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

## TL;DR

This study identifies organisational factors contributing to workplace adversity among critical care nurses in ICUs, emphasizing staff shortages and poor leadership.

## Contribution

The paper provides novel quantitative insights into organisational factors linked to workplace adversity in critical care nursing.

## Key findings

- Staff shortages and poor nurse-to-patient ratios are major contributors to workplace adversity.
- Leadership style and access to professional development significantly impact nurse well-being.
- Addressing these factors is crucial for maintaining effective ICU environments.

## Abstract

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.

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.

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.

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.

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.

Direct line managers working in ICUs should proactively identify and address the organisational factors that contribute to workplace adversity in their respective units.

What is known about the topic
○Recent qualitative studies directly address workplace adversity as a construct, exploring factors such as resilience, stress and burnout as causes.
What this paper adds
○Few quantitative studies have addressed the concept of organisational factors associated with workplace adversity among critical care nurses.○Additionally, this study provided unique insights specifically into demographic variables and variances among hospital groups.

What is known about the topic
○Recent qualitative studies directly address workplace adversity as a construct, exploring factors such as resilience, stress and burnout as causes.

Recent qualitative studies directly address workplace adversity as a construct, exploring factors such as resilience, stress and burnout as causes.

What this paper adds
○Few quantitative studies have addressed the concept of organisational factors associated with workplace adversity among critical care nurses.○Additionally, this study provided unique insights specifically into demographic variables and variances among hospital groups.

Few quantitative studies have addressed the concept of organisational factors associated with workplace adversity among critical care nurses.

Additionally, this study provided unique insights specifically into demographic variables and variances among hospital groups.