Although incivility has been identified as an important issue in workplaces, little research has focused on reducing incivility and improving employee outcomes. Health care workers (N = 1,173, Time ...1; N = 907, Time 2) working in 41 units completed a survey of social relationships, burnout, turnover intention, attitudes, and management trust before and after a 6-month intervention, CREW (Civility, Respect, and Engagement at Work). Most measures significantly improved for the 8 intervention units, and these improvements were significantly greater than changes in the 33 contrast units. Specifically, significant interactions indicating greater improvements in the intervention groups than in the contrast groups were found for coworker civility, supervisor incivility, respect, cynicism, job satisfaction, management trust, and absences. Improvements in civility mediated improvements in attitudes. The results suggest that this employee-based civility intervention can improve collegiality and enhance health care provider outcomes.
Aim
To examine the relationship between nurses' exposure to workplace bullying and Post‐Traumatic Stress Disorder symptomology and the protective role of psychological capital (PsyCap).
Background
...Workplace bullying has serious organisational and health effects in nursing. Few studies have examined the relation of workplace bullying to serious mental health outcomes, such as Post‐Traumatic Stress Disorder. Even fewer have examined the effect of intrapersonal strengths on the health impact of workplace bullying.
Method
A survey of 1205 hospital nurses was conducted to test the hypothesized model. Nurses completed standardized measures of bullying, Post‐Traumatic Stress Disorder and PsyCap.
Result
A moderated regression analysis revealed that more frequent exposure to workplace bullying was significantly related to Post‐Traumatic Stress Disorder symptomology regardless of the PsyCap level. That is, PsyCap did not moderate the bullying/PTSD relationship in either group. Bullying exposure and PsyCap were significant independent predictors of Post‐Traumatic Stress Disorder symptoms in both groups. Efficacy, a subdimension of PsyCap, moderated the bullying/Post‐Traumatic Stress Disorder relationship only among experienced nurses.
Conclusion
Workplace bullying appears to be predictive of Post‐Traumatic Stress Disorder symptomology, a serious mental health outcome.
Implications for nursing management
Workplace bullying is a serious threat to nurses' health and calls for programmes that eliminate bullying and encourage greater levels of positive resources among nurses.
Aim
To test a hypothesized model linking new graduate nurses’ perceptions of their manager's authentic leadership behaviours to structural empowerment, short‐staffing and work–life interference and ...subsequent burnout, job satisfaction and patient care quality.
Background
Authentic leadership and structural empowerment have been shown to reduce early career burnout among nurses. Short‐staffing and work–life interference are also linked to burnout and may help explain the impact of positive, empowering leadership on burnout, which in turn influences job satisfaction and patient care quality.
Design
A time‐lagged study of Canadian new graduate nurses was conducted.
Methods
At Time 1, surveys were sent to 3,743 nurses (November 2012–March 2013) and 1,020 were returned (27·3% response rate). At Time 2 (May–July 2014), 406 nurses who responded at Time 1 completed surveys (39·8% response rate). Descriptive analysis was conducted in SPSS. Structural equation modelling in Mplus was used to test the hypothesized model.
Results
The hypothesized model was supported. Authentic leadership had a significant positive effect on structural empowerment, which in turn decreased both short‐staffing and work–life interference. Short‐staffing and work–life imbalance subsequently resulted in nurse burnout, lower job satisfaction and lower patient care quality 1 year later.
Conclusion
The findings suggest that short‐staffing and work–life interference are important factors influencing new graduate nurse burnout. Developing nurse managers’ authentic leadership behaviours and working with them to create and sustain empowering work environments may help reduce burnout, increase nurse job satisfaction and improve patient care quality.
Destructive interpersonal experiences at work result in negative feelings among employees and negative work outcomes. Understanding the mechanisms through which bullying can lead to burnout and ...subsequent turnover is important for preventing and managing this problem. Leaders play a key role in shaping positive work environments by discouraging negative interpersonal experiences and behaviours. The aim of this study is twofold. Specifically we aim to examine the relationship between authentic leadership and new graduate nurses experiences of workplace bullying and burnout over a 1-year timeframe in Canadian healthcare settings. Furthermore we aim to examine the process from workplace bullying to subsequent burnout dimensions, and to job and career turnover intentions. Results of structural equation models on new graduate nurses working in acute care settings in Ontario (N = 205) provide support for the hypothesized model linking supervisor's authentic leadership, subsequent work-related bullying, and burnout, and these in turn to job and career turnover intentions. Thus, the more leaders were perceived to be authentic the less likely nurses' were to experience subsequent work-related bullying and burnout and to want to leave their job and profession. The results highlight the important role of leadership in preventing negative employee and organizational outcomes.
