The relationship between organizational justice and bullying behaviors among nurses: the role of nurse managers' caring behaviors

BACKGROUND

Organizational justice is pivotal in fostering a fair and supportive workplace culture, which strengthens the connections between managers and nurses, among nurses themselves, and ultimately, between nurses and their patients. Assessing the perceived levels of organizational justice and managerial behaviors can identify key areas for improving nurses' commitment and loyalty, while simultaneously reducing incidents of workplace bullying.

PURPOSE

This study aims to investigate how bedside nurses perceive organizational justice, nurse managers' caring behaviors, and their exposure to workplace bullying. Additionally, it seeks to explore the relationship between organizational justice, nurse managers' caring behaviors, and nurses' perceived exposure to workplace bullying.

METHODS

A descriptive-correlational study was conducted in the inpatient care unit of a Saudi hospital. A convenience sample of 256 nurses participated, completing the Organizational Justice Questionnaire (OJQ), the Caring Factor Survey: Caring of the Manager (CFS-CM), and the Negative Acts Questionnaire-Revised (NAQ-R). The collected data were analyzed using descriptive statistics and regression analysis.

RESULTS

Descriptive statistics revealed moderate levels of perceived organizational justice and managerial caring behaviors among nurses, alongside low reported exposure to workplace bullying. Significant correlations were found among the studied variables, indicating that higher perceived organizational justice was associated with higher managerial caring and lower workplace bullying (p < 0.05). Mediation analysis demonstrated a significant indirect effect of organizational justice on workplace bullying through the mediating role of nurse managers' caring behaviors (a×b = -0.0652, p < 0.001). Furthermore, the direct effect of organizational justice on workplace bullying remained significant even when accounting for the mediator (c = -0.5509, p < 0.001).

CONCLUSION

This study highlights the vital role of organizational justice and managerial caring in cultivating a positive work environment and mitigating workplace bullying. Implementing clear policies and procedures while promoting fairness and equality in resource allocation, decision-making processes, and interactions are essential strategies for fostering positive attitudes and work behaviors among nurses.

Evolution of Chatbots in Nursing Education: Narrative Review

Background

The integration of chatbots in nursing education is a rapidly evolving area with potential transformative impacts. This narrative review aims to synthesize and analyze the existing literature on chatbots in nursing education.

Objective

This study aims to comprehensively examine the temporal trends, international distribution, study designs, and implications of chatbots in nursing education.

Methods

A comprehensive search was conducted across 3 databases (PubMed, Web of Science, and Embase) following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram.

Results

A total of 40 articles met the eligibility criteria, with a notable increase of publications in 2023 (n=28, 70%). Temporal analysis revealed a notable surge in publications from 2021 to 2023, emphasizing the growing scholarly interest. Geographically, Taiwan province made substantial contributions (n=8, 20%), followed by the United States (n=6, 15%) and South Korea (n=4, 10%). Study designs varied, with reviews (n=8, 20%) and editorials (n=7, 18%) being predominant, showcasing the richness of research in this domain.

Conclusions

Integrating chatbots into nursing education presents a promising yet relatively unexplored avenue. This review highlights the urgent need for original research, emphasizing the importance of ethical considerations.

Relationship between workplace spirituality with organization-based self-esteem and workplace deviant behaviors among Iranian nurses

BACKGROUND

Despite the numerous studies conducted on workplace spirituality, there is still lack of studies that have explored the relationship between workplace spirituality with organization-based self-esteem and workplace deviant behaviors. This study aims to examine the relationship between workplace spirituality with organization-based self-esteem and workplace deviant behaviors among Iranian nurses.

METHODS

236 nurses from 5 hospitals participated in this descriptive, analytical, and cross-sectional study from August to December 2022. Data was gathered by four questionnaires: demographic information, workplace spirituality, organization-based self-steam, and workplace deviant behaviors. The data were analyzed by SPSS 26 based on descriptive and inferential statistics (Independent Two-sample t Test, Pearson correlation coefficient and multiple regression).

RESULTS

Based on the findings, nurses had a moderate level of perception of workplace spirituality and organization-based self-esteem while having a low level of perception regarding the occurrence of workplace deviate behaviors. Results of Pearson correlation coefficient test showed a positive and statistically significant relationship between workplace spirituality and organization-based self-esteem. Additionally, there was an inverse and significant relationship between workplace spirituality and organization-based self-esteem with workplace deviant behaviors. Results of multiple regression analyses indicate that by controlling the demographic characteristics of nurses, the meaningful work and sense of community have a significant relationship with organization-based self-esteem. Furthermore, by controlling the demographic characteristics of nurses, permanent employment status, sense of community, alignment with the organization's values, and organization-based self-esteem have a significant relationship with workplace deviant behavior.

