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Journal of Research in Nursing logoLink to Journal of Research in Nursing
. 2025 Apr 9;30(4):306–323. doi: 10.1177/17449871241270773

The mediating role of job stress between organisational silence and social loafing in nurses

Aysun Türe 1, İrfan Akkoç 2, Korhan Arun 3,✉, Abdullah Çalışkan 4
PMCID: PMC11985482  PMID: 40224356

Abstract

Background:

Teamwork assumes that the healthcare system and patient care require the transpersonal care process between nurses, physicians and management, which is essential to healing. Hospital management has tried to improve charitable factors to deflect the silence among nurses and promote harmony among them. In addition, social loafing reduces harmony and teamwork, thus reducing patient and healthcare safety.

Aim:

This study aimed to research the effect of organisational silence on social loafing as mediated by job stress among hospital nurses.

Methods:

A cross-sectional survey was conducted with 328 nurses from a university health, practice and research hospital in Turkey. Structured questionnaires measured perceptions of organisational silence, social loafing and job stress. Path and regression analyses assessed relationships and mediation effects among the variables.

Results:

The study validated a model that links organisational silence, social loafing and job stress, demonstrating significant direct and indirect effects. It found that job stress is a mediator between organisational silence and social loafing, supporting the proposed hypotheses.

Impact:

To improve patient care safety, it’s important to reduce social loafing and address any defensive silence among nurses. This can be achieved through teamwork and support from hospital management and professionals.

Only hospital nurses were involved in this study.

Keywords: job stress; organisational silence (Acquiescent Silence, Defensive Silence, Prosocial Silence); social loafing

Introduction

Organisational silence is a prevalent but complex issue within the healthcare sector, particularly among nursing professionals. Despite its commonality, the outcomes of silence can have serious repercussions, affecting the individuals involved and the overall quality of patient care and team dynamics (De los Santos et al., 2020). This concept has been explored extensively in recent research (Cole et al., 2019; Mert et al., 2021; Yalçın and Baykal, 2019), highlighting its significance and the need for a deeper understanding of its implications.

Consequences of organisational silence can be a negative commitment to organisations, including not exerting considerable effort on behalf of the organisation (Vakola and Bouradas, 2005). This attitude can become a personal willingness not to help and not to put in personal effort, indicating a link between silence, thus reduced effort, and social loafing in organisational settings (Chen, 2022). Previous research has highlighted that organisational settings like nurse participation in hospital affairs, foundations for quality of care, manager skill at leadership, nurse–physician relationships and nurse staffing in influencing nurse outcomes are different in nursing environments (Hanrahan et al., 2010; Pittman et al., 2019). Additionally, research by Simonetti et al. (2019) and Almeida et al. (2020) has shown that organisational characteristics of the nursing workforce and practice environment are associated with patient outcomes. Consequently, it is crucial to study the consequences of organisational silence, like loafing, which is significant but different in healthcare from other organisational contexts.

Organisational silence negatively influences both employees and broader management and operational issues within healthcare (White et al., 2019). The reluctance of nurses to voice concerns about patient care, hospital management and other critical issues can be attributed to a culture of silence, which has long-term adverse effects (Heinzen and Goodfriend, 2019). This culture fosters an environment where silence is perceived as unfavourable, leading to a lack of engagement from team members and contributing to the proliferation of social loafing behaviours.

Social loafing

One of the critical manifestations of organisational silence is social loafing, a phenomenon where individuals withhold effort from team-based activities, believing their contributions are either unnecessary or will not be recognised. This behaviour, also known as loafing, has a detrimental impact on collective efforts, undermining the effectiveness of teamwork, which is essential in healthcare settings (Haslam, 2011). Social loafing varies under specific factors, notably among nurses who might feel overshadowed by medical doctors or more experienced colleagues, exacerbating silence in healthcare teams.

Nursing environments and job stress

The interplay between organisational silence, social loafing and job stress in nursing environments presents a complex challenge. Organisational environment factors significantly influence job stress, often resulting from perceived dysfunctional events or conditions at work (De los Santos et al., 2020). Organisational silence contributes to this stress, mainly due to fear or disengagement within the organisational setting (du Plessis and Blom, 2020). This situation underscores the need to address the root causes of silence and loafing behaviours to mitigate their impact on job stress among nurses.

Main contributions of the study

This study makes three primary contributions to the existing body of research. Firstly, it explores the antecedents of social loafing, which have been predominantly examined at the individual or group levels but not in the context of varying work environments, particularly those involving complex and challenging tasks in healthcare settings (Liden et al., 2004). Secondly, it establishes a link between organisational silence and weakening social bonds, thereby facilitating social loafing. Lastly, the study applies interdependence theory to examine the effects of nurses’ silence on the propensity of other team members to engage in loafing behaviours, offering new insights into the dynamics between silence, loafing and job stress within nursing environments.