Retaining skilled and engaged nurses is critical during a time of shortage, however growing reports of workplace bullying threaten nurses’ health and wellbeing, especially the transition of newly ...graduated nurses entering the profession. High rates of burnout and turnover among new nurses puts additional strain on limited financial resources in healthcare organizations and can compromise the quality of care provided to patients.
The purpose of this study is to test a model linking authentic leadership to new graduate nurses’ experiences of workplace bullying and burnout, and subsequently, job satisfaction and intentions to leave their jobs.
This study employed a cross-sectional survey design with 342 new graduate nurses (defined as less than two years of practice experience) working in acute care hospitals in Ontario, Canada. Participants completed a questionnaire with measures of authentic leadership, workplace bullying, burnout, job satisfaction and turnover intentions. The model was tested using path analysis techniques within structural equation modeling.
The model fit indices suggested that the original hypothesized model did not adequately fit the data (χ2=33.59, df=5, p=.000, χ2/df=6.72, IFI=.937, CFI=.937, RMSEA=.130), thus an additional theoretically justified direct path from authentic leadership to job satisfaction was added, which improved the fit substantially (χ2=5.26, df=4, p=.261, χ2/df=1.32, IFI=.997, CFI=.997, RMSEA=.030). Authentic leadership had a negative direct effect on workplace bullying, which in turn had a direct positive effect on emotional exhaustion. Authentic leadership also influenced job satisfaction indirectly through bullying and emotional exhaustion. Authentic leadership, workplace bullying and emotional exhaustion all had significant direct effects on job satisfaction, which in turn, was related to lower turnover intentions.
The findings from this study demonstrate the fundamental importance of authentic leadership in creating supportive working environments. An authentic leadership style may reduce the probability of a unit culture of workplace bullying developing, contributing to a nursing workforce that is less burned out, more satisfied with their job, and ultimately, less likely to leave their position.
laschinger h.k.s. (2012) Journal of Nursing Management 20, 472–484
Job and career satisfaction and turnover intentions of newly graduated nurses
Aim To describe new graduate nurses’ worklife ...experiences in Ontario hospital settings in the first 2 years of practice and to examine predictors of job and career satisfaction and turnover intentions.
Background With a large cohort of nurses approaching retirement, every effort must be made to ensure that the work environments of new graduate nurses are positive, promoting job satisfaction and commitment to the profession to address the nursing workforce shortage.
Method A cross‐sectional analysis of data from a mail survey of new graduate nurses (n = 342) in their first and second year of experience was used to address the research objectives.
Results Overall, new graduate nurses were positive about their working conditions and there were few differences between nurses in their first and second years of practice. Structural and personal factors explained significant amounts of variance (31–68%) in both job and career satisfaction and turnover intentions. Empowerment, work engagement and burnout were important significant predictors.
Conclusions Modifiable workplace factors play an important role in influencing new graduates’ job and career satisfaction and turnover intentions.
Implications for nursing management Managers can employ strategies to enhance quality work environments that promote retention of new graduates and lessen the nursing workforce shortage.
The frontline clinical manager role in healthcare is pivotal to the development of safe and healthy working conditions and optimal staff and patient care outcomes. However, in today's dynamic ...healthcare organizations managers face constant job demands from wider spans of control and complex role responsibilities but may not have adequate decisional authority to support effective work performance resulting in unnecessary job strain. Prolonged job strain can lead to burnout, health complaints, and increased turnover intention. Yet, there is limited research that examines frontline manager job strain and its impact on their well-being and work outcomes. The substantial cost associated with replacing experienced managers calls attention to the need to address job strain in order to retain this valuable organizational asset.
Using Karasek's Job Demands-Control theory of job strain, a model was tested examining the effects of frontline manager job strain on their burnout (emotional exhaustion and cynicism), organizational commitment and ultimately, turnover intentions.
