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We embed a field experiment in a nationwide recruitment drive for a new health care position in Zambia to test whether career benefits attract talent at the expense of prosocial motivation. In line with common wisdom, offering career opportunities attracts less prosocial applicants. However, the trade-off exists only at low levels of talent; the marginal applicants in treatment are more talented and equally prosocial. These are hired, and perform better at every step of the causal chain: they provide more inputs, increase facility utilization, and improve health outcomes including a 25 percent decrease in child malnutrition.

Purpose This study aims to investigate to role of empowering leadership and psychological empowerment on nurses' work engagement and affective commitment. Design/methodology/approach Self-administered questionnaire data from 231 nurses working in a university hospital in Saudi Arabia were analysed using a cross-sectional research design using structural equation modelling (SEM) to assess the relationship between empowering leadership (EL), affective commitment (AC) and work engagement (WE) while testing for the mediating role of psychological empowerment (PE). Findings SEM analysis demonstrated that EL significantly relates to AC. AC similarly significantly relates to WE. Further, the results showed that PE substantially mediates the relationship between EL and WE. There is no significant direct relationship found between EL and WE. Practical implications The study findings are essential for nursing managers. They illustrate that nurses become more committed to their organisation and, in return, more engaged with their work when they receive EL. Therefore, nursing managers could train their leaders to practice EL as increased WE has been found to result in other positive work attitudes such as reduced turnover intention. Originality/value This study corroborates the relationships between EL, AC and WE, as well as the mediating role of PE. However, this research is unique as the long-established relationship between EL and WE was not supported. It shows that the propositions of leader-member exchange theory may not hold for unique non-Western contexts, in this case, Saudi Arabia.

PurposeThe complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities perspective, this study investigates the effects of nurses' implicit voice theories (IVTs) on the behaviors that influence their individual agility.Design/methodology/approachThis research uses quantitative survey data collected from 2,552 Canadian nurses during the fourth wave of the Covid-19 pandemic in the fall of 2021. Structural equation modeling is used to test a conceptual model that hypothesizes the effects of three different IVTs on nurses' creativity, spontaneity, agility and the quality of care they deliver to patients.FindingsThe results reveal that voice-inhibiting cognitions (like “suggestions are criticisms for higher-ups”, “I first need a solution or solid data”, and “speaking up has negative repercussions”) negatively impact nurses' creativity and spontaneity in crafting solutions to problems they face daily. In turn, this affects nurses' individual agility as they attempt to adapt to changing circumstances and, ultimately, the quality of care they provide to their patients.Practical implicationsEven if organizations have little control over employees' pre-held beliefs regarding voice, they can still reverse them by developing and nurturing a voice-welcoming culture to boost their workers' agility.Originality/valueThis study combines two theoretical frameworks, voice theory and dynamic capabilities theory, to study how individual-level factors (cognitions and behaviors) contribute to nurses' individual agility and the quality of care they provide to their patients. It answers the recent calls of scholars to study the mechanisms through which healthcare operations can develop and sustain dynamic capabilities, such as agility, and better face the “new normal”.

This paper aims to examine the effect of motivation, commitment, and satisfaction on nurse loyalty at Islamic Hospitals. The sampling technique uses a purposive method, where the requirement to be a sample is a nurse who has worked for one year. Based on this technique, a sample of 69 nurses was obtained with a response rate of 92%. Data were analyzed using structural equation modeling with a partial least square approach, by two separate but sequentially related stages (outer and inner model). The results showed that extrinsic motivation can affect employee commitment and job satisfaction. Intrinsic Motivation can affect job satisfaction but does not affect employee commitment. Extrinsic and intrinsic motivation cannot directly influence nurse loyalty, nor can it be mediated by nurse commitment or job satisfaction. Nurses will be loyal to the hospital if intrinsic and extrinsic motivation is mediated by employee commitment and job satisfaction respectively.

PurposeThe purpose of this paper is to study the effect of two positive organizational factors: the perceived supervisor support (PSS) and the self-efficacy (SE) on nurses' burnout (BO), which concurrently affect the turnover intention (TI) and the mediating role of BO in this relationship.Design/methodology/approachA cross-sectional survey-based study of a sample of 552 Lebanese registered nurses from 19 Lebanese hospitals was conducted.FindingsThe authors’ findings confirm that PSS and SE both reduce the level of BO and the turnover intention significantly. The higher the perceived supervisors' support and the nurses' SE, the less they experience BO. BO has partially mediated the relationship of the PSS and SE on TI. This study reveals that supervisors' support is well perceived by Lebanese nurses, whose s is relatively high, while their levels of BO are considered moderate. However, BO levels vary proportionally with demographic variables, namely age, work experience, gender, marital status and education.Originality/valueThis study provides new evidence on the relationship between PSS, SE and BO and turnover intention of Lebanese nurses. It is unique in studying the role of nurses' SE with regard to BO and TI and improving the quality of nurses' work life. It shows the significance of the supervisors' role in supporting the psychological state of nurses. The context of the study, Lebanon, is also novel as it differs from advanced economies institutionally, culturally and in legal frameworks that govern the employee–supervisor relationships.

PurposeThe study aims to look into the mechanism by which perceived human resource management (HRM) practices impact nurses' engagement, by specifically looking into the role of psychological availability and psychological safety.Design/methodology/approachA cross-sectional questionnaire survey was conducted among nurses (n = 465). Data were collected from nurses of National Accreditation Board for Hospitals and Healthcare Providers (NABH) accredited hospitals by employing two stage sampling.FindingsResults indicate significant positive association between HRM practices and employee engagement. Role of psychological safety and psychological availability as mediators was also confirmed. The study supported the proposition that HRM practices affected employee engagement through psychological safety and then psychological availability thus approving serial mediation.Originality/valueThis research also contributes to a more comprehensive understanding of the ways to achieve employees' psychological safety, availability, and thus nurse engagement.

During the 2000s, over a dozen U.S. states passed laws that prohibit healthcare employers from mandating overtime for nurses. Using a nationwide panel data set from 2004 to 2012, we find that these mandatory overtime laws reduced the service quality of nursing homes, as measured by an increase in deficiency citations. This outcome can be explained by two undesirable changes in the staffing hours of registered nurses : decreased hours of permanent nurses and increased hours of contract nurses per resident day. We observe that the increase in deficiency citations concentrates in the domains of administration and quality of care rather than quality of life, and the severity levels of the increased citations tend to be minor rather than major. We also find that the laws’ negative effect on quality is more severe in nursing homes with higher percentages of Medicare-covered residents. These observations are consistent with the predictions of a stochastic staffing model that incorporates demand uncertainty and operational flexibility. Furthermore, we rule out an alternative hypothesis that the quality decline is induced by an increase in nurse wages. This paper was accepted by Gad Allon, operations management .