Workplace Adversity Among Critical Care Nurses: Associations With Key Organisational Factors

BACKGROUND: Workplace adversity in intensive care units (ICUs) is a multifaceted phenomenon resulting from a combination of organisational, discipline-specific and external influences. Guided by the Job Demands-Resources (JD-R) model, this study explored the organisational factors associated with workplace adversity among critical care nurses in ICUs. Currently, there is a paucity of research that explicitly analyses workplace adversity as a central concept. AIM: To determine organisational factors associated with workplace adversity from the perspective of critical care nurses working in adult, paediatric and neonatal ICUs in public and private hospitals in the Eastern Cape Province, South Africa. STUDY DESIGN: The study employed a quantitative, cross-sectional correlational survey design. The target population consisted of critical care nurses. A census sampling method was employed, and data were collected using a structured self-report questionnaire. Descriptive and inferential statistics were used to conduct the data analyses using Statistica Version 13.5. RESULTS: Three hundred and fifty-three (353) questionnaires were completed. Respondents highlighted the following organisational factors as the primary contributors to workplace adversity: 90% (n = 312) staff shortages, 70% (n = 243) insufficient nurse-to-critically ill patient ratios, 57% (n = 197) limited access to professional development and 50% (n = 171) unsuitable leadership style of direct line managers. CONCLUSIONS: Unaddressed organisational factors causing workplace adversity have the potential to destabilise ICU environments, undermine staff well-being, patient care and overall healthcare system performance. Identifying and mitigating these factors is, therefore, essential to sustaining effective and resilient ICU settings. RELEVANCE TO CLINICAL PRACTICE: Direct line managers working in ICUs should proactively identify and address the organisational factors that contribute to workplace adversity in their respective units.