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Workplace safety culture is pivotal in healthcare settings, known to enhance nurses' effectiveness and productivity. Yet, the specific pathways through which safety culture influences these outcomes, especially in relation to compassion fatigue, are not fully understood.
This study investigated the mediating role of compassion fatigue in the relationship between workplace safety culture, career satisfaction, and turnover intention among nurses.
A cross-sectional survey was conducted with 269 nurses from various acute healthcare facilities in Eastern Visayas, Philippines. Three standardized scales were used to collect the data. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).
Workplace safety culture was negatively associated with compassion fatigue (β = −0.2604, p = 0.0012) and turnover intention (β = −0.2778, p = 0.0048) and positively associated with career satisfaction (β = 0.3986, p = 0.0001). Compassion fatigue partially mediated the relationship between workplace safety culture and career satisfaction (β = 0.0645, 95% CI [0.0213, 0.1215]) and the relationship between workplace safety culture and intention to stay (β = −0.0756, 95% CI [−0.1398, −0.0263]).
A positive workplace safety culture was associated with a lower compassion fatigue, which in turn enhanced career satisfaction and lower turnover intention among nurses. Healthcare organizations and policymakers should prioritize strategies that enhance safety culture and provide support for nurses to manage compassion fatigue effectively, ultimately leading to better patient care and a more stable nursing workforce.
Compassion competence among nurses is crucial for patient safety and the quality of nursing care, yet the mechanisms linking these factors remain unclear, indicating a significant gap in current understanding.
This study aimed to explore the mediating role of adherence to safety standards in the relationship between nurse compassion competence and patient safety incidents.
A cross-sectional study was conducted among 455 nurses across 3 hospitals in Visayas, Philippines. Participants completed self-report measures assessing compassion competence, adherence to safety standards, and perceived patient safety incidents. Data were analyzed using SPSS Hayes Macro Model 4 to examine direct and indirect effects.
Higher levels of compassion competence in nurses were positively associated with increased adherence to safety standards (β = 0.3438, p = 0.0019) and fewer patient safety incidents (β = −0.2586, p = 0.0001). Adherence to safety standards was found to partially mediate the relationship between compassion competence and patient safety incidents (β = 0.0451, 95% CI [0.0106, 0.0862]).
Fostering compassion competence in nurses can enhance adherence to safety standards, ultimately leading to a reduction in patient safety incidents in healthcare environments. The findings underscore the critical role of compassion competence not just as a desirable nursing trait but as a strategic lever for improving patient safety. Healthcare organizations should implement structured professional development programs that cultivate empathy, emotional intelligence, and effective communication—core elements of compassion competence. Nursing leadership must also embed compassion-driven practices into patient safety protocols, promote a culture of accountability and empathy, and support interdisciplinary collaboration to ensure consistent adherence to safety standards and minimize preventable harm.
Nurses face heightened risks of developing posttraumatic stress disorder (PTSD) due to occupational stressors, with prevalence rates significantly higher than the general population before and during the COVID-19 pandemic. Although PTSD symptoms are known to impair various domains of functioning, research examining which specific PTSD symptom clusters most strongly impact nurses' functioning remains limited.
This study examines how individual PTSD symptom clusters relate to overall functioning and distracted practice, a measure of workplace functioning, in nurses with probable PTSD.
We examined relationships between PTSD symptoms and functioning among 420 U.S. nurses recruited through social media platforms in late 2021. Participants completed validated measures assessing PTSD symptom clusters (PTSD Checklist for DSM-5), anxiety (Generalized Anxiety Disorder Scale), depression (Patient Health Questionnaire), general psychosocial functioning (The Brief Inventory of Psychosocial Functioning), and a proxy measure for workplace functioning (Distracted Practice Scale), with hierarchical regression analyses used to evaluate the unique contributions of PTSD symptom clusters to functional outcomes while controlling for demographic, workplace, and mental health variables.
PTSD symptom clusters accounted for significant additional variance in both general functional impairment (9.5%) and occupational impairment (9.3%), beyond demographic, workplace, and other mental health variables. For general psychosocial impairment, PTSD cluster D, negative alterations in cognition and mood, and cluster E, arousal symptoms, were the most impactful, whereas PTSD cluster B, reexperiencing, and cluster D were most strongly associated with workplace functional impairments. Final models revealed that education level predicted general psychosocial impairment while years of nursing experience predicted impairments in workplace functioning.
Nurses with PTSD during the COVID-19 pandemic faced significant impairments in overall and work functioning. Our findings highlight that PTSD symptoms vary in how they impact functioning. Symptom clusters such as negative mood, arousal, and reexperiencing were linked to worsened functioning. Tailored support programs should address specific PTSD symptoms.
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