When empowered nurses are under stress: Understanding the impact on attitudes and behaviours

Abstract

The present study examined the role of stress as a moderator on the indirect effect of structural empowerment, through psychological empowerment, on three important nurse‐related outcomes: affective organizational commitment, nursing workarounds, and safety performance. The results demonstrated that structural empowerment and psychological empowerment were positively related to affective organizational commitment and safety performance, whereas neither were significantly related to nursing workarounds. Consistent with previous findings, structural empowerment was also positively correlated with psychological empowerment. Mediation models were predominantly supported, providing evidence for the expanded model of empowerment. Finally, all three moderated mediation models were significant, although the impact of stress on the nursing workaround process was contrary to what was proposed. Findings offer significant implications for both researchers and practitioners, particularly in relation to the importance of workplace empowerment, the role of stress, and the nature of the nursing workarounds construct.

Workplace bullying, psychological hardiness, and accidents and injuries in nursing: A moderated mediation model

“…Fevre and colleagues reported that approximately half of the participants in the United Kingdom experienced some forms of unreasonable treatment at work and 40% reported workplace disrespect to be the most common phenomenon [2]. Other studies showed that health sector employees are one of the most vulnerable population to expose to psychosocial risk at work [3]. As previously reported, 65% of nursing professionals in the USA observed lateral violence among co-workers [4].…”

A Systematic Review of Nursing Practice Workarounds

“…Nursing practice workarounds were recognized as common in nursing practice in 8 of 13 studies (62%) 19-21,23,26-29 . A few examples of strategies to decrease/prevent NPWs included new ways to record medical information using software not paper, electronic systems for drug prescription, and pumps that deliver precise medication.…”

“…Investigation of medication administration workarounds was the purpose of four of 13 (30%) studies 17,20,23,28 ; while the purpose of the remaining 3 of 13 (23%) studies 18,21,29 examined the influence of stress and professionalism on NPW. Six (46%) studies were qualitative, 21,22,24-26,28 five (38%) quantitative, 17-19,23,29 and two (15%) had a mixed methods designs 20,27 . Overall, all 13 (100%) studies used a diverse group of measures to examine the phenomenon 17-29 …”

A study of Indiana University Health's spirit of inquiry and innovation during COVID

“…PPE limitations forced the nurses to create workarounds that reflected their ingenuity but also created frustration and stress. This finding is substantiated in a survey of 153 American nurses, which revealed workarounds were highly correlated with nurse stress (r=.70, p < .001) (Heron & Bruk-Lee, 2020). Identifying workarounds can help uncover limitations in available technologies, typical care delivery processes, and physical environments (Litwack, 2018;van der Veen et al, 2020;Yoder-Wise, 2015) but need to be replaced with viable and sustainable innovative solutions (Litwack, 2018).…”