Exploring the Moderating Effect of a Caring Work Environment on the Relationship Between Workplace Mistreatment and Nurses' Ability to Provide Patient Care

Abstract

<p>Workplace mistreatment (bullying, horizontal violence, and incivility) has been shown to impact nurses’ work satisfaction, job turnover, and physical and mental health. However, there are limited studies that examine its effect on patient outcomes. A correlational descriptive study of 79 acute care nurses was used to test a social justice model for examining the relationship between workplace mistreatment, quantified as threats to dimensions of nurses’ well-being (health, personal security, reasoning, respect, attachment, and self-determination), and nurses’ ability to provide quality patient care. In addition, this study considered the moderating effect of caring work environment among co-workers on nurses’ ability to provide quality patient care in the face of workplace mistreatment. Stories of workplace mistreatment were collected anonymously and analyzed for alignment with threats to six dimensions of well-being. Ability to provide<br />patient care was measured using the Healthcare Productivity Survey and a caring work environment was measured via the Culture of Companionate Love scale.<br /><br />The results demonstrated that threats to all six dimensions of well-being described by Powers and Faden (2006) were expressed in nurses’ stories of workplace mistreatment. Furthermore, 87% reported a decrease in ability to provide patient care after an incident of workplace mistreatment. Yet frequency of threatened dimensions did not have a significant relationship with ability to provide patient care. Moreover, there was a significant moderator effect of the caring work environment on the relationship<br />between number of threatened dimensions of well-being and ability to provide quality patient care. Nurses in high caring environments loss less ability to provide care than nurses in low caring environments when one to three dimensions of well-being were threatened. However, this relationship reversed when four or more dimensions were threatened. Implications include further research on the relationship between workplace<br />mistreatment and nurse well-being and changing practice to include fostering a caring work environment in healthcare facilities.</p>