CONCLUSIONS

The study suggests that organizations must prioritize promoting workplace spirituality and organization-based self-esteem to ensure a healthy work environment and prevent workplace deviant behaviors.

The impact of perceived organizational justice on young nurses' job performance: a chain mediating role of organizational climate and job embeddedness

BACKGROUND

The level of nurses' job performance has always been of great concern, which not only represents the level of nursing service quality but is also closely related to patients' treatment and prognosis. The aim of this study was to analyze the relationship between perceived organizational justice and job performance and to explore the mediating role of organizational climate and job embeddedness among young Chinese nurses.

METHODS

A cross-sectional survey of 1136 young nurses was conducted between March and May 2023 using convenience sampling. Data were collected using the Job Performance Scale, Organizational Justice Assessment Scale, Nursing Organizational Climate Scale, and Job Embeddedness Scale, and the resulting data were analyzed using SPSS 25.0 and AMOS 26.0.

RESULTS

There was a significant positive correlation between job performance and perceived organizational justice (r = 0.477, p < 0.01), organizational climate (r = 0.500, p < 0.01), and job embeddedness (r = 0.476, p < 0.01). Organizational climate and job embeddedness acted as chain mediators between perceived organizational justice and job performance. The total effect of perceived organizational justice on job performance (β = 0.513) consisted of a direct effect (β = 0.311) as well as an indirect effect (β = 0.202) mediated through organizational climate and job embeddedness, with the mediating effect accounting for 39.38% of the total effect.

CONCLUSIONS

Organizational climate and job embeddedness play a chain mediating role between perceived organizational justice and job performance, so hospital managers should pay attention to the level of perceived organizational justice among young nurses, and develop a series of targeted measures to improve their job performance using organizational climate and job embeddedness as entry points.

Assessing the mediating role of organizational justice between the responsible leadership and employee turnover intention in health-care sector

PURPOSE

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

DESIGN/METHODOLOGY/APPROACH

Both online and offline questionnaire was used to collect the data from 387 Indian health-care employees, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) with the help of SmartPLS 4.

FINDINGS

The study's findings demonstrated a significant positive association between RL and OJ and a negative association between OJ and employee TI. Furthermore, results also confirmed the mediating role of OJ between RI and TI.

RESEARCH LIMITATIONS/IMPLICATIONS

The generalizability of the study's data collection is limited because it is based on the responses of Indian health-care sector employees to an online and offline survey. The authors propose that the health-care sector uses RL as an approach that takes a broad view of the parties with a stake and focuses on creating fairness in acts and justice at the workplace to address the major issue of employee turnover.

ORIGINALITY/VALUE

This study expanded on previous research by demonstrating that the influence of responsible leadership on employee TI is mediated by OJ in the context of India's health-care sector. It also contributes to the literature regarding RI, OJ and TI. The study also enriched the body of knowledge about using the PLS-SEM approach to predict employee TI.

The nurses' perception of the factors influencing professional misconduct: A qualitative study

BACKGROUND

Professional misconduct undermines safe and quality care; however, little is known about its nature and influential factors.

AIM

This study aimed to explain the factors influencing professional misconduct in nurses.

RESEARCH DESIGN

This qualitative study was conducted using the conventional content analysis method.

PARTICIPANTS AND RESEARCH CONTEXT

Data were collected using semi-structured interviews with 19 nurses working in the hospital selected through a purposeful method and analyzed by Graneheim and Lundman approach.

ETHICAL CONSIDERATIONS

The ethics committee of Tehran University of Medical Sciences approved this study with the ethics code IR.TUMS.FNM.REC.1400.187. Informed consent was obtained from all participants. Participants were assured of confidentiality.

FINDINGS

Factors influencing professional misconduct by nurses were categorized into three main categories: human factors (nurses' professional characteristics, personal characteristics of nurses and patient/companion, patient's clinical condition), procedural factors (procedural conditions, possibility of proving misconduct), and organizational factors (recruitment process, conditions of resources, managing misconduct, bureaucracy, and ward characteristics).