Literature review

Hypothesis description

Employee silence is intentional, not as a cultural norm of speaking behaviour or not having any knowledge (Dyne et al., 2003), withholding any improving knowledge about work-related issues (Morrison and Milliken, 2000; Pinder and Harlos, 2001). In other words, organisational silence is a behavioural issue where members withhold their thoughts, expressions and suggestions that may enhance the organisational activities and process. There are three main perspectives on organisational silence in the literature: forms of silence, silence constructs and the outcomes of the silence (Brinsfield, 2014). This study focused on the outcomes of silence as social loafing and the mediating effects of job stress between organisational silence and loafing.

Fear and disengaged workplace behaviours are two primary forms of silence (Chou and Chang, 2020). When employees disengage, they are unwilling to get involved (Dyne et al., 2003). Brinsfield (2014) defined this kind of disengagement and lack of involvement at work as a form of silence. Fear of silence depends on not challenging authorities and people of higher status. Moreover, silence has three dimensions in organisations as a behaviour: acquiescent, defensive and prosocial. Acquiescent silence is a passive disengagement where individuals withhold their knowledge by resigning. Acquiescent silence occurs when employees withhold information because they are pretty sure their opinions will not be well-valued by supervisors (Hawass, 2016). In other words, acquiescent silence is employee silence, a form of consent that differs from silencing (Harlos, 2016). According to Knoll and Van Dick (2013), prosocial silence is favourably correlated with stress and negatively correlated with well-being. Because failing to speak up and observing others’ faults have disorienting repercussions. Defensive silence is based on fear of consequences or protection by not speaking (Schneider and Barbera, 2014). In contrast to fear and disengagement, prosocial silence is intentional and proactive behaviour of not talking based on consideration and awareness of other organisational members, like not complaining or tolerating some inconveniences (Dyne et al., 2003). However, this type of silence is due to the desire to preserve social capital, safeguard their social network and uphold a sense of organisational membership (Barry and Wilkinson, 2016). Prosocial silence can be understood as considering interpersonal interactions and showing concern for one’s co-workers. Therefore, it may have positive silence, at least in the short term, and has some negative consequences for organisational and individual well-being (Austin, 2009). Moreover, employees are proactive in defensive and prosocial silence but passive in acquiescent silence. In a nutshell, acquiescent silence is disengaged; defensive silence is self-protective and prosocial silence is other-oriented (Dyne et al., 2003; Milliken et al., 2003).

According to social impact theory, loafing can be felt among group members, and their contribution to group performance is not individually identifiable (Robbins, 1995). Akin to this theory, group members loaf when they perceive threatened assignments (Milinga et al., 2019). This can be the case for novice nurses working with more experienced nurses or doctors. However, the activation of loafing may not always be the output of the action of silent behaviour. Instead, it may depend on on-task behaviour or organisational silence culture (Pope, 2019). One of the main aspects of what is believed to be a social loafer is the perception of taking a free ride (Gabelica et al., 2019). These outcomes of silence differ from the categorial behaviour of loafing (Higgins, 2012). Point it differently, some forms of loafing may not be related to silence. However, the silence of the group members can be seen as loafers.

Organisational silence is individual dissent behaviour that does not engage with team goals (Yetim and Erigüç, 2018). In other words, silence prevents group members from engaging in the job (Knoll and Redman, 2016). The interdependence theory states that the power of the other healthcare provider in an interdependent situation is connected to the nurse’s dependence on a connection (Chadee, 2022; Rumble, 2022). Since each member depends on the other for healthcare results, this reliance means that silent members might affect how other nurses behave during interactions. Thus, silent members also can be seen as loafers, or they can affect non-loafers. According to the discussions above, even if not all loafing behaviours can be related to silence, the nature of the relationship between silence and its outcome increases loafing.

Donaghey et al. (2019) also noted the problematic nature of organisational silence in the hospital setting. Decentralisation and perceived environmental uncertainty can impact managerial variations in organisational structures (Hammad et al., 2013). For example, healthcare professionals may resist managerial prerogatives by seeking to subvert and ‘capture’ reform components, indicating potential differences in managerial dynamics (Waring, 2007).

Moreover, Sheikh et al. (2021) specifically investigated the correlation between job stress and job performance among nurses during the COVID-19 pandemic in 2021. Additionally, Raso et al. (2021) found that nurses working in COVID hospitals reported elevated stress levels, with a notable percentage considering leaving their positions or the profession. These studies collectively suggest that nurses may have faced heightened stress levels in 2021, particularly due to the challenges posed by the COVID-19 pandemic.

  • H1a-c: Acquiescent, Defensive and Prosocial Organisational silence dimensions increase Social Loafing significantly and positively.

