The impact of workplace violence on medical-surgical nurses’ health outcome: A moderated mediation model of work environment conditions and burnout using secondary data

Abstract

BackgroundWorkplace violence is a prevalent phenomenon in healthcare and nurses are particularly at risk from workplace violence due to the nature of their work or inadequacies within their work environments. Although workplace violence is known to have serious negative implications for nurses, patients and the larger healthcare system, the mechanism through which it functions is less clear. ObjectiveThe purpose of this study is to examine whether work environment conditions moderate the mediating effect that burnout has on the relationship between workplace violence and three health outcomes. DesignA secondary analysis of cross-sectional correlational survey data was conducted. SettingThe study took place in British Columbia, Canada. Participants537 medical-surgical nurses were included in the study. MethodsSurvey data were analyzed using moderated mediation regressions with the PROCESS macro on SPSS. ResultsBurnout mediated the relationship between workplace violence and health outcomes including musculoskeletal injuries, anxiety disorders and sleep disturbances. Work environment conditions moderated the direct relationship between workplace violence and burnout; and the indirect relationship between workplace violence and the three health outcomes. In healthier work environments, workplace violence was more strongly related to increased reports of burnout, musculoskeletal injuries, anxiety disorders and sleep disturbances compared to less healthy work environments. ConclusionNurses in healthier work environments may not expect workplace violence, and they may be at more burnout risk than nurses in less healthy environments who have normalized unsafe work conditions. Violence may be the new ‘reality shock’ for nurses.