CONCLUSION

This study assists in explaining the factors influencing professional misconduct by nurses. Therefore this study's results can help managers and planners develop interventions to prevent and correct factors that contribute to misconduct and strengthen factors that prevent misconduct in order to ensure quality and safe patient care.

Work ethics and its relationship with workplace ostracism and counterproductive work behaviours among nurses: a structural equation model

BACKGROUND

The organization's work ethics is the cornerstone to promoting positive nurses' behaviours and overcoming counterproductive ones.

PURPOSE

The current study aims to explore the relationship between work ethics (WEs) and counterproductive work behaviours (CWB) among nurses and testify to the mediating role of workplace ostracism (WO) in this relationship.

METHODS

A descriptive correlational study was conducted in an Egyptian hospital. A convenient sample of staff nurses (N = 369) who agreed to participate in the study answered work ethics, counterproductive work behaviours, and workplace ostracism questionnaires, which were proven to be valid and reliable study measures. Descriptive and inferential statistics were applied, and relationships were presented using structural equation modelling.

ETHICAL CONSIDERATIONS

Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants' rights to voluntary participation and withdrawal were maintained.

RESULTS

The majority of nurses (78.5%) perceived a high level of work ethics while majority of nurses reporting low levels of counterproductive work behaviours and workplace ostracism (82.25%, 75.75%), respectively. In addition to the negative correlations, the findings revealed that WEs have a significant negative influence on each of CWB (β - 0.482, p < 0.005) and WO (β - 0.044, p < 0.005). The regression analysis showed that WEs can negatively predict about 15% of the variance in each of CWB and WO. On the other hand, WO has a positive effect on CWB (β 0.035, p < 0.021) and mediates the relationship between WEs and CWB.

DISCUSSION

Ostracism negatively affects the attitudes of nurses, which in turn results in negative behavioural outcomes (i.e., deviant behaviour).

CONCLUSION

It is imperative for the hospital and nurse managers to establish a work environment that fosters support and cultivate work ethics and ethical work climate with the aim of managing negative work behaviours, enhancing nurses' retention and satisfaction, and eventually improving the quality of patient care.

Moral Breakdowns and Ethical Dilemmas of Perioperative Nurses during COVID-19: COREQ-Compliant Study

(1) Background: The COVID-19 pandemic has led to an increase in the complexity of caregiving, resulting in challenging situations for perioperative nurses. These situations have prompted nurses to assess their personal and professional lives. The aim of this study was to explore the experiences of perioperative nurses during the first wave of the COVID-19 pandemic, with a specific focus on analyzing moral breakdowns and ethical dilemmas triggered by this situation. (2) Methods: A qualitative design guided by a hermeneutical approach was employed. Semi-structured interviews were conducted with 24 perioperative nurses. The interviews were transcribed and thematically analysed following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. (3) Results: The findings revealed three main categories and ten subcategories. These categories included the context in which moral breakdowns emerged, the ethical dilemmas triggered by these breakdowns, and the consequences of facing these dilemmas. (4) Conclusions: During the first wave of COVID-19, perioperative nurses encountered moral and ethical challenges, referred to as moral breakdowns, in critical settings. These challenges presented significant obstacles and negatively impacted professional responsibility and well-being. Future studies should focus on identifying ethical dilemmas during critical periods and developing strategies to enhance collaboration among colleagues and provide comprehensive support.

Investigating the link between organisational justice, positive organisational behaviour and productivity in emergency nurses

BACKGROUND

Human resource management and employees' performance are fundamental to the success of healthcare organisations. Therefore, it is important to consider the factors that may affect employees' performance.

AIM

To determine the relationship between perceived organisational justice, positive organisational behaviour (POB) and the productivity of emergency nurses.

METHOD

This was a descriptive-analytical study that involved distributing questionnaires to emergency nurses working in hospitals affiliated with Mazandaran University of Medical Sciences in Iran. The researchers used proportionate stratified sampling to calculate the sample size. Three questionnaires were used to collect data on organisational justice, POB and productivity. The data were analysed using the Pearson correlation coefficient and multiple regression tests.

RESULTS

The questionnaires were distributed to 284 emergency nurses and completed by 234 of them. The results demonstrated a significant relationship between the productivity of the emergency nurses and the variables of perceived organisational justice and POB.

CONCLUSION

Higher levels of perceived organisational justice and POB in the ED setting are likely to lead to increased productivity among emergency nurses, and as a result the quality of patient care is likely to improve. Therefore, healthcare organisations should pay particular attention to the application of organisational justice, with the aim of promoting POB among nurses and increasing their productivity.

