exploring the relationships of perceived workplace ... · and critical care nurses in community ......
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Item type Presentation
Format Text-based Document
Title Exploring the Relationships of Perceived WorkplaceIncivility, Stress and Burnout on Nurses' TurnoverIntentions, Turnover Rate and Perceived Level ofPsychological Empowerment Through the Lens ofComplexity Science
Authors Oyeleye, Olubunmi O.
Downloaded 26-Jun-2018 21:54:54
Link to item http://hdl.handle.net/10755/291022
Exploring the relationships of perceived workplace incivility, stress and burnout on nurses’ turnover intentions, turnover rates and perceived level of psychological empowerment among medical surgical and critical care nurses in community and tertiary hospitals through the lens of complexity science
BUNMI OYELEYE, DNP, RN, NEA-BC Sigma Theta Tau International Conference
Indianapolis, IN April 14, 2013
PURPOSE OF STUDY
• Explore the relationships of workplace incivility, stress
and burnout on nurses’ intent to leave their jobs, turnover rates and level of nurses’ psychological empowerment among critical care and medical surgical nurses in the community and tertiary hospitals through the lens of complexity science
BACKGROUND
Workplace Incivility “low intensity deviant behavior” (Andersson and
Pearson,1991) Persistent demeaning and downgrading of
individuals (Stagg, 2010) Organizations’ cultural norms for tolerance: dance
of civility/incivility Numerous interchangeable terms such as violence,
bullying, hostility, verbal abuse, workplace victimization etc, have been used
Estimated financial costs of workplace violence is $4.2 billion/year
Litmus test for managers
BACKGROUND
Workplace Stress
“a nonspecific response of the body to any demand, whether it is caused by, or results in, pleasant or unpleasant conditions”…(Seyle, 1982)
Sources of stress in nursing: heavy workload, physical work environment, inadequate staffing, death and dying situations, conflicts with coworkers
Effects of stress: behavioral, physical and financial impact
BACKGROUND
Burnout Syndrome of emotional exhaustion, depersonalization
and lack of personal accomplishment (Maslach & Jackson, 1981)
Prolonged stress results in burnout
Effects of burnout: behavioral, physical and financial impact
BACKGROUND
Empowerment
Two complementary perspectives:
- Structural
-Psychological
Structured workplace environment enable employees to feel empowered thereby employees respond and rise to the challenges present in their organization
Employees with sufficient empowerment are able to fulfill the tasks the organization is asking of them, problem solve and engage in innovation practices
THEORETICAL BACKGROUND
Complexity Science: Systems thinking
Ability to see, integrate, and appreciate the emerging view of unity and wholeness, reciprocity, interdependence and co creation within the web of life
Concept of non- locality demonstrates that once a quantum entity such as an electron comes in contact with another, the entities retain a connection even when separated by time and space
Traditional science defines relationship by geographic proximity.
THEORETICAL BACKGROUND
Example: a nurse’s negative attitude on a new graduate nurse even if the new graduate nurse is removed from the negativity.
Nurses as scientists and artists Nurses as complex adaptive beings Understanding of healthcare as a complex adaptive
system Complex adaptive system - missed/avoided opportunities maladaptive modes that increase “dance of incivility” -seized opportunities adaptive modes which increase “dance of civility”
CONCEPTUAL FRAMEWORK
Modified Framework (Clark & Springer 2012; Nadeau & Kafatos 2002; Cortina et al, 2001)
PROPOSED CONCEPTUAL FRAMEWORK
QUESTIONS
Are there differences between medical surgical and critical care nurses’ perceived workplace incivility, stress levels, burnout, intent to leave, turnover rates and levels of psychological empowerment?
Are there relationships among perceived workplace incivility, stress levels, burnout rates, intent to leave, turnover rates and levels of psychological empowerment in medical-surgical nurses in community and tertiary hospitals?
Are there relationships among perceived workplace incivility, stress levels, burnout rates, intent to leave, turnover rates and levels of psychological empowerment among critical care nurses in community and tertiary hospitals?
METHODS
Exploratory, correlational and non experimental quantitative study
Target population: medical surgical and critical care nurses in the 200 beds and 248 beds community hospitals and 697 beds tertiary hospital
Convenience sampling method with 400 surveys
Five survey instruments used (as mentioned in Fig. II)
IRB approved
Table I: t-test Differences between medical-surgical and critical care nurses on study variables Group/ Variable n Mean SD t-test df Significance (2-tailed) Stress MS 36 21.31 3.76 CC 25 21.76 3.85 -.459 59 .648 Burnout MS 30 62.1 13.3 CC 24 66.79 9.69 -1.458 52 .151 Incivility MS 36 39.72 12.34 CC 25 41.44 12.06 -.539 59 .592 Turnover Intention MS 36 4.44 2.82 CC 25 5.48 2.99 -1.376 59 .174 Empowerment MS 36 73.72 13.98 CC 25 77.28 12.73 -1.014 59 .315
RN
Education
Levels
Total
Workplace
Incivility
Total Turnover
Intention
Total
Psychological
Empowerment
Total Stress
Total Burnout
Total Years of
Nursing
RN Education
Levels
(N=61)
1 .089 .089 .026 .138 .283* -.005
Total Workplace
Incivility
(N=61)
1 .496** -.015 .432** .377** .339**
Total Turnover
Intention
(N=61)
1 -.166 .201 .374** .255*
Total Psychological
Empowerment
(N=61)
1 .074 -.042 .002
Total Stress (N=61)
1 .503** .246
Total Burnout
(N=54)
1 .274*
Total Years of
Nursing
(N=61)
1
** Correlation is significant at the 0.01 level (2 tailed) *Correlation is significant at the 0.05 level (2 tailed)
DISCUSSION
Stress and burnout were related to workplace incivility
Factors related to turnover intentions included incivility and burnout
Workplace incivility correlated with stress, burnout, turnover intentions and total years of nursing
RN education levels correlated with burnout
Total years of nursing correlated with incivility, burnout and turnover intentions
From a theoretical perspective, nurses reported moderate levels of psychological empowerment, however it was not found to be associated with any of the study variables
Turnover rates data was not available
NURSING IMPLICATIONS
Nursing leadership interventions with regards to zero tolerance policy, code of professionalism
Managers’ fluency in identifying factors that predispose environment to “dance of incivility”
Leadership creating open communication environment: transparency
Nursing Administrators as advocates for healthy workforce…access to gyms, structured relaxation techniques, wellness programs, supportive social network environment, appropriate healthy food choices
Nurse leaders must develop greater self awareness which will increase their ability to manage and respond to staff’s needs
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