Silence within an organisation can stem from two main sources: the organisation itself and its individuals. At the organisational level, leadership behaviours can create an atmosphere where employees feel discouraged from speaking up, or in some instances, like in hospitals, there might exist a bias towards protecting the institution’s interests over addressing issues that could jeopardise patient safety (Pope, 2019). On an individual level, employees harbouring negative feelings towards their colleagues or the organisation, or those concerned about their job security, are more prone to withhold information. Stress, for instance, can impair an employee’s ability to communicate silence with peers (Zak, 2017) effectively, a situation that becomes even more critical for those in roles demanding high levels of problem-solving (Günüşen et al., 2014; Scandura, 2018).

In hospitals or healthcare settings, organisational silence stands out from other organisational contexts due to the distinct characteristics of the healthcare field. Nurses often hesitate to address or challenge doctors and fellow nurses, whereas doctors seldom raise issues regarding nurses. Healthcare professionals pointed to a lack of confidence, worries about the repercussions of their engagement and the fear of backlash as reasons for their reluctance to address issues with colleagues (Henriksen and Dayton, 2006). Previous studies have highlighted that organisational silence in hospitals can lead to a lack of meaningful discussions about practices that ensure safe and high-quality care and moral dilemmas in healthcare settings and cause patient deaths due to medication errors in hospitals (Doo and Kim, 2020; Yalçın and Baykal, 2019). Moreover, hierarchical structures, divisions between managers and healthcare professionals, and communication challenges-in short organisational systems in hospitals can reinforce organisational silence (Li, et al., 2022; Milliken et al., 2003; Nam et al., 2014).

Moreover, workgroup identification and professional commitment can influence employee silence, with potential differences in the effects of individual-level antecedents (Tangirala and Ramanujam, 2008). Nurses’ attitudes towards work significantly correlate with their professional commitment (Ghonem and Abdrabou, 2021). Moreover, nurses’ professional commitment was significantly affected during the COVID-19 pandemic (Baka, 2015). Consequently, the change in commitment of the nurses will significantly affect the organisational silence.

Beer and Eisenstat (2000) observed that keeping employees silent can lead to increased stress and disengagement. A culture of organisational silence, marked by hesitancy to express concerns, difficulty in sharing negative feedback, and a general lack of open communication, contribute to job stress (Kumar et al., 2015). They further explain that defensive silence used as a shield against external threats, and prosocial silence, intended to safeguard the organisation or peers, can affect how individuals communicate and their stress levels. The phenomenon known as the Mum Effect, a type of self-preserving silence, can obstruct effective communication and decision-making in companies, potentially escalating stress among staff (Dyne et al., 2003; Perkins, 2014). Additionally, the impact of organisational silence on job stress remains consistent across both novice and veteran employees (Yum et al., 2024). Nevertheless, existing studies have not thoroughly explored how silence among nurses in healthcare settings directly leads to increased stress and disengagement, nor have they detailed how such environments promote silence.

  • H2: Organisational silence increases job stress significantly.

  • H2a-c: Acquiescent, Defensive and Prosocial silence dimensions increase job stress significantly.

Numerous studies have indicated that job stress can have both positive and negative consequences. However, it is observed that the negative factors associated with job stress have significant positive correlations, whereas the positive factors are negatively correlated with job stress. This means that job stress can lead to increased adverse outcomes and decreased positive occupational outcomes in healthcare organisations. For instance, healthcare workers who experience high levels of job stress are more likely to engage in presenteeism, characterised by being physically present but not fully committed to their work tasks. This can lead to social loafing tendencies, which may negatively impact the organisation’s overall performance. Furthermore, job stress can lead to various negative outcomes, such as indifference towards work, lack of interest and enthusiasm for the job and a general feeling of loafing more frequently among nurses. All these factors can significantly impact employee well-being, organisational culture and overall healthcare performance over time.

Literature supports that situational constraints may also affect social loafing behaviour (Varshney, 2019). Recent research found that in healthcare, workplace-related demands were associated with nearly three-fold increased odds for stress (Zhou et al., 2020). According to this research, it is evident that the organisational setting is far more critical in healthcare than individual factors. Consequently, the nursing profession and healthcare settings can cause three times more stress on nurses than individual factors, so it is important to analyse job stress among nurses. The main weakness of studying the direct impact of silence on the job stress approach is that it fails to examine the role that the management component in healthcare, except for inappropriate actions by individual managers, may play in creating silence (De los Santos et al., 2020; Donaghey et al., 2019). High workload and work-related stress, common stressors in healthcare environments, have increased the risk of negative consequences, including social loafing behaviour (Van Den Hombergh et al., 2009). Significantly, a perceived stressful job may increase loafing or variations (Kim and Lee, 2019; Zhu et al., 2019). In conclusion, the literature supports the notion that job stress can increase social loafing behaviour among healthcare workers, including nurses, by impacting their engagement, motivation and job performance.

