Letter to the Editor: Expanding the Discourse on Decent and Precarious Work in Nursing

Abstract

In October 2024, Hult et al. published the article ‘Decent and Precarious Work Among Nursing and Care Workers: A Mixed-Method Systematic Review’ in Journal of Advanced Nursing. The article critically examines the impact of decent and precarious work on nursing outcomes. We acknowledge the value of their contributions and appreciate the authors' efforts in broadening our understanding of employment quality in healthcare. However, we believe that recent studies on related themes offer additional perspectives that may enhance the discourse initiated by Hult et al. Here, we draw on three of our previously published studies to extend their findings.

Our study, titled ‘Decent Work and Ethical Ideologies of Nurses: A Multicenter Cross-Sectional Study’, highlighted how decent work influences nurses' ethical ideologies, such as idealism and relativism (Zoromba et al. 2024). Similar to Hult et al.'s findings, we found that decent work fosters favourable workplace behaviours, particularly adherence to ethical standards. However, our study emphasises that key components such as organisational values and interpersonal safety are not only essential for well-being but also promote ethical ideologies. This underscores that fostering decent work conditions benefits both the emotional and ethical dimensions of healthcare work. Our second study, ‘How Decent Work Influences Internal Whistleblowing Intentions: The Mediating Roles of Felt Obligation and Organizational Identification’, examined how decent work promotes proactive behaviours like whistleblowing (El-Gazar and Zoromba 2024). While Hult et al. primarily focus on employee retention and well-being, our research suggests that decent work can also catalyse moral actions by strengthening organisational identification. Specifically, our findings demonstrate that felt obligation and identification mediate the relationship between decent work and whistleblowing intentions, providing a framework to explore other ethical behaviours cultivated by decent work conditions.

In ‘The Role of Psychological Ownership in Linking Decent Work to Nurses' Vigor at Work: A Two-Wave Study’, we explored how psychological ownership mediates the effect of decent work on vigour (El-Gazar et al. 2024). While Hult et al. emphasise the mental health benefits of decent work, we propose that vigour offers a complementary lens for understanding employee engagement. Our findings suggest that decent work not only reduces stress but also fosters an environment where nurses feel ownership of their roles, leading to sustained energy and job satisfaction. The nuanced inclusion of psychological ownership deepens the understanding of how decent work translates into high job performance (International Labour Organization, 2019).

While Hult et al.'s systematic review provides a comprehensive overview, highlighting the significance of sustainable employment policies in mitigating precarious work conditions, our findings highlight the need to explore additional dimensions, such as ethical ideologies, whistleblowing and psychological ownership, within the context of decent work. Our research suggests that the concept of decent work extends beyond job satisfaction to encompass critical moral and behavioural outcomes. This recent approach of nursing research stressing investing in leadership programs to foster organisational identification and ethical behaviours, including whistleblowing, encouraging psychological ownership through strategies that enhance nurses' autonomy and engagement. To further enrich this discourse, we recommend that future studies adopt longitudinal approaches, as employed in our two-wave design, to capture temporal changes in work conditions and behaviours. Additionally, interventions aimed at enhancing organisational values and psychological ownership could amplify the benefits of decent work.

Conclusion: We commend Hult et al. for their valuable contribution to nursing research. Our studies complement their findings by offering insights into the behavioural and psychological outcomes associated with decent work. We hope that our discussion encourages further research and informs practical interventions aimed at enhancing working conditions in healthcare.

M.A.Z. and H.E.E. planned the letter and made substantial contributions to conception and design. M.A.Z., S.A.A. and H.E.E. were major contributors in writing and drafting the manuscript. H.E.E. and M.A.Z. were major contributors in writing the letter. All authors given final approval of the version to be published and Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

The authors declare no conflicts of interest.

Data sharing is not applicable to this article, as no new data were created or analyzed in this study.