The Relationship Between Coping Strategies, Compassion Satisfaction, and Compassion Fatigue During the COVID-19 Pandemic

Introduction

The rapid spread of COVID-19 poses a significant threat to nurses' lives and health, resulting in varying degrees of mental distress. Nurses may experience compassion fatigue, and their professional quality of life and satisfaction may suffer as a result. Their coping mechanisms may vary as well, influencing their compassionate and safe care.

Objectives

The study's objectives are to explore levels of compassion satisfaction and fatigue among nurses and identify their coping strategies. Further, to investigate the relationship between coping strategies, compassion satisfaction, and compassion fatigue during the COVID-19 pandemic.

Methods

Using a descriptive correlational design, this study was conducted with a convenience sample of 443 nurses working in an Egyptian university hospital. Nurses completed the coping strategy indicator scale and the professional quality of life (compassion satisfaction and compassion fatigue) scale. The data were analyzed using descriptive statistics, Pearson correlation, and regression analysis.

Results

Nurses' professional quality of life was average in terms of compassion satisfaction (2.95 ± 0.92) and compassion fatigue (2.38 ± 0.35). Nurses have a moderate use of coping strategies (2.13 ± 0.35). Problem-solving was rated as the highest coping strategy, while avoidance was rated as the lowest. Coping strategies showed a positive correlation with compassion satisfaction (r = 0.503, p < .001) and a negative correlation with compassion fatigue (r = -0.352, p < .001). In addition, coping strategies could predict 25.4% and 12.4% of compassion satisfaction and compassion fatigue, respectively (p < .001).

Conclusion

Compassion satisfaction and fatigue are key determinants of nurses' quality of work life. Coping strategies, especially problem-solving and support systems, are vital to increase compassion satisfaction and mitigate burnout and secondary stress syndrome. Nurse managers should establish supportive work environments that promote nurses' well-being. Resilience-building programs and coping strategies' training are recommended to enhance the nurses' quality of work life and positive work attitudes.

Decent Work and Workplace Deviance Among Chinese Physicians: A Relative Deprivation Perspective

Purpose

Managing workplace deviance has long been a hot topic in the organizational research. However, the mechanisms through which decent work affects workplace deviance have yet to be fully understood. Drawing upon relative deprivation theory, this study examines the relationship between decent work and workplace deviance by focusing on the mediating role of relative deprivation and the moderating role of career calling.

Methods

Two waves of data from 307 doctors and 61 supervisors of public hospitals in central China were examined using a the moderated mediation model.

Results

Decent work is negatively associated with workplace deviance via the mediation of relative deprivation, and the negative relationship between decent work and relative deprivation is negatively moderated by career calling. The mediating role of relative deprivation is moderated by career calling, and the indirect effect is stronger when career calling is high than when it is low.

Conclusion

By focusing on the mediating role of relative deprivation and the moderating role of career calling, this study contributes to the literature by addressing the previously unexamined relationship between decent work and workplace deviance. Moreover, this study responds to calls for research on decent work from the perspective of relative deprivation.

The meta-analysis of organisational deviant behaviours research: past, present, and future

Purpose

This study aims to reach a perception of the advance of research on deviant organisational behaviours.

Design/methodology/approach

This research has been done through the text mining method. By reviewing, the papers were selected 360 papers between 1984 and 2020. Based on the Davis–Boldin index, 11 optimal clusters were gained. Then the roots were ranked in any group, using the Simple Additive Weighting technique. Data were analysed by RapidMiner and MATLAB software.

Findings

According to the results obtained, clusters are included leadership styles, job attitudes, spirituality in the workplace, work psychology, personality characteristics, classification and management of deviant workplace behaviours, service and customer orientation, deviation in sales, psychological contracts, group dynamics and inappropriate supervision.

Originality/value

This study provides a landscape and roadmap for future investigation on deviant organisational behaviours.

Servant leadership in relation to organizational justice and workplace deviance in public hospitals

Purpose

Leadership literature has identified that the servant leadership style can reduce employee negative work outcomes, even in challenging work environments like the health-care sector as nurses play an important role in the performance of a hospital. That is why, the efficiency and effectiveness of the nurses are believed to be directly linked to improved health benefits to the public. So, this study aims to investigate the inter-relationship between servant leadership, organizational justice and workplace deviance of nurses in public sector hospitals.