  • H3: Job stress increases Social Loafing significantly.

The findings reveal that the detrimental effects of silence on job satisfaction can be significantly influenced by an employee’s level of vigour, particularly in those with a lower tendency towards positive affectivity (Hsieh and Huang, 2022). In addition, the study by Malik et al. (2021) delves into how the relationship between workplace psychological aggression, job stress and vigour unfolds over time, suggesting that job stress could mediate the relationship between psychological aggression and an employee’s vigour. This highlights the critical role of identifying and addressing workplace stressors to mitigate their impact on employee silence, which is closely linked to loafing. Mackey et al. (2017) further explored how stressors might indirectly influence employees’ personal and social outcomes. Yean et al. (2022) pinpointed organisational constraints, role overload and role ambiguity as key stressors that lead to job dissatisfaction and potentially encourage counterproductive behaviour at work. Lastly, it is hypothesised that job stress acts as a mediating factor between silence and loafing.

  • H4: Job stress mediates the relationship between silence and social loafing.

Acquiescent silence, a form of silence characterised by resignation rather than fear, has been a subject of interest in organisational behaviour studies. Cultural dimensions like collectivism have been linked to acquiescent silence, with findings indicating that collectivism serves as an antecedent of acquiescent silence.

Prosocial silence is a form of silence characterised by intentional and proactive behaviour primarily focused on benefiting others or the organisation. It differs from other forms of silence, such as acquiescent and defensive silence, in that it is accompanied by positive emotions and a cooperative motive (Knoll et al., 2021). Employees engaging in prosocial silence withhold work-related ideas, information, or opinions with the goal of benefiting others based on altruism or cooperative motives (Kızrak and Yeloğlu, 2024). However, prosocial silence may involve employees refraining from sharing certain information or opinions to protect or support their colleagues or the organisation (Howard and Holmes, 2019).

Studies in the realm of employee performance have indicated an adverse correlation between acquiescent silence, which is the tendency of employees to remain silent and compliant even in situations where they disagree with their superiors or peers, and their overall performance. Conversely, there is a favourable correlation between prosocial silence, which is the act of intentionally staying silent to avoid causing harm or negative consequences to others, and the performance of employees (Gençer et al., 2023).

Furthermore, in online communities, acquiescent silence and defensive silence have been found to negatively impact community operation performance, whereas prosocial silence has a positive effect (Pei et al., 2022).

Organisational silence is a complex phenomenon that can take different forms, such as acquiescent, defensive or prosocial silence, depending on the context. For example, studies have shown that the support for silence from supervisors plays a crucial role in how employees perceive and enact organisational silence behaviours. Specifically, when supervisors encourage or tolerate silence, it can negatively affect employees’ commitment to the organisation and willingness to speak up about important issues (Rayan et al., 2020). Moreover, a significant interaction between social context and baseline performance is related to employees’ cohesiveness and performance. Aiello and Kolb (1995b) found that low-baseline group members felt the effects of social context more than low-baseline aggregate members or participants who worked alone; however, high-baseline group members actually felt the effect of social context less than their high-baseline counterparts. This suggests that organisational factors like job stress can mediate how silence is perceived and practiced within an organisation (Rayan et al., 2020). Hypotheses are shown in the conceptual study model (Figure 1).

Figure 1.

Figure 1.

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Study concept model.

  • H4a-c: Job stress mediates the relationship between acquiescent, defensive, prosocial silence and social loafing.

Methods

Design

Cross-sectional research investigated the mediating role of job stress between organisational silence (acquiescent, defensive, prosocial silence) and social loafing.

Sampling and participants

The study’s target group consists of nurses employed at a university-affiliated health, practice and research hospital in Turkey, totalling 530. After discarding incomplete questionnaires, 328 were deemed valid for analysis. Based on Israel’s (2013) criteria, for a ±5% margin of error at a 95% confidence level and p = 0.5, a sample size of 240 (n = 240, 600 ⩽ N ⩽ 699, where N represents the population size and n the sample size) is required. Therefore, the participation of 328 individuals is adequate for further analyses assuming a normal distribution. Demographic details of the nurse participants include 71% being female (n = 233), 50% married (n = 164) and 54.3% holding a university degree (n = 178). The average age of participants is 30.96 years (SD = 5.77), with an average tenure of 7 years (SD = 5.02).

Scales

Organisational Silence Scale: Van Dyne et al., (2003) developed the organisational silence scale (i.e. ‘This employee withholds relevant information due to fear’, ‘This employee goes along and communicates support for the group, based on self-protection’, and ‘This employee withstands pressure from others to tell organisational secrets’). The scale consists of three dimensions and 15 expressions. Organisational silence consists of three sub-dimensions: acquiescent silence, defensive silence and prosocial silence. Each dimension contains five items. The scale obtained answers with a 5-point Likert scale (1 = Strongly disagree; 5 = Strongly agree). Van Dyne et al. (2003) did not report the instrument’s reliability. Turkish validation of the scale was done by Kahya (2013). As a result of the reliability analysis, the Cronbach’s alpha reliability coefficient of the scale is found to be acquiescent silence 0.88, defensive silence 0.88 and prosocial silence 0.80.

