The Value of Relationships at Work: Examining Nurses' Workplace Social Capital in Hospital Settings

Purpose: The purpose of this study was to examine the role of nurses’ workplace social capital by testing a hypothesized model linking nurses’ perceptions of authentic leadership and structural empowerment to their workplace social capital, and the subsequent effects on team effectiveness and patient care quality.

Methods:  A cross-sectional study was conducted using the tailored design method (Dillman, Smyth, & Christian, 2009). A sample of 1000 Registered Nurses working in hospitals across Ontario, Canada were invited to participate in the study (July-Sept 2015). A total of 249 useable surveys were returned, while 16 were returned undeliverable (26.83% response rate, excluding undelivered surveys). Of these, 33 were missing data for some variables in the model and were excluded from further analysis (final n = 214). Valid and reliable questionnaires were used to assess each of the main study variables. Descriptive statistics were conducted using SPSS (IBM, 2014, version 23.0). The hypothesized model between study variables was assessed using structural equation modeling in Mplus (Muthén & Muthén, 2012).

Results:  Participants (n = 214) were mostly female (94.2%), 47.3 years old (SD 11.4), with 22.8 (SD = 12.9) years of nursing experience. Most were working full time (70.1%) in medical-surgical (48.8%), critical care (36.9%), or maternal/child (10.7%) specialty areas. Results showed that the hypothesized model was an acceptable fit for the data: χ²(220) = 437.018, p = .000; CFI = .921; TLI = .910; RMSEA = .068 (.059-.077); SRMR = .076 but also suggested a significant direct path between social capital and quality of care, therefore this logical path was added to the model. The modified model showed a superior fit, supporting the importance of this additional relationship in the model: χ²(218) = 414.334, p = .000; CFI = .929; TLI = .917; RMSEA = .065 ; SRMR = .066. All hypothesized relationships were significant including the new path between social capital and quality of care (β = .35). Authentic leadership had a significant positive effect on structural empowerment (β = .49), structural empowerment had a significant positive effect on social capital (β = .46), social capital had a significant positive effect on team effectiveness (β = .28), and team effectiveness had a significant positive effect on quality of care (β = .22). Authentic leadership also had a significant indirect effect on social capital through its effect on structural empowerment (β =.27).

Conclusion: The findings supported the hypothesized model linking authentic leadership and empowering working conditions to nurses’ workplace social capital, which in turn had positive effects on both team effectiveness and patient care quality. Higher levels of team effectiveness were also positively related to patient care quality.  Results from this study improve our understanding of social capital in nurses’ work life and suggest that cultivating positive relationships at work is a good investment that creates value for patients and organizations. Authentic leadership development and structuring the work environment in ways that empower nurses to accomplish their work are strategies that managers and organizations can use to create conditions that facilitate social capital in the workplace.