Work engagement supports nurse workforce stability and quality of care: Nursing team-level analysis in psychiatric hospitals

Burnout and work engagement are two sides of one coin, two opposite poles related not only to how workers personally experience their jobs but also to how they experience their jobs within the context of work teams/groups. Engaged workers have a lot of energy, are very enthusiastic about their jobs and are absorbed by their work. Nurses' job performance in hospitals, including psychiatric hospitals, is dependent upon their relationships with physicians and other healthcare workers and their superiors, how they are involved in the decisions about their work and whether or not they are provided with the right resources and adequate support. When nursing teams are able to perform well, nurses tend to be more engaged and satisfied with their jobs and are more willing to stay in their positions. Engaged nursing teams report better quality of patient care in psychiatric hospitals. Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n=357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care.