Job Stress Scale: The level of job stress was measured by seven items (i.e., ‘I feel fidgety or nervous because of my job’), which was developed by House and Rizzo (1972). The Cronbach’s alpha reliability coefficients ranged between 0.71 and 0.89. The scale obtained answers with a 5-point Likert scale (1 = Strongly disagree; 5 = Strongly agree). Turkish validation of the scale was done by Efeoğlu (2006). As a result of the reliability analysis, the Cronbach’s alpha reliability coefficient of the scale is found to be 0.84.

Social Loafing Scale: Developed by Mulvey and Klein in 1998, the Social Loafing Scale is a four-item tool to assess perceived employee loafing, featuring high internal consistency (Cronbach’s alpha of 0.89). It includes items such as ‘Considering their capabilities, the people I work with are doing their best for their jobs’. and ‘Employees in my workplace contribute less than I expect to work’. Turkish validation of the scale was done by Turunç (2015) and yielded an acceptable reliability (Cronbach’s alpha of 0.68).

The organisational silence, job stress and social loafing scales obtained answers with a 5-point Likert scale (1 = Strongly disagree; 5 = Strongly agree).

Data collection

A self-report survey questionnaire in Eskisehir City collected these cross-sectional data. Participants were registered nurses who had worked in a university hospital. Survey questionnaires were administered to 500 nurses with a convenience sampling method, and 328 valid questionnaires were used for data analysis, with a response rate of 65.6%. Nurses voluntarily participated in this study (between January and February 2021), and informed oral consent was given by all the participating nurses before completing the questionnaire.

Statistical analysis

The data analysis was carried out using SPSS, setting the statistical significance at a 95% confidence level. Initially, we evaluated how well the measurement model fit the data. This involved performing a confirmatory factor analysis to assess the structural validity of the research model, utilising the maximum likelihood estimation approach. We assessed the reliability of the scales through the Cronbach’s alpha reliability coefficient. Descriptive statistics were compiled to outline sociodemographic characteristics. The relationships between study variables were examined using Pearson correlation analyses. Following these initial steps, the mediation model was explored using IBM AMOS and the PROCESS macro for SPSS. The mediation model’s validity was tested through structural equation modelling and the bootstrap approach (model 4).

Ethical considerations

This research was conducted with the voluntary participation of hospital nurses, adhering to the guidelines and regulations set forth by the Scientific Research and Publication Ethics Committee of Toros University. The research protocol obtained approval from the committee with the assigned approval number 7 on 05 January 2021.

Results

Initially, the construct validity of our variables was assessed by testing the measurement model. This model comprises study variables, including scale items indicative of the pertinent latent constructs. It features three key variables: relationship-oriented leadership, encompassing ten statements; organisational citizenship behaviour, with nineteen statements and workplace flourishing, which includes eight statements. Confirmatory factor analysis (CFA) results indicate that the observed factor loadings are statistically significant, ranging from .66 to .87. The fit indices for the measurement model (χ²/SD = 2.91; p < 0.001; CFI = 0.90; TLI = 0.89; RMSEA = 0.076) suggest that it is appropriately suited to the data.

Table 1 presents the data on reliability, mean, standard deviation and correlation analysis results related to organisational silence, social loafing and job stress among nurses. The study’s research model highlighted significant connections among dependent, independent and mediator variables as shown in Table 1. Correlation analysis findings indicated positive correlations between the independent variable (organisational silence) and both the dependent variable (social loafing) and the mediator variable (job stress).

Table 1.

Reliability, mean, standard deviation and correlation values.

Variable dimensions M SD 1 2 3 4 5
1. Acquiescent silence 3.61 0.79 (0.95)
2. Defensive silence 3.63 0.82 0.46** (0.87)
3. Prosocial silence 3.70 0.94 0.47** 0.25** (0.81)
4. Social loafing 3.74 0.86 0.67** 0.25** 0.60** (0.77)
5. Job stress 3.73 0.88 0.61** 0.39** 0.53** 0.71** (0.83)
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Alpha reliability coefficients are shown in parentheses.

**

p < 0.01.

