Journal
INTERNATIONAL JOURNAL OF NURSING STUDIES
Volume 122, Issue -, Pages -Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.ijnurstu.2021.104032
Keywords
Nursing; Self-scheduling; Propensity score; Organizational justice; Leader-member exchange; Job satisfaction; Affective commitment; Empowered work environment
Categories
Funding
- Ghent University, Belgium
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Self-scheduling has a negative impact on organizational justice, leading to a decrease in procedural justice score and indirect negative effects on procedural justice through the mediator leader-member exchange. Furthermore, self-scheduling also has negative indirect effects on all investigated outcomes via the mediator leader-member exchange.
Background: Nurses have a very stressful and demanding job, which probably affects their health and well-being. This has resulted in a search for an optimal nurse schedule. Self-scheduling is one method to enhance flexibility and give more control to the employee. Literature on self-scheduling is scarce and mainly focused on the implementation process. So far, little is known about the long-term effects of self-scheduling. Objective: The comparison of effects of self-scheduling versus fixed scheduling on three dimensions of organizational justice (distributive, procedural, interactional justice) and three work attitudes (job sat-isfaction, affective commitment, global em powerment). This total effect is decom posed into direct and indirect effects via hypothesised mediators (leader-member exchange and organizational justice). Design: A cross-sectional multisite-matched study. Setting: A questionnaire was distributed to nurses and nurse assistants of twelve nursing homes in Flan-ders (Belgium). Six matched pairs of nursing homes were formed, each containing a nursing home that uses self-scheduling (for at least one year) and one that uses fixed scheduling. Participants: The study sample included 308 nurses and nurse assistants, of which 160 surveys were from nursing homes using fixed scheduling, versus 148 surveys from nursing homes using self-scheduling. Methods: Using a double robust fixed effects regression model adjusted for the propensity score, the total effect of self-scheduling compared to fixed scheduling was analysed on the proposed outcomes. Subse-quently, a (multiple) mediation analysis was performed. Results: If all people would have used self-scheduling instead of fixed scheduling, on average a significant decrease in the mean procedural justice score (estimated mean difference =-0.20, 95% CI-0.36 to -0.05) would be found. There is a significant negative direct effect (estimated mean difference =-0.12, 95% CI-0.21 to-0.03) and indirect effect via the mediator leader-member-exchange (estimated mean difference =-0.08, 95% CI-0.15 to-0.01) on procedural justice. In addition, significant negative indirect effects of self-scheduling were found via the mediator leader-member exchange on all the investigated outcomes. Conclusion: Drawing up the work schedule is perceived as less fair in the case of self-scheduling. Further-more, self-scheduling has a negative indirect effect on several work attitudes as a result of the changed relationship between the head nurse and the employees. The increase in task variety and decision-making autonomy for the employees and the altered leadership role of the head nurse can have a major impact on the dynamics of the entire team. (c) 2021 Elsevier Ltd. All rights reserved.
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