Design/methodology/approach

A self-administrated questionnaire using a drop-and-collect method was used for collecting the data from nurses working in the public sector hospitals of Pakistan using a convenient sampling technique. In total, 370 questionnaires were distributed among the nursing staff, of which 201 completed and usable questionnaires were returned and used for data analysis. Further, the partial least squares structural equation modeling approach is used in this study using SmartPLS version 3 software to test the hypothesized model and determine the direct and indirect effects.

Findings

Results showed a negative relationship between servant leadership and workplace deviance, positive relationship between servant leadership and organizational justice, negative relationship between organizational justice and workplace deviance and that organizational justice mediates in the relationship between servant leadership and workplace deviance.

Practical implications

This study provides valuable recommendations and practical implications to address the nurses’ deviant workplace behaviors in the public sector hospitals of Pakistan.

Originality/value

This study is novel as it shows the significance of servant leadership behavior which has the ability to positively influence organizational justice perception leading to less likelihood of the emergence of nurses’ deviant workplace behavior, specifically in the context of public sector hospitals of Pakistan.

Organizational Justice and Health: A Survey in Hospital Workers

In complex systems such as hospitals, work organization can influence the level of occupational stress and, consequently, the physical and mental health of workers. Hospital healthcare workers were asked to complete a questionnaire during their regular occupational health examination, in order to assess the perceived level of organizational justice, and to verify whether it was associated with occupational stress, mental health, and absenteeism. The questionnaire included the Colquitt Organizational Justice (OJ) Scale, the Karasek/Theorell demand-control-support (DCS) questionnaire for occupational stress, and the General Health Questionnaire (GHQ12) for mental health. Workers were also required to indicate whether they had been absent because of back pain in the past year. Organizational justice was a significant predictor of occupational stress. Stress was a mediator in the relationship between justice and mental health. Occupational stress was more closely related to perceptions of lack of distributive justice than to perceptions of procedural, informational, and interpersonal justice. Physicians perceived significantly less distributive justice than other workers. In adjusted univariate logistic regression models, the perceptions of organizational justice were associated with a significant reduction in the risk of sick leave for back pain (OR 0.96; CI95% 0.94−0.99; p < 0.001), whereas occupational stress was associated with an increased risk of sick leave (OR 6.73; CI95% 2.02−22.40; p < 0.002). Work organization is a strong predictor of occupational stress and of mental and physical health among hospital employees.

Professional Identity and Emotional Labor Affect the Relationship between Perceived Organizational Justice and Job Performance among Chinese Hospital Nurses

AIM

To investigate the influence of perceived organizational justice, professional identity, and emotional labor on nurses' job performance.

BACKGROUND

Previous studies have not explored the impact of professional identity and emotional labor on the relationship between perceived organizational justice and job performance. However, how to mobilize the enthusiasm of nurses and improve their job performance is the key for nursing managers to realize the sustainable development of hospitals.

METHODS

A cross-sectional survey design was conducted. A total of 951 nurses from public hospitals in China participated in the survey from March-June 2021. The descriptive statistical approach, Pearson's correlation analysis, and the PROCESS Macro Model 4 and 14 in regression analysis were used to analyze the available data.

RESULTS

The results showed that nurses' perceived organizational justice, professional identity, emotional labor, and job performance were significantly positive correlations between every two variables, with coefficients ranging between 0.24-0.75. Professional identity played a whole mediating role in perceived organizational justice and job performance, accounting for 98.04% of the total effect; meanwhile, this process was moderated by emotional labor.

CONCLUSIONS

Perceived organizational justice positively predicted nurses' job performance; as a mediating mechanism with moderating, professional identity and emotional labor further explained how perceived organizational justice promoted the job performance of nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

This study highlighted the moderated mediation role of professional identity and emotional labor between nurses' perceived organizational justice and job performance. Understanding this mechanism has guiding significance for nursing managers to improve nurses' job performance.

Occupational Fatigue and Associated Factors among Saudi Nurses Working 8-Hour Shifts at Public Hospitals

Introduction

Shift work and demanding work schedules contribute to occupational fatigue, negatively affecting patient safety and nurses’ well-being, consequently placing nurses and patients at risk for injury and adverse health outcomes. For preventing fatigue and minimizing its negative consequences, information about its characteristics and associated factors is required.