In this research phase, we employed the Bootstrap method as suggested by Hayes (2018) to evaluate the mediation effects. The model selected for our study is Model 4, which encompasses mediation relationships (Hayes, 2018). Within the framework of our study’s model, we utilise the bootstrap method for total, direct and indirect effects as developed by Hayes and Scharkow (2013), applying 5000 re-samples, a 95% symmetric confidence interval and a 95% confidence interval adjusted for skewness (Preacher and Hayes, 2008). This research leverages the bootstrap approach to elucidate the mediator variable’s indirect effect on workplace flourishing. It is posited that the mediation effect of this variable between the independent and dependent variables is deemed significant when the bootstrap upper (BootULCI) and lower (BootLLCI) confidence interval values are concurrently observed within a 95% confidence interval (Hayes, 2013). Following the analysis of the independent variable’s impact on the dependent variables within the research model, path coefficients are detailed in Table 2, whereas Table 3 displays the total, direct and indirect effects.

Table 2.

Path analysis results.

Nomenclature ß SE t p LLCI ULCI
Outcome variable: Job stress
 Acquiescent silence 0.40 0.03 13.99 0.0000 0.34 0.45
 Defensive silence 0.31 0.04 7.71 0.0000 0.23 0.39
 Prosocial silence 0.50 0.04 11.41 0.0000 0.41 0.58
Outcome variable; Social loafing
 Acquiescent silence 0.28 0.03 8.55 0.0000 0.22 0.35
 Job stress 0.54 0.05 10.55 0.0000 0.44 0.64
 Defensive silence −0.04 0.04 −0.90 0.3671 −0.11 0.04
 Job stress 0.83 0.05 16.98 0.0000 0.73 0.92
 Prosocial silence 0.32 0.05 7.02 0.0000 0.23 0.41
 Job stress 0.62 0.05 12.62 0.0000 0.53 0.72
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LLCI: lower limit of the bootstrap confidence interval with %95; ULCI: upper limit of the bootstrap confidence interval with %95; Bootstrap sampling size = 5000.

Table 3.

Total, direct and indirect effects.

Nomenclature ß SE T p LLCI ULCI
Model 1 Acquiescent silence (X), Job stress (M), Social loafing (Y)
Total effect 0.50 0.03 16.43 0.0000 0.44 0.56
Direct effect 0.28 0.03 8.55 0.0000 0.22 0.35
ß BootSE BootLLCI BootULCI
Indirect effect 0.2139 0.029 0.16 0.27
Model 2 Defensive silence (X), Job stress (M), Social loafing (Y)
ß SE t p LLCI ULCI
Total effect 0.22 0.05 4.57 0.0000 0.13 0.32
Direct effect −0.04 0.04 −0.90 0.3671 −0.11 0.04
ß BootSE BootLLCI BootULCI
Indirect effect 0.2596 0.05 0.17 0.35
Model 3 Prosocial silence (X), Job stress (M), Social loafing (Y)
ß SE t p LLCI ULCI
Total effect 0.63 0.05 13.36 0.0000 0.54 0.73
Direct effect 0.32 0.05 7.02 0.0000 0.23 0.41
ß BootSE BootLLCI BootULCI
Indirect effect 0.31 0.04 0.23 0.40
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X: Independent variable; Y: Dependent variable; M: Mediating variable; BootLLCI: Lower limit of the bootstrap confidence interval with %95; BootULCI: Upper limit of the bootstrap confidence interval with %95; Bootstrap sampling size = 5000.

The path analysis showing the path coefficients of the relationships between the variables in the model can be seen in Table 2. The path coefficient between the Acquiescent silence and Job stress variable is ß = 0.40, and there is a significant relationship (p < 0.001); the path coefficient between Job Stress and Social Loafing is ß = 0.54 and (p < 0.001). It is seen that the path coefficient between Acquiescent Silence and Social Loafing is ß = 0.50 (p < 0.001), and the path coefficient of Acquiescent Silence with Social Loafing through Job Stress is ß = 0.28 and (p < 0.001). According to these findings, Hypothesis 1a, Hypothesis 2a and Hypothesis 3 are supported.

The path analysis showing the path coefficients of the relationships between the variables in the model can be seen in Table 2. The path coefficient between Defensive Silence and the Job Stress variable is ß = 0.31, and there is a significant relationship (p < 0.001); the path coefficient between Job Stress and Social Loafing is ß = 0.83 and (p < 0.001). It is seen that the path coefficient between Defensive Silence and Social Loafing is ß = 0.22 and (p < 0.001), and the path coefficient of Defensive Silence with Social Loafing through Job Stress is ß = −0.04 (p > 0.05), These findings support Hypothesis 1b and Hypothesis 2b.

The path coefficient between the Prosocial Silence and Job Stress variable is ß = 0.50 and there is a significant relationship (p < 0.001); the path coefficient between Job Stress and Social Loafing is ß = 0.62 and (p < 0.001). It is seen that the path coefficient between Prosocial Silence and Social Loafing is ß = 0.63 (p < 0.001), and the path coefficient of Prosocial Silence with Social Loafing through Job Stress is ß = 0.32 and (p < 0.001). These findings support Hypothesis 1c and Hypothesis 2c.

