Stretch service goals strive to motivate healthcare practitioners to maintain high quality in service provision. However, little is known about how stretch service goals trigger nurses’ unethical behavior.
Research aim
This study aimed to investigate the influence of stretch service goals on nurses’ unethical behavior, as well as the mediating effects of patient entitlement and nurses’ emotional dissonance.
Research design
A quantitative cross-sectional study is designed.
Participants and research context
We sourced data by conducting a time-lagged three-wave survey study from March to September 2020. Random sampling was used, and data were collected from 422 nurse-patient pairs in Chinese hospitals. Bootstrapping method and structural equation modeling were employed to verify the conceptual model.
Ethical considerations
The study was approved by the designated authority within hospitals and ethical committees.
Results
Stretch service goals are not directly related to nurses’ unethical behavior. Stretch service goals can trigger nurses’ unethical behavior via patient entitlement. Patient entitlement and nurses’ emotional dissonance play a chain-mediating role between stretch service goals and nurses’ unethical behavior.
Conclusions
In the context of the healthcare industry, nurses may engage in unethical behavior due to the pressure of achieving stretch service goals. This study contributes to opening the “black box” of stretch service goals and nurses’ unethical behavior by exploring the chain-mediating effect of patient entitlement and nurses’ emotional dissonance.
QiLCaiDLiuB, et al.Effect of workplace ostracism on emotional exhaustion and unethical behaviour among Chinese nurses: a time-lagged three-wave survey. J Adv Nurs2020; 76(8): 2094–2103. DOI: 10.1111/jan.14405.
HuangFFYangQZhangJ, et al.Cross-cultural validation of the moral sensitivity questionnaire-revised Chinese version. Nurs Ethics2016; 23(7): 784–793.
4.
ChoeKKimSLeeC, et al.Effect of ethics seminar on moral sensitivity and ethical behavior of clinical nurses. Int J Environ Res Public Health2021; 18(1): 241. DOI: 10.3390/ijerph18010241.
5.
YasirMJanA. Servant leadership in relation to organizational justice and workplace deviance in public hospitals. Leadersh Health Serv2022. DOI: 10.1108/LHS-05-2022-0050.
6.
YangJSHaoDJ. Dilemmas for nurses in China. Lancet2018; 392(10141): 30. DOI: 10.1016/S0140-6736(18)31185-1.
7.
ChenCZhangZJiaM. Stretch goals and unethical behavior: role of ambivalent identification and competitive psychological climate. Manag Decis2021; 59(8): 2005–2023. DOI: 10.1108/MD-04-2019-0433.
8.
ZhangZJiaM. How can companies decrease the disruptive effects of stretch goals? The moderating role of interpersonal-and informational-justice climates. Hum Relat2013; 66(7): 993–1020. DOI: 10.1177/00187267134836.
9.
KraaijJVLallemanPWalravensA, et al.Differentiated nursing practice as a catalyst for transformations in nursing: a multiphase qualitative interview study. J Adv Nurs2022; 78(1): 165–175. DOI: 10.1111/jan.15001.
10.
HobfollSE. Conservation of resources: a new attempt at conceptualizing stress. Am Psychol1989; 44(3): 513–524. DOI: 10.1037/0003-066x.44.3.513.
11.
ZhangCMayerDMHwangE. More is less: learning but not relaxing buffers deviance under job stressors. J Appl Psychol2018; 103(2): 123–136. DOI: 10.1037/apl0000264.
12.
ZhangYAnYWangL, et al.Psychosocial factors associated with career success among nurses: a latent profile analysis. J Adv Nurs2023; 79(2): 652–663. DOI: 10.1111/jan.15524.
13.
Linder-PelzS. Social psychological determinants of patient satisfaction: a test of five hypotheses. Soc Sci Med1982; 16(5): 583–589. DOI: 10.1016/0277-9536(82)90312-4.
14.
MaBLiXZhangL. The effects of loyalty programs in services - a double-edged sword?J Serv Mark2017; 31(5): 464–477. DOI: 10.1108/JSM-06-2016-0227.
15.
MelanconJPGardnerMJDalakasV. The era of consumer entitlement: investigating entitlement after a perceived brand failure. J Consum Mark2021;38(7):780–790. DOI: 10.1108/JCM-09-2020-4138.
