Examining the relationships between the work environment and forms of workplace mistreatment perceived by nurse middle managers

Abstract

This study uses a cross-sectional correlational research design using a non-experimental causal technique to examine the direct relationships between (a) nurse middle manager (NMM) characteristics, (b) NMM relationships, and (c) NMM role functions and workplace mistreatment (WPM) variables. This study also examines the indirect relationships between organizational change and WPM variables through NMM relationships and NMM role functions. Additionally, this study observes the effects of the work environment variables on the WPM variables in a hypothesized model based on theoretical ordering. Antecedents of workplace incivility (WPI) and workplace bullying (WPB) in nursing work environments have not been extensively studied and how environmental factors are interrelated and the nature of the relationships these variables have with WPI and WPB remains unknown. Nurse middle managers have a unique perspective of business operations and the delivery of patient care, and this population offers insight into issues within the health care context and how forms of WPM manifests in the work environment. A total of 139 nurse middle managers (82 inpatient, 44 outpatient, and 13 other clinical areas) employed through 75 different organizations across 30 states were represented in this study. Across all settings, 97.8% of the participants reported experiencing a degree of incivility and 89.9% of the participants reported experiencing a degree of bullying. The results of hierarchical linear regressions analyses established that NMM work environment variables explained a significant amount of variance in the WPM variables and Model 2 for WPI and WPB were significant, R2 = 24.00%, F(7, 131) = 5.93, p < .001; R2 = 17.00%, F(7, 131) = 3.84, p = .001, respectively. A significant negative direct relationship was found between NMM-director relationships and adequate budgeted resources and WPI, β = -.30, p < .05; β = -.24, p < .05, respectively. A significant negative direct relationship was found between NMM-director relationships and WPB β = -.30, p < .05. The results indicate the importance of addressing work environment relationships with upline directors and ensuring adequate resources to offset or prevent perceptions of WPI and WPB among NMMs. These findings bare implications for future intervention studies to improve relationships between NMM and their upline directors and ensure adequate financial resources to prevent forms of WPM.