A stable registered nurse (RN) workforce, job satisfaction of RNs and the quality of nursing work environments play an important role in securing high-quality patient outcomes. Empirical evidence suggests that workplace incivility [WPI] (overt and covert disrespect and rudeness) from colleagues and coworkers contribute to job dissatisfaction for RNs. However, there is a paucity of research examining RNs’ experiences with WPI and turnover intention.
Finding novel ways to improve RN job satisfaction and reduce RN turnover and intent to leave their jobs is critical to ensure high-quality care for patients in the U.S. The purpose of this integrative review was to summarize the current literature examining relationships between WPI and turnover intention in RNs in acute care settings.
Methods:
Several combination search terms related to WPI, nursing work environment, and turnover intention were used to search six electronic databases. The sample included eight quantitative and two qualitative studies. Inclusion criteria were primary research studies, in English, published between 2000 and 2018, on studies that correlated RNs experiences with WPI and turnover intention in acute care settings. Exclusion criteria included unpublished manuscripts, studies about WPI in non-nursing populations and, studies conducted in non-acute care settings. Studies were critically appraised, and data were extracted based on study design, purpose, setting, sample, instruments, method of data collection, statistical analysis and major findings.
Results:
Empirical evidence suggests that WPI exist among RNs in acute care settings. Quantitative studies revealed statistically significant relationships between WPI and turnover intention in RNs in acute care settings at either the p=.01 or p=.05 level. One study revealed associations with WPI and specific physical symptoms in RNs who work in acute care settings including angina, weight loss, and fatigue; and psychological symptoms including fear, nervousness, depression, sadness, anxiety, and mistrust. Additional consequences of RNs experiences with WPI included poor morale, decreased productivity and increased errors.
Conclusion:
The findings from this study suggest that WPI is a significant determinant of turnover intention in RNs in acute care settings both in the U.S. and internationally, but our confidence is limited by exclusive reliance on self-reported data, cross-sectional designs and inconsistent definition and measurements of WPI. Further research is needed in this area of inquiry to inform evidence-based interventions to improve nursing work environments and decrease turnover intention in RNs in acute care settings.