Objectives

This study aimed to assess occupational fatigue “acute fatigue, chronic fatigue, and inter-shift recovery” among Saudi nurses working 8-h shifts. Further, we explored factors associated with fatigue from nurses’ perspectives.

Methods

We conducted a mixed-method study with a convenience sample of Saudi nurses (N = 282) working in four public hospitals in Saudi Arabia. Data were collected using the nurses’ profile form; the occupational fatigue exhaustion recovery (OFER) scale, for relevant quantitative data; and open-ended questions for qualitative data. We used descriptive and inferential statistics for analysing the quantitative data and content analysis of the qualitative data.

Results

The results showed that Saudi nurses rated themselves moderately fatigued with working 8-h shifts. The inter-shift recovery subscale showed a negative correlation with chronic fatigue and acute fatigue (r = −0.518, r = −0.356, P < 0.001). Sleeping problems, meals per day, and frequency of exercise showed significant relations with chronic fatigue among nurses (p < 0.05). In addition, three categories were derived from the qualitative content analysis. Saudi nurses reported work-related, psychosocial, and individual factors as major contributors to fatigue and recovery.

Conclusion

Occupational fatigue is a multidimensional issue, and nurses and nurse managers are challenged with reducing its prevalence and negative impact on nurses and patients. Our quantitative and qualitative findings suggest the need for a comprehensive approach to fatigue management and mitigation, including organizational support, creative workforce planning, flexible work schedules, and psychosocial support. Fatigue reduction and prevention policies and educational programs are vital strategies to improve nurses’ well-being and inter-shift recovery.

The Effect of Organizational Justice on Job Performance and the Mediating Role of Job Satisfaction: A Study on Nurses

This study aims identifying the effects of nurses' perceptions of organizational justice on their performance and to test the mediating role of job satisfaction. This is a cross-sectional study. This study conducted with 374 nurses working hospitals. The research model was tested using structural equation modeling and the bootstrap technique. Organizational justice has been found to have a significant impact on job performance and job satisfaction. Job satisfaction had a partial mediating role. The results of this study could guide the more effective and efficient use of human resources in nursing management and contribute to the literature of health and nursing management.

The Relationship Between Transformational Leadership Practices of First-Line Nurse Managers and Nurses' Organizational Resilience and Job Involvement: A Structural Equation Model

BACKGROUND

Nurse leaders play a unique role in seeking ways to promote a strong nurse workforce and positive work attitudes and behaviors among nurses to assist in their success. The leadership practice of nurse managers could be an important factor in promoting nurses' organizational resilience and job involvement.

AIM

To determine the relationship between transformational leadership practices of first-line nurse managers and nurses' organizational resilience and job involvement.

METHODS

A descriptive correlational research design was conducted at a Saudi university hospital. The study consisted of 60 nurse managers and 211 nurses. Measures included Leadership Practices Inventory, organizational resilience, and job involvement questionnaires. Results were analyzed using inferential statistics and Structural Equation Modeling.

RESULTS

In addition to the positive significant correlation found among the studied variables, First-Line Nurse Managers' Leadership practices accounted for 43% and 40% of the variance of nurses' organizational resilience and job involvement.

LINKING EVIDENCE TO ACTION

Nurse leaders perform a crucial role in embracing and executing effective strategies through their transformational leadership and managerial caring to support nurses' resilience and job involvement. Shared governance and a respectful working atmosphere that conveys gratitude to nurses are popular strategies that enhance the efficacy of nursing leadership and promote positive work attitudes among nurses.

Organisational Justice and Political Agency among Nurses in Public Healthcare Organisations: A Qualitative Study Protocol

Nurses are rarely treated as equals in the social, professional, clinical, and administrative life of healthcare organisations. The primary objective of this study is to explore nurses’ perceptions of organisational justice in public healthcare institutions in Majorca, Balearic Islands, Spain, and to analyse the ways in which they exercise their political agency to challenge the institutional order when it fails to reflect their professional ethos. An ethnomethodological approach using critical discourse analysis will be employed. The main participants will be nurses occupying different roles in healthcare organisations, who will be considered central respondents, and physicians and managers, who will be considered peripheral respondents. Data generation techniques include semi-structured interviews, a sociodemographic questionnaire, and the researcher’s field diary. This is one of the first studies to address organisational justice in healthcare organisations from a macrostructural perspective and to explore nurses’ political agency. The results of this study have the potential to advance knowledge and to ensure that healthcare organisations are fairer for nurses, and, by extension, for the patients in their care.