16.
HoytCLPriceTLEmrickAE. Leadership and the more-important-than-average effect: overestimation of group goals and the justification of unethical behavior. Leadersh2010;6(4):391–407. DOI: 10.1177/1742715010379309.
17.
QureshiSMPurdyNMohaniA, et al.Predicting the effect of nurse-patient ratio on nurse workload and care quality using discrete event simulation. J Nurs Manag2019; 27(5): 971–980. DOI: 10.1111/jonm.12757.
18.
KarimiLLeggatSGDonohueL, et al.Emotional rescue: the role of emotional intelligence and emotional labour on well-being and job-stress among community nurses. J Adv Nurs2014; 70(1): 176–186. DOI: 10.1111/jan.12185.
19.
AfsarBCheemaSMasoodM. The role of emotional dissonance and emotional intelligence on job-stress, burnout and well-being among nurses. Int J Inf Syst Change Manag2017; 9(2): 87–105. DOI: 10.1504/IJISCM.2017.10008755.
20.
GouLMaSWangG, et al.Relationship between workplace ostracism and turnover intention among nurses: the sequential mediating effects of emotional labor and nurse-patient relationship. Psychol Health Med2022; 27(7): 1596–1601. DOI: 10.1080/13548506.2021.1905859.
21.
MadupalliRKPoddarA. Problematic customers and customer service employee retaliation. J Serv Mark2014; 28(3): 244–255. DOI: 10.1108/JSM-02-2013-0040.
22.
CaiJQinZWangH, et al.Trajectories of the current situation and characteristics of workplace violence among nurses: A nine-year follow-up study. BMC Health Serv. Res2021; 21: 1–9. DOI: 10.1186/s12913-021-07245-y.
23.
KaracaADurnaZ. Patient satisfaction with the quality of nursing care. Nurs Open2019; 6(2): 535–545. DOI: 10.1002/nop2.237.
24.
CropanzanoRMitchellMS. Social exchange theory: An interdisciplinary review. J Manage2005; 31(6): 874–900. DOI: 10.1177/0149206305279602.
25.
WetzelHAHammerschmidtMZablahAR. Gratitude versus entitlement: a dual process model of the profitability implications of customer prioritization. J Mark2014; 78(2): 1–19. DOI: 10.1509/jm.12.0167.
26.
AndelaMTruchotDVan der DoefM. Job stressors and burnout in hospitals: the mediating role of emotional dissonance. Int J Stress Manage2016; 23(3): 298–317. DOI: 10.1037/str0000013.
27.
XanthopoulouDBakkerABFischbachA. Work engagement among employees facing emotional demands. J Pers Psychol2013; 12(2): 74–84. DOI: 10.1027/1866-5888/a000085.
28.
KorschunDBhattacharyaCBSwainSD. Corporate social responsibility, customer orientation, and the job performance of frontline employees. J Mark2014; 78(3): 20–37. DOI: 10.1509/jm.11.0245.
29.
CampbellWKBonacciAMSheltonJ, et al.Psychological entitlement: interpersonal consequences and validation of a self-report measure. J Pers Assess2004; 83(1): 29–45. DOI: 10.1207/S15327752JPA8301_04.
30.
GrandeyAFooSCGrothM, et al.Free to be you and me: a climate of authenticity alleviates burnout from emotional labor. J Occup Health Psychol2012; 17(1): 1–14. DOI: 10.1037/a0025102.
31.
AndelaMTruchotDMargotVDD. Job stressors and burnout in hospitals: the mediating role of emotional dissonance. Int J Stress Manag2016; 22(3): 298–317. DOI: 10.1037/str0000013.
32.
JiangYFengTHuangY. Antecedent configurations toward supply chain resilience: the joint impact of supply chain integration and big data analytics capability. J Oper Manag2024; 70(2): 257–284. DOI: 10.1002/joom.1282.
33.
LiYWuDWangA, et al.Unveiling the antecedent configurations of cerebral infarction recurrence using qualitative comparative analysis. J Neurorestoratology2024; 12(1): 100091. DOI: 10.1016/j.jnrt.2023.100091.
