When Empowered Nurses are Under Stress: Understanding the Impact on Attitudes and Behaviors.

The present study examined the role of stress as a moderator on the indirect effect of structural empowerment, through psychological empowerment, on three important nurse-related outcomes: affective organizational commitment, nursing workarounds, and safety performance. The results demonstrated that structural empowerment and psychological empowerment were positively related to affective organizational commitment and safety performance, while neither were significantly related to nursing workarounds. Consistent with previous findings, structural empowerment was also positively correlated with psychological empowerment. Mediation models were predominantly supported, providing evidence for the expanded model of empowerment. Finally, all three moderated mediation models were significant, although the impact of stress on the nursing workaround process was contrary to what was proposed. Findings offer significant implications for both researchers and practitioners, particularly in relation to the importance of workplace empowerment, the role of stress, and the nature of the nursing workarounds construct.