Factors influencing workplace social capital among registered nurses in China

AIM

To examine the modifiable predictors and the level of workplace social capital, transformational leadership, emotional intelligence and organizational justice among registered nurses in Chinese hospitals.

BACKGROUND

Workplace social capital is a relational network developed among nurses and other healthcare professionals that provides social support, and gives value to their working lives. Internationally, cultivating high levels of social capital is critical as it can help improve nurse satisfaction and care, and address nurse turnover. However, knowledge of factors influencing nurses' workplace social capital is limited in China.

METHODS

In this cross-sectional, descriptive predictive study, 344 registered nurses were randomly selected from three urban Chinese hospitals in Zhejiang province. Five standard instruments were applied to collect data. Descriptive statistics were used to present the level of the variables and stepwise multiple regression was performed to identify the predictors of nurses' workplace social capital.

RESULTS

Among eight potential factors, transformational leadership and emotional intelligence positively predicted workplace social capital. Nurses perceived the overall level of workplace social capital, emotional intelligence and unit managers' transformational leadership as high, and the overall level of organizational justice as moderate.

DISCUSSION

Enhancing unit managers' transformational leadership and nurses' emotional intelligence was found to positively influence the development of workplace social capital. Although it is not a predictor of workplace social capital, nurses' organizational justice should be improved due to its importance and current unsatisfactory level.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing and health policymakers need to consider the enhancement of transformational leadership and emotional intelligence when implementing policies to improve nurses' workplace social capital, nursing retention and job satisfaction.

A qualitative study on the experiences of the first nurses assigned to COVID-19 units in Turkey

AIM

To explore the experiences of the first nurses assigned to work in COVID-19 units with the onset of the outbreak in Turkey.

BACKGROUND

Even though the risks faced by nurses while performing a dangerous task during the epidemic are similar, their experiences may differ.

METHOD

This qualitative study was carried out with 17 nurses. The interviews were carried out individually and online. The data were analysed using Colaizzi's phenomenological method.

RESULTS

From the analyses of the data, four key themes have emerged as follows: 'needs', 'anger', 'questioning' and 'decision'. Needs include visibility, support, adaptation and sleep/rest. Nurses were angry because of their unmet expectations, feelings of injustice, and selfish and insensitive behaviours they faced. They questioned their profession and decided to either alienate from the profession or continue with the gains they had made.

CONCLUSION

This study found that nurses perceived an imbalance between their efforts and their achievements.

IMPLICATIONS FOR NURSING MANAGEMENT

This study provides evidence for nursing managers to anticipate problems that may arise both during and after the outbreak. Nurses should be made to feel that they are valued members of the health care institution, and effective strategies should be implemented to improve their perceptions of organisational justice.

A model for occupational stress amongst paediatric and adult critical care staff during COVID-19 pandemic

Purpose

The coronavirus 2019 pandemic has placed all intensive care unit (ICU) staff at increased risk of psychological distress. To date, measurement of this distress has largely been by means of validated assessment tools. We believe that qualitative data may provide a richer view of staff experiences during this pandemic.

Methods

We conducted a cross-sectional, observational study using online and written questionnaires to all ICU staff which consisted of validated tools to measure psychological distress (quantitative findings) and open-ended questions with free-text boxes (qualitative findings). Here, we report our qualitative findings. We asked four questions to explore causes of stress, need for supports and barriers to accessing supports. A conventional content analysis was undertaken.

Results

In total, 269 of the 408 respondents (65.9%) gave at least one response to a free-text question. Seven overarching themes were found, which contribute to our proposed model for occupational stress amongst critical care staff. The work environment played an important role in influencing the perceived psychological impact on healthcare workers. Extra-organisational factors, which we termed the “home-work interface” and uncertainty about the future, manifested as anticipatory anxiety, had a proportionally larger influence on worker well-being than would be expected in non-pandemic conditions.

Conclusion

Our findings have important implications for appropriate allocation of resources and ensuring well-being of the ICU multidisciplinary team for this and future pandemics.

Workplace bullying, knowledge hiding and time theft: Evidence from the health care institutions in Pakistan

AIM(S)

This paper examined the impact of workplace bullying (WPB) on mild aggressive deviant behaviour, such as knowledge hiding and employee time theft, in Pakistani health care institutions. Additionally, this study investigated the mediating role of negative emotions on the relationship between WPB and its outcomes.

