Nurses--Job satisfaction.

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
patient care was measured using the Healthcare Productivity Survey and a caring work
environment was measured via the Culture of Companionate Love scale. 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
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
mistreatment and nurse well-being and changing practice to include fostering a caring
work environment in healthcare facilities.

Creating a safety culture is the focus in the current healthcare environment. An inhouse,
around-the-clock laborist service delivery model has been associated with positive
outcomes, but little is known about the laborist structure’s contribution to the labor-anddelivery
working environment. The purpose of this descriptive correlational study was to
explore the effects of physician service delivery model on safety culture, nurse-physician
collaboration, and nurses’ job satisfaction. An additional purpose was to examine
associations between nurses’ perceptions of safety culture, nurse-physician collaboration,
and job satisfaction. Ray’s (1981, 1989) Theory of Bureaucratic Caring and Homan’s
(1974) Social Exchange Theory guided this study. A survey consisting of demographic
questions, the Collaborative Practice Scale (Weiss & Davis, 1985), the Hospital Survey
on Patient Safety Culture (Agency for Healthcare Research and Quality, 2015;
HSOPSC), and the McCloskey and Mueller Satisfaction Scale (McCloskey & Mueller,
1990) was distributed to registered nurses (RNs) nationwide. The results indicated that nurses in facilities using the around-the-clock model had higher perceptions of nursephysician
collaboration, but not of safety culture or job satisfaction in relation to the
physician service-delivery model. Significant moderate-to-strong correlations between
nurses’ perceptions of patient safety and job satisfaction, and a weak correlation between
bedside nurses’ perceptions of nurse-physician collaboration and job satisfaction were
demonstrated. Additional significant correlations were found between the instrument
subscales. Control/responsibility in the MMSS scale was positively associated with both
management support for patient safety, supervisors’ and managers’ expectations and
actions promoting patient safety, and overall perceptions of safety in the HSOPSC scale.
Praise and recognition in the MMSS scale were positively associated with
supervisor/manager expectations and actions promoting patient safety in the HSOPSC
scale.
Further appraisal is needed to understand the mechanism by which the laborist
model affects patient care and work environment. Recommendations for future research
include replicating the study with a larger sample sizes in specific groups based on the
role and scheduled shift, conducting the study in a single system or location to mitigate
the effects of other variables; and exploring physicians’ perspectives on the variables
being studied.