Building empowering work environments that foster civility and organizational trust: testing an intervention.

BACKGROUND: Creating supportive and empowering workplace conditions is important, not only because these conditions are related to improved nurse health and well-being but also because they are important for retaining top performing nurses. The current nursing shortage emphasizes the need to create such conditions. OBJECTIVES: The aim of this study was to examine the impact of a workplace intervention (Civility, Respect, and Engagement in the Workplace [CREW]) on nurses' empowerment, experiences of supervisor and coworker incivility, and trust in nursing management. METHODS: Registered nurses (Time 1, n = 755; Time 2, n = 573) working in 41 units across five hospitals in two provinces completed measures of workplace empowerment, supervisor and coworker incivility, and trust in management before and after a 6-month intervention. Eight units participated in the intervention, and 33 units were control groups. Multilevel modeling was used to test the impact of the intervention. RESULTS: A significant interaction of time by intervention was found for the access to support and resources empowerment structures, total empowerment, supervisor incivility, and trust in management. DISCUSSION: Compared with the control group, nurses who experienced the intervention program reported significant improvements in empowerment, supervisor incivility, and trust in management. Despite methodological challenges experienced in this study, the CREW process appears to be a promising intervention approach to enhance quality of nursing work environments, which may contribute to the retention of the nursing workforce.

Time to Disentangle the Information and Communication Technology (ICT) Constructs: Developing a Taxonomy around ICT Use for Occupational Health Research.

The use of information and communication technology (ICT) in the workplace has gained considerable research attention in the occupational health field due to its effects on employee stress and well-being. Consequently, new ICT-related constructs have proliferated in occupational health research, resulting in a need to take stock of both potential redundancies and deficiencies in the current measures. This paper disentangles ICT-related constructs, developing a taxonomy of ICT-related constructs in terms of ICT demands, resources, motivation, use, and strains. We then integrate this taxonomy with stress and motivation theories to identify three key implications for ICT and workplace health research and practices in terms of providing suggestions on understudied areas for building better theories, highlighting important psychometric issues for building better constructs and measures, and offering recommendations for building better interventions. This review aims to serve as a guide for researchers to move forward with the current state of research and provide recommendations for organizations in terms of both potential repercussions and best practices for ICT use in the workplace.

When respect deteriorates: incivility as a moderator of the stressor-strain relationship among hospital workers.

AIM: To test whether incivility at work exacerbates the relationship between stressors and strain for hospital workers. BACKGROUND: A climate of incivility and disrespect among colleagues was expected to heighten the impact of work stressors on the mental and physical health of care providers. METHODS: Members of 17 care-providing units from five hospital systems in Canada completed surveys, before and after a civility intervention (eight intervention vs. nine comparison units). Analyses tested whether (1) incivility moderated the stressor-strain relationship at baseline (n=478), and (2) the stressor-strain relationship decreased for the intervention units relative to comparison units 6 months later (n=361). RESULTS: (1) Pre-intervention, individuals reporting more incivility on their unit showed a stronger stressor-strain relationship. (2) The negative relationship between work overload and mental health was mitigated among intervention group staff 6 months after the introduction of a colleague-based civility programme. CONCLUSIONS: Besides being a stressor itself, incivility exacerbates the relationship between existing job role stressors and strain among health care workers. IMPLICATIONS FOR NURSING MANAGEMENT: Colleague civility and respect have an important ripple effect of buffering inevitable work stressors, helping health care providers respond to stress with greater health and resiliency.

Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes.

AIM: The aim of this study was to examine the influence of empowering work conditions and workplace incivility on nurses' experiences of burnout and important nurse retention factors identified in the literature. BACKGROUND: A major cause of turnover among nurses is related to unsatisfying workplaces. Recently, there have been numerous anecdotal reports of uncivil behaviour in health care settings. METHOD: We examined the impact of workplace empowerment, supervisor and coworker incivility, and burnout on three employee retention outcomes: job satisfaction, organizational commitment, and turnover intentions in a sample of 612 Canadian staff nurses. RESULTS: Hierarchical multiple linear regression analyses revealed that empowerment, workplace incivility, and burnout explained significant variance in all three retention factors: job satisfaction (R(2) = 0.46), organizational commitment (R(2) = 0.29) and turnover intentions (R(2) = 0.28). Empowerment, supervisor incivility, and cynicism most strongly predicted job dissatisfaction and low commitment (P < 0.001), whereas emotional exhaustion, cynicism, and supervisor incivility most strongly predicted turnover intentions. CONCLUSIONS: In our study, nurses' perceptions of empowerment, supervisor incivility, and cynicism were strongly related to job satisfaction, organizational commitment, and turnover intentions. IMPLICATIONS FOR NURSING MANAGEMENT: Managerial strategies that empower nurses for professional practice may be helpful in preventing workplace incivility, and ultimately, burnout.

Third-party attitudes and strain reactions to the threat of a labor strike.

The authors examined how dispute-related stressors predicted strain experienced by third parties (N = 270) and their perceptions of a potential strike by part-time faculty. Immediately preceding a strike deadline, the authors surveyed students on their support for the union, perceived fairness, perceived effects of the impending strike, and perceived control. The authors also measured perceptions regarding information about the strike and psychological strain. Students facing increased disruptions because of the potential strike had decreased perceived control over their own tasks and over the university policies, and they experienced higher strain. Having more information about the dispute was associated with increased perceived task and policy control but was unassociated with strain. Both task and policy control moderated the relationship between disruptions and strain.

Gender, mood state, and justice preference: do mood states moderate gender-based norms of justice?