BACKGROUND

Although mild deviant behaviour has been proven to affect the health care sector, its antecedents are still untapped.

METHOD

Data were collected from 233 nurses working in hospitals located across Pakistan via self-administered questionnaires in three time lags to test both the direct and indirect effects of WPB. The hypothesized correlations were tested using structural equation modelling (SEM).

RESULTS

The results revealed that WPB increased knowledge hiding and employee time theft amongst nurses. The indirect effect of negative emotions was established on the aforementioned relationships.

CONCLUSION

This study contributes to the existing literature by concentrating on predictors that trigger deviant behaviour amongst nurses. It also assessed the mediating impact of emotions, wherein such endeavour is essential for researchers and practitioners.

IMPLICATIONS FOR NURSING MANAGEMENT

The study outcomes are significant for the hospital sector to improve their strategies, such as implementing resilience during stressful events to address WPB and deviant behaviour amongst nurses.

Investigating the relationship between organizational justice, job satisfaction, and intention to leave the nursing profession: A cross-sectional study

AIMS

This study aims to test a hypothetical model linking various dimensions of organizational justice to the job satisfaction and nurses' intention to leave the profession based on the theoretical assumptions of the Alexander model of voluntary turnover.

DESIGN

A cross-sectional survey.

METHODS

This study was conducted on 317 inpatient ward nurses of six teaching hospitals in Tehran, Iran during 1 September 2017-14 November 2018. Clinical nurses were recruited by a multistage random sampling. Data were collected using structured questionnaires of organizational justice, job satisfaction, and nurses' intention to leave. Data were analysed by structural equation modelling using Amos 22 statistical program.

RESULTS

The structural equation model demonstrated adequate fit and the hypothesized correlations were partially supported. The findings suggested that the distributive justice (p < .001; β = 0.24) and interactional justice (p < .001; β = 0.44) could indirectly affect the nurses' intention to leave the nursing profession via the direct impact on job satisfaction, while job satisfaction had a significant, negative effect on the nurses' intention to leave (p < .001; β = -0.71).

CONCLUSIONS

According to the results, the model fit was acceptable, suggesting the validity of the final model. Furthermore, distributive and interactional justice could reduce the intention to leave the nursing profession by influencing the job satisfaction of the clinical nurses.

IMPACT

This was one of the first studies to determine the aspects of justice that must be further emphasized by healthcare managers to increase the job satisfaction of nurses and their retention in healthcare systems. The findings indicated that fair interactions have a greater impact on job satisfaction and retention of nurses than procedural and distributive justice. The results of this study provide valuable references for nursing managers to increase the job satisfaction of nurses and their retention in healthcare settings.

Determinants and mitigating factors of the brain drain among Egyptian nurses: a mixed-methods study

Background

A brain drain is a migration of employees in their quest for an improved level of living conditions, better earnings, access to advanced technology and secure political conditions in diverse places worldwide. The brain drain of nurses is an ongoing phenomenon that impacts the quality and quantity of the nursing workforce and affects the quality of care. The nurses' brain drain is commonly known as a result of the interplay of many factors. So, identification of these factors and how to manage them is a timely topic in nursing research.

Aims

This study aims to investigate determinants of the nurses' brain drain and mitigating factors from nurses' perspectives in Egypt.

Methods

Mixed-methods research was conducted using a concurrent triangulation design. A sample of 325 nurses who were working at an Egyptian university hospital answered a brain drain questionnaire while the qualitative investigation was guided by a semi-structured interview with a purposive sample of 35 nurses to elicit exploratory perspectives on factors causing brain drain and mitigation strategies. Results were analysed using inferential statistics and thematic data analysis.

Results

Both push and pull factors can predict about 99.6% and 97.5% of the nurses' brain drain, respectively. Seven themes were derived from the qualitative content analysis, and six themes were categorised under 'push-pull' factors. In addition, the 'mitigating factors theme' was identified with five sub-factors as possible solutions. Economic and work environment reasons were reported as the most influential for nurses' brain drain.

Conclusions

Policymakers could use the identified factors from quantitative and qualitative data for creating a system that would improve nurses' conditions and policies, and prevent nurses' migration. Nursing leaders have a significant role with non-remuneration strategies in retaining nurses through creating an empowering work environment. In addition, shared governance, a strong nursing syndicate role and professorial marketing would be essential mitigating factors for the nurses' brain drain.