Secondary analysis of data collected in an online cross-sectional survey of frontline managers was conducted using structural equation modeling.
All 500 eligible frontline managers from 14 teaching hospitals in Ontario, Canada, were invited to participate and 159 responded for a 32% response rate.
Participants received an email invitation with a secure link for the online survey. Ethics approval was obtained from the university ethics board and the respective ethics review boards of the 14 organizations involved in the study. The model was tested using path analysis techniques within structural equation modeling with maximum likelihood estimation.
The final model fit the data acceptably (χ2=6.62, df=4, p=.16, IFI=99, CFI=.99, SRMR=.03, RMSEA=.06). Manager job strain was significantly positively associated with burnout which contributed to both lower organizational commitment and higher turnover intention. Organizational commitment was also negatively associated with turnover intention and there was an additional direct positive relationship between job strain and turnover intention.
Preliminary support was found for a model showing that manager job strain contributes to burnout, reduced organizational commitment and higher turnover intentions. Findings suggest that organizations need to monitor and address manager job strain by ensuring managers’ role demands are reasonable and that they have the requisite decision latitude to balance role demands.
Improving patient safety within health care organizations requires effective leadership at all levels.
The objective of this study was to investigate the effects of nurse managers' transformational ...leadership behaviors on job satisfaction and patient safety outcomes.
A random sample of acute care nurses in Ontario (N = 378) completed the crosssectional survey. Hypothesized model was tested using structural equation modeling.
The model fit the data acceptably. Transformational leadership had a strong positive influence on workplace empowerment, which in turn increased nurses' job satisfaction and decreased the frequency of adverse patient outcomes. Subsequently, job satisfaction was related to lower adverse events.
The findings provide support for managers' use of transformational leadership behaviors as a useful strategy in creating workplace conditions that promote better safety outcomes for patients and nurses.
•Nursing leadership is pivotal to providing high-quality patient care and ensuring favorable organizational outcomes.•Transformational leadership indirectly influences nurses' job satisfaction and prevalence of adverse patient outcomes through workplace empowerment.•Managers who demonstrate transformational leadership in the workplace have greater potential to create environments that support professional nursing practice that promote high-quality patient care.•Health care administrators need to consider change of policies to improve the work environment by providing leadership development and mentorship opportunities for existing and aspiring managers.
Nurse turnover: A literature review – An update Hayes, Laureen J.; O’Brien-Pallas, Linda; Duffield, Christine ...
International journal of nursing studies,
July 2012, 2012-Jul, 2012-7-00, 20120701, Volume:
49, Issue:
7
Journal Article
Peer reviewed
Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of ...inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations.
The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies.
A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years.
Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications.
Keyword searches were conducted for publications published 2006 or later that examined turnover or turnover intention in employee populations of registered or practical/enrolled or assistant nurses working in the hospital, long-term or community care areas. Literature findings are presented using an integrative approach and a table format to report individual studies.
From about 330 citations or abstracts that were initially scanned for content relevance, 68 studies were included in this summary review. The predominance of studies continues to focus on determinants of nurse turnover in acute care settings. Recent studies offer insight into generational factors that should be considered in strategies to promote stable staffing in healthcare organizations.
Nursing turnover continues to present serious challenges at all levels of health care. Longitudinal research is needed to produce new evidence of the relationships between nurse turnover and related costs, and the impact on patients and the health care team.
Abstract
Although health professional educational programs have been successful in equipping graduates with skills, knowledge and professionalism, the emphasis on specialization and ...profession-specific education has enhanced the development of a uniprofessional identity, which has been found to be a major barrier to interprofessional collaborative person-centred practice (IPCPCP). Changes within healthcare professional education programs are necessary to enable a shift in direction toward interprofessional socialization (IPS) to promote IPCPCP. Currently, there is a paucity of conceptual frameworks to guide IPS. In this article, we present a framework designed to help illuminate an IPS process, which may inform efforts by educators and curriculum developers to facilitate the development of health professions students' dual identity, that is, an interprofessional identity in addition to their existing professional identity, as a first step toward IPCPCP. This framework integrates concepts derived from social identity theory and intergroup contact theory into a dual identity model of IPS.
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