Latent profile analysis of the nursing work environment and their association with second victim experiences among nurses: a multicentre study in China

Abstract Background Nurses involved in adverse events can become “second victims”, but little is known about how the broader nursing work environment is configured and how those configurations relate to second-victim experiences. This study aimed to identify latent profiles of the nursing work environment among Chinese clinical nurses and to examine how profile membership was associated with second-victim distress, perceived support, turnover intention, and absenteeism. Methods Between June and September 2025, 3,309 clinical nurses from 20 tertiary hospitals across three regions in China (Chongqing, Guizhou, and Hong Kong) completed an online survey comprising the Second Victim Experience and Support Tool (SVEST) and the Nursing Work Environment Scale. Latent profile analysis was used to identify distinct subgroups, and multinomial logistic regression was performed to examine factors associated with profile membership. Results Three latent profiles were identified: Moderately Resourced (74.7%), Support-Deprived (9.4%), and Optimally Supported (15.9%). Relative to the Support-Deprived profile, supervisor support showed the strongest association with Optimally Supported membership (OR = 0.14), followed by institutional (OR = 0.19) and colleague support (OR = 0.50). The Support-Deprived group had the highest rate of adverse event exposure yet the lowest perceived support, whereas psychological distress did not differ across profiles. The three-profile structure was largely consistent across regions, with only a small difference in the prevalence of the Support-Deprived profile (highest in Hong Kong, 11.4%). Two hypothesis-generating concepts—permissive absence and structural–relational asymmetry—are proposed for future testing. Conclusion The nursing work environment was significantly associated with second victim experiences. A small but clinically vulnerable Support-Deprived subgroup warrants proactive, organisation-level intervention, and context-tailored strategies should complement rather than replace system-wide efforts to improve the practice environment.