationship between workaholism and burnout, since nursing entails professional vocation.

Method:

The study followed a cross-sectional design. 614 nurses of six hospitals in South Italy have compiled two Self-report questionnaires: the Dutch Utrecht WorkAholism Scale (workaholism - Italian version) and the Link Burnout Questionnaire (burnout). Part of the group of subjects was diagnosed with both syndromes or considered at risk of developing them. The impact of workaholism on burnout was examined using Structural Equation Models for each variable.

Results:

More than 26% of the nurses are affected by burnout whereas 21% are workaholics. Working excessively proved to be a good predictor of both psychophysical exhaustion and disillusion.

Conclusions:

Nurses are at risk of workaholism and burnout. The study shows that workaholism is a predictor of nurses’ burnout, in particular working excessively (a dimension of workaholism) affects their psychophysical well-being and professional vocation.

Exploring the relationship of horizontal violence, organizational cynicism and turnover intention in the context of social exchange theory

Purpose

The purpose of this paper is to explore the relationship of horizontal violence, organizational cynicism and turnover intention in the nursing profession.

Design/methodology/approach

A quantitative approach was utilized and 870 questionnaires were distributed to collect data from nursing staff working in Punjab region of Pakistan by using non-probability multistage sampling technique. A total of 711 questionnaires were returned, out of which, 668 questionnaires were scrutinized. Additionally, confirmatory factor analysis and structural equation modeling were applied to analyze the data.

Findings

The results revealed an insignificant mediating effect of organizational cynicism between the relationship of horizontal violence and turnover intention.

Research limitations/implications

The current study has adopted a multistage non-probability sampling technique to collect data because the management of hospitals restricted researcher access to personal information about the nurses. Therefore, at the first stage, the researcher used convenience sampling and at the second stage, the researcher utilized quota sampling to collect the data. Moreover, the findings of the current study are based on cross-sectional data because of the limited time and resources.

Practical implications

The current study fosters the ongoing debate in organizational studies related to cynicism, and it is noteworthy for the nursing managers to understand the significant factors which directly or indirectly affect the nursing attitude.

Originality/value

The current study explored the mediating role of organizational cynicism between horizontal violence and turnover intention to fill the research gap.