Exploring patient incivility impact on nurse retention: the mediating role of well-being

PURPOSE: Workplace incivility is a pervasive and costly feature in healthcare settings. This article focuses on incivility from patients towards nurses, for which research is still scarce. Based on the job demands-resources model, we analyse the combined effects of patient incivility and job autonomy on nurses' turnover intentions, through the mediating role of well-being. DESIGN/METHODOLOGY/APPROACH: Through an online questionnaire shared on social networks, a sample of 201 nurses working in Portugal was obtained. The hypotheses under study were tested using structural equations modelling with partial least squares. FINDINGS: Patient incivility is negatively related to nurses' well-being and retention. Multi-group analysis reveals that the relationship between patient incivility and turnover intention is significantly stronger for male nurses, suggesting that female nurses may be more prone to normalise patient incivility. Results also show a positive association between job autonomy and life satisfaction. Life satisfaction mediates the relationships between working conditions variables - patient incivility and job autonomy - and turnover intention. PRACTICAL IMPLICATIONS: This study highlights the importance of healthcare managers implementing preventive measures against this pervasive feature of nurses' work settings. ORIGINALITY/VALUE: The article adds to previous research by proposing a broad model to analyse the joint and separate effects of job demands and job resources on nurses' life satisfaction and turnover intention. Furthermore, results from this study highlight the relevance of an overall cognitive evaluation of well-being, which has not been as extensively researched as measures of physical and mental health.