As seen in Table 3, the lower limit (Acquiescent Silence BootLLCI = 0.16; Defensive Silence BootLLCI = 0.17; Prosocial Silence BootLLCI = 0.23) and the upper limit (Acquiescent Silence BootULCI = 0.27; Defensive Silence BootULCI = 0.35; Prosocial Silence BootULCI = 0.40) of the Bootstrap results belonging to the Organisational Silence–Social Loafing–Job Stress relationship in the model at 95% confidence interval is above zero at the 95% confidence interval; the mediating role was considered statistically significant (Hayes, 2013). It is understood that relationship-oriented leadership is indirectly related to workplace flourishing on organisational citizenship behaviour. According to this finding, mediation Hypotheses 4 and sub-hypotheses 4a and 4c are partially supported, and Hypothesis 4b is fully supported.

Discussion

This study examined the influence of organisational silence and job stress on nurses’ social loafing. To the authors’ knowledge, this paper is one of the leading studies to explore how these organisational issues are related within the nursing profession and healthcare context. Path and multivariate analyses showed significant correlations between organisational silence, job stress and social loafing. Although the mediating effect of the job stress between acquiescent and prosocial silence is partially supported, the mediating effect of the stress between defensive silence and social loafing is fully supported (Figure 2).

Figure 2.

Figure 2.

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Final model of the study and hypotheses.

***indicates p < 0.001.

Hypotheses H1a–c and H2a–c are supported. The first group of hypotheses are about the effect of silence dimensions on social loafing. The latter group of Hypotheses (H2a–c) are about the effects of silence dimensions on job stress. Succinctly, organisational silence increases social loafing and job stress. The complexity of tasks and nurses’ sense of contribution can impact social loafing behaviours, with more challenging tasks resulting in reduced social loafing as individuals feel valued and motivated (Chen and Cheng, 2018). Suppose organisational silence contributes to an environment characterised by job insecurity or perceived injustice. In that case, it may indirectly exacerbate social loafing tendencies among healthcare workers (Yildiz and Elibol, 2021). Furthermore, the inverse relationship between organisational silence and job satisfaction among nurses emphasises the potential impact of silence behaviours on employees’ well-being and job-related attitudes like job stress (Kılıç et al., 2021). Recent research by Erdoğan et al. (2022) and Panahi (2019) supported our findings as they found a significant relationship between high stress levels and employee organisational silence.

Stress does not related to loafing even if task complexity and group cohesiveness do relate loafing (Zhu et al., 2019). Interestingly, job stress fully mediates the relationship between defensive silence and loafing. Defensive silence is a form of self-defence by not speaking out or fearing what speaking out would bring (Dyne et al., 2003). These authors defined defensive silence as proactive self-protective behaviour depending on fear. The complete mediation of job stress means that when nurses feel stressed, they fear more, so they proactively avoid and increase self-protect behaviours. This result also shows that defensive silence is directly related to job stress, which is supported by previous research that shows that nurses cut communication with their organisations when stressed, which can cause more loafing behaviours (Deniz et al., 2013). In a study by Aiello and Svec (Aiello and Svec, 1993), group monitoring of difficult tasks led to higher productivity than individual monitoring. Monitoring individuals and groups on simpler tasks showed no difference in performance, but individual monitoring caused more stress. Group monitoring can effectively oversee work while reducing stress among nurses (Aiello and Kolb, 1995a).

Job stress did not fully mediate social loafing with the other dimensions of silence: acquiescent and prosocial silence. In other words, nurses feel stressed, but this is not the cause of the loafing, as in defensive silence. In other words, when nurses proactively defend themselves by silence, this behaviour exponentially increases job stress, which in turn causes loafing. On the other hand, with acquiescent and prosocial silence, nurses disengage and stop cooperating, which will cause stress and natural loafing. These results contradict studies that found acquiescence and silence to be more prevalent among nurses regarding current issues (Doo and Kim, 2020).

In acquiescent silence, nurses may withhold their views because they think that speaking up will not make a difference and that potential recipients are not responsive or interested in the particular issue (Pinder and Harlos, 2001). Nevertheless, this kind of silence is reactive, meaning they perceive some negative or no response from management and disengage with some resignation. This can result from the Turkish Healthcare context, which can be more bureaucratic and punishing. So, in more formalised organisations, silence is more used as a reactive action when nurses experience distress (Bari, Ghaffar, and Ahmad, 2020; Rai and Agarwal, 2018). This result is supported by Creese et al.’s (2021) research which found that a perceived inability to effect change raises silence among hospital doctors. Being identified (accused in health care) as an individual, not as part of a team, can lead to job stress, potentially resulting in disengagement and reduced productivity (Schlosser and Zolin, 2012).