The present study extends research on distributive justice by investigating whether a person's mood state moderates the robust effects of gender norms on allocation decisions. One hundred and eighty undergraduates (90 men: 90 women) were asked to undergo a mood induction procedure in which they were randomly assigned to a positive, negative, or neutral mood condition, and to work on a task with either a male or female co-worker (confederate). This resulted in a 2 (gender of participant) x 2 (gender of confederate) x 3 (positive vs. neutral vs. negative mood) between-subjects factorial design. Following completion of the task, participants were informed that they did 60% of the work and their co-worker did 40%. They were then asked to divide money between themselves and their co-worker in a way that they considered fair. The analysis revealed a three-way interaction in participants self-payment whereby men in a negative mood, working with other men took more pay for themselves than did participants in all other conditions. Specifically, 60% of the participants in this condition, allocated the payment either equitably or in a manner suggesting even greater self-interest. These results support the view that gender effects are strongly influenced by the presence of other relevant contextual cues.

Examining Type A behavior pattern to explain the relationship between job stressors and psychosocial outcomes.

Despite cautions against using a global measure of Type A behavior pattern (TABP), few studies have examined the TABP components of Achievement Striving (AS) and Impatience/Irritability (II). The authors examined these 2 components to assess whether they moderated the relationships between job stressors and psychosocial outcomes. Results based on 106 employees from a large Canadian organization supported the independence of the 2 TABP components. After controlling for the job stressors (i.e., overload, ambiguity, intrarole conflict, and lack of job control), II and AS accounted for additional variance in job satisfaction, perceived stress, and life satisfaction, although these components were uniquely related to different outcomes. Finally, AS and II moderated several of the stressor-psychosocial outcome relationships.

Perceived information and communication technology (ICT) demands on employee outcomes: the moderating effect of organizational ICT support.

Although many employees are using more information communication technology (ICT) as part of their jobs, few studies have examined the impact of ICT on their well-being, and there is a lack of validated measures designed to assess the ICT factors that may impact employee well-being. Therefore, we developed and validated a measure of ICT demands and supports. Using Exploratory Structural Equation Modeling, we found support for 8 ICT demands (i.e., availability, communication, ICT control, ICT hassles, employee monitoring, learning, response expectations, and workload) and two facets of ICT support (personal assistance and resources/upgrades support). Jointly, the ICT demands were associated with increased strain, stress, and burnout and were still associated with stress and strain after controlling for demographics, job variables, and job demands. The two types of ICT support were associated with lower stress, strain, and burnout. Resources/upgrades support moderated the relationship between learning expectations and most strain outcomes and between ICT hassles and strain. Personal assistance support moderated the relationship between ICT hassles and strain.

Getting better and staying better: assessing civility, incivility, distress, and job attitudes one year after a civility intervention.

Health care providers (n = 1,957) in Canada participated in a project to assess an intervention to enhance workplace civility. They completed surveys before the intervention, immediately after the intervention, and one year later. Results highlighted three patterns of change over the three assessments. These data were contrasted with data from control groups, which remained constant over the study period. For workplace civility, experienced supervisor incivility, and distress, the pattern followed an Augmentation Model for the intervention groups, in which improvements continued after the end of the intervention. For work attitudes, the pattern followed a Steady State Model for the intervention group, in that they sustained their gains during intervention but did not continue to improve. For absences, the pattern reflected a Lost Momentum Model in that the gains from preintervention to postintervention were lost, as absences returned to the preintervention level at follow-up. The results are discussed in reference to conceptual and applied issues in workplace civility.

Bringing the troops back home: Modeling the postdeployment reintegration experience.

Using a sample of Canadian Forces personnel (N = 490) returning from deployment in Afghanistan, we tested a model of reintegration experiences, with a focus on affective organizational commitment, support factors, posttraumatic stress symptoms, changes in alcohol use, and turnover intentions. The model provided an excellent fit to the data, although homecoming experiences were not associated with commitment as predicted. No differences emerged between novice (single tour) and experienced (multiple tours) personnel, although the number of tours was associated with increased affective commitment as expected.

The impact of civility interventions on employee social behavior, distress, and attitudes.

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.

Occupational injuries and stressors among Canadian air medical health care professionals in rotor-wing programs.

INTRODUCTION: Air medical health care providers work in a unique environment that may affect occupational injury rates and patterns. Despite this knowledge, little high-quality evidence exists regarding occupational injuries specifically incurred by air medical health care professionals. We sought to characterize the epidemiology of occupational injuries experienced by Canadian rotor-wing health care providers. METHODS: A survey was sent to the 4 rotor-wing programs in Canada. All crewmembers participating directly in patient care were asked to complete the survey detailing any acute occupational injuries sustained within the previous year. A series of both open- and closed-ended questions was used to collect participant demographics and information regarding any injuries sustained. RESULTS: One hundred and six (40.6%) participants completed the survey. Three hundred and thirty acute injuries were reported. Hand lacerations and leg contusions were most prevalent (31 and 24 individuals incurred these injuries, respectively). Acute back injuries were also prevalent with 25 (23.6%) participants reporting at least one back injury. Overall, an injury rate of 3.2 injuries per person per year was reported. Lifting was cited as a common factor in injury (30 cases). Most injuries required little treatment, with only 17 needing physician intervention, and only 6 required more than 1 week off work. CONCLUSION: Injuries among Canadian air medical crews are common, but fortunately, the majority are minor. Specific injury prevention strategies may focus on stretcher design, cabin ergonomics, and extremity protective equipment.