Do perceived high performance work systems influence the relationship between emotional labour, burnout and intention to leave? A study of Australian nurses.

AIMS: The purpose of this article was to explore the relationships between perceived high performance work systems, emotional labour, burnout and intention to leave among nurses in Australia. BACKGROUND: Previous studies show that emotional labour and burnout are associated with an increase in intention to leave of nurses. There is evidence that high performance work systems are in association with a decrease in turnover. There are no previous studies that examine the relationship between high performance work systems and emotional labour. DESIGN: A cross-sectional, correlational survey. METHODS: The study was conducted in Australia in 2008 with 183 nurses. Three hypotheses were tested with validated measures of emotional labour, burnout, intention to leave, and perceived high performance work systems. Principal component analysis was used to examine the structure of the measures. The mediation hypothesis was tested using Baron and Kenny's procedure and the moderation hypothesis was tested using hierarchical regression and the product-term. RESULTS: Emotional labour is positively associated with both burnout and intention to leave. Burnout mediates the relationship between emotional labour and intention to leave. Perceived high performance work systems negatively moderates the relationship between emotional labour and burnout. Perceived high performance work systems not only reduces the strength of the negative effect of emotional labour on burnout but also has a unique negative effect on intention to leave. CONCLUSION: Ensuring effective human resource management practice through the implementation of high performance work systems may reduce the burnout associated with emotional labour. This may assist healthcare organizations to reduce nurse turnover.

Nurse perceptions of the quality of patient care: Confirming the importance of empowerment and job satisfaction.

AIM: This aim of this study was to investigate the interactive effects of psychological empowerment and job satisfaction on the relationship between high-performance work systems (HPWS) and nurses' perceptions of the quality of patient care they provide. BACKGROUND: Studies of high-performing organizations in a variety of industries have consistently reported a positive relationship between HPWS and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved patient outcomes have been reported in international health care studies. METHOD: We used regression analysis with tests of mediation and moderation to analyze survey responses collected in March 2008 of 201 nurses in a large regional Australian health service. FINDINGS: Psychological empowerment fully mediated the relationship between HPWS and perceptions of quality of patient care. Job satisfaction moderated the relationship between HPWS and perceptions of quality of patient care. CONCLUSION: Hospital managers should focus on promoting HPWS and ensuring that nurse unit managers have the competencies to empower and to enhance the job satisfaction of their staff.

The effects of burnout and supervisory social support on the relationship between work-family conflict and intention to leave: a study of Australian cancer workers.

PURPOSE: The aim of this paper is to examine the effects of burnout and supervisory social support on the relationship between work-family conflict, and intention to leave of cancer workers in an Australian health care setting. DESIGN/METHODOLOGY/APPROACH: Data collected from a public hospital of 114 cancer workers were used to test a model of the consequences of work-family conflict. The strength of the indirect effects of work-family conflict on intention to leave via burnout will depend on supervisor support was tested by conducting a moderated mediation analysis. FINDINGS: Path analytic tests of moderated mediation supported the hypothesis that burnout mediates the relationship between work-family conflict (i.e., work-in-family conflict and family-in-work) and intention to leave the organisation and that the mediation framework is stronger in the presence of higher social supervisory support. Implications are drawn for theory, research and practice. ORIGINALITY/VALUE: This study applies the innovative statistical technique of moderated mediation analysis to demonstrate that burnout mediates the relationship between work-family conflict and intention to leave the organisation and that the mediation framework is stronger in the presence of lower social supervisory support. In the context of the continued shortage of many clinician groups theses results shed further light on the appropriate course of action for hospital management.