McMahon, Katharine, I/O psychology M.S., Portland State University; Yang, Liu-Qin, I/O Psychology Ph.D., Portland State University

This present study focuses on daily occurrences of coworker-initiated incivility in nursing and attempts to identify the immediate progression of consequences. Past studies focused on the level of affect as opposed to the change, or shift, in affect. This study enables an understanding of the dynamic affect regulation following exposure to incivility, as well as the implications of such regulation for downstream well-being and performance.

H1: On days on which nurses experience incivility from coworkers during the first half of their shift, incivility will be related to PA downshift-NA upshift.

H2a: Experiencing PA downshift-NA upshift will be related to higher levels of procrastination later in the work shift.

H2b: Experiencing PA downshift-NA upshift will be related to higher levels of blood pressure later in the work shift compared to the same-day baseline.

H3a: On days on which nurses experience coworker incivility during the first half of their shift, PA downshift-NA upshift will mediate the relationship between incivility and procrastination

H3b: On days on which nurses experience coworker incivility during the first half of their shift, PA downshift-NA upshift will mediate the relationship between incivility and blood pressure

In the high-risk industry of healthcare, 85% of nurses reported experiencing incivility in the last year, with 37% admitting that they had instigated it (Lewis & Malecha, 2011). The apprehensive and chaotic situations paired with the tense environment generates precarious characteristics that prime strained, agitated, and emotionally charged interactions. Unfortunately, nurses expect workplace aggression and consider it to be the norm. This normalization builds upon the already problematic inconspicuousness of incivility. Even this lowest form of aggression still results in negative consequences for the target individual and others (Schilpzand et al., 2016), and therefore warrants theoretical understanding of its insidious process. Besides shedding new light on the immediate progression of consequences of daily incivility incidents, this study makes a new contribution to the affective shift literature by identifying a potential antecedent of an upshift in positive affect and downshift in negative affect that was alluded to but not yet tested by Yang and colleagues’ (2016) affective shift model. Lastly, the inclusion of procrastination and blood pressure (2 new outcomes) extends the nomological network of incivility.

This study was conducted pre-COVID within a healthcare system in the Boston area using convenience sampling. The final sample consisted of 20 nurses who were asked to complete daily diaries three times a day for six work shifts in two consecutive work weeks after completing a baseline survey at least two weeks prior. We received a total number of 102 observations with valid data. Each observation theoretically comprised of three time points from the same work shift; nurses completed Time 1 surveys immediately after getting to work (T1), Time 2 surveys approximately halfway through their shift (T2), and Time 3 surveys at the end of their shift (T3). All focal survey measures were previously validated scales and nurses recorded their own blood pressure at each time point using work equipment. Analyses were conducted with multilevel modeling in Mplus 7.2 by using linear models (LMM) with fixed effect components.

Results showed a significant relationship between coworker incivility and this particular affective shift, B =.03, SE =.01, p < .02, which supported Hypothesis 1. Results indicated a nonsignificant relationship between affective shift and procrastination, B = .01, SE = .13, ns., which failed to support Hypothesis 2a. Interestingly, PA upshift-NA upshift , showed a significant relationship with procrastination, B = .21, SE = .06, p < .001. Furthermore, results showed a significant, positive relationship between affective shift and blood pressure, B = .53, SE = .25, p = .03. Hypothesis 3 was not supported.

Results suggested that incivility experienced during the first half of a nurse’s shift predicted PA downshift-NA upshift and that shift predicted elevated blood pressure. This agrees with past literature, for example, ESM designs have produced results with higher levels of negative affect following incivility (Park et al., 2018; Sakurai, 2011; Zhou et al., 2015). This study builds upon the research by also including positive affect, something addressed less often but still has theoretical support (Cortina et al., 2001). Furthermore, this study expands upon previous research by establishing the actual shift of affective states rather than the levels. This provides insight to the personality systems interaction theory and the affective shift model that argues for the dynamic component of emotions as pivotal in the influence for cognitive and motivational processes such as attention and goal orientation (Kuhl et al., 2000; Yang et al., 2016). Limitations include small sample size, range restriction of some variables, single source self report measures, and sensitivity of blood pressure.

Results from this study suggested that incivility and affective shift may predict systolic blood pressure level but not procrastination. Furthermore, incivility’s association with blood pressure was not mediated through affective shift, suggesting that incivility and affective shift have distinct, separate roles in physiological reactions. Future research could build upon this model to examine contingency factors, such as social support, which may increase the capacity to self-regulate and buffer the connection between incivility and its consequences. Future research could also explore alternative mediation mechanisms to explain the connection between incivility and its outcomes.

Tags: Applied research, Empirical study, Health care and social assistance, Practitioner report or field study, Psychological and Biological Effects of Job Stress, Theoretical and Conceptual Issues in Job Stress, Workplace Mistreatment and Threats, Workplace Mistreatment; Threats; and Violence, Workplace Stress; Outcomes; and Recovery