According to Dyne et al. (2003), the primary motivation for prosocial silence is feeling cooperative and altruistic. Such silence is more inwardly motivated and aggressive than defensive silence. As a result, prosocial individuals might not report a colleague’s error because preventing harm to others enhances their perception of themselves (Knoll and van Dick, 2013). Prosocial silence, therefore, played a significant role in forecasting the job stress for which management actions are largely irrelevant. However, other authors view this kind of silence as constructive since it may have good organisational implications. They take precautions to protect confidential organisational knowledge by keeping it hidden from others (Rafferty and Restubog, 2011). Ongoing exposure to discriminatory behaviours is relatively high in Turkish healthcare, preventing nurses from speaking up (Pavithra et al., 2022). This result is backed up by recent research that found external locus of control is more prominent in prosocial silence (Rhee et al., 2014). Turkish nurses are more other-cared and do not tell their colleagues’ mistakes to management. In turn, this behaviour will result in loafing but decrease cooperation and still be stressed.

This study aimed to find the empirical basis for developing strategies to improve team efficiency by examining the mediating effect of job stress on the relationship between organisational silence and social loafing. Outside of the individualistic perspective, social loafing has not even been recognised as a transcultural concept (Hernandez-Pozas, 2020), but this study found that silence significantly affects loafing behaviours. Job stress partially mediates between the acquiescent and prosocial silence dimensions but fully mediates the relationship between defensive silence and social loafing. Based on these results, organisational job stress, as a mediator variable, increases the effect of loafing among nurses on team effectiveness. These results suggest developing a safety culture and building trust to reduce organisational silence among nurses, thus reducing social loafing behaviours to improve patient safety and team efforts. Moreover, the findings of the study suggest that organisational silence can contribute to job stress by fostering a culture of reluctance to voice concerns, discomfort in conveying negative information and a lack of openness in communication. Addressing organisational silence and promoting a supportive environment for open communication may help reduce stress levels and improve overall employee well-being.

Limitations

This study has several limitations that should be considered. Firstly, the use of self-report surveys may introduce response bias, as participants may provide socially desirable answers. Secondly, the cross-sectional design limits the ability to infer causality between organisational silence, job stress and social loafing. Thirdly, the study was conducted in a single university-affiliated health practice and research hospital in Turkey, which may limit the generalisability of the findings to other settings or countries. Lastly, while the scales used have been validated in Turkish contexts, cultural factors may still influence the responses that are not accounted for in this study.

Implications for nursing management

The crux of patient-centred care is shared teamwork, the process by which a patient and the healthcare professional accomplish health-related tasks based on the best available person. The results of this study pointed out that job stress significantly mediates defensive silence concerning social loafing.

Nurses may choose to remain at facilities they dislike or where they experience poor treatment from managers or superiors because interactions among them are dynamic and can be modified based on other members’ expectations of outcomes. Hospital management should be aware that costs and benefits are not always directly measurable in terms of money but can also be more subjective, such as the expense of mental effort or the benefit of satisfaction from allowing nurses to express their emotions and feel safe and trusted at work.

The research on organisational silence among nurses is limited, but organisational silence needs to be reduced in the nursing unit and healthcare organisations. Thus, nurse managers should manage organisational silence by giving credit to their voices to develop and improve a sense of trust between nursing administrators and nurses. Hospital managers must create behavioural norms in interdependent relationships that span longer than one encounter. Furthermore, healthcare administrators should be aware of nurses’ adverse impacts of social loafing. Nurse managers should empower nursing staff to create a safety culture to reduce defensive silence and social loafing.

Job stress is part of the nursing profession. Overall, the literature indicates that although executive job stress is universal, the amount of stress experienced and the sources of the stress may vary (Riggio, 2018). Moreover, our study showed that this stress is highly related to organisational silence. Thus, nurse leaders should encourage their subordinates to speak freely or participate in managerial processes. Job stress can be a temporary adaptation process (Burke and Richardsen, 2001), especially for newly recruited nurses.

Consequently, nurse leaders may increase attention for newly comers. From an organisational perspective, nurses should be courageous to seek assistance and support. Another coping strategy for job stress can be not to avoid or distance subordinate nurses, which will be perceived as ignoring and might lead to silence.

Key points for policy, practice and/or research.

  • • Organisational silence needs to be reduced in the nursing unit and healthcare organisations for reducing loafing.

  • • When nurses feel stressed they use proactive self-protective behaviour depending on fear. In other words, job stress also increases fear.

  • • Job stress is an important factor in loafing.

  • • Silent members might affect how other nurses behave during interactions and interdependence in healthcare may make things worse.

Biography

Aysun Türe got her doctorate from Istanbul University, Health Sciences Institute on Nursing Management. Her postgraduate is from Afyon Kocatepe University, Health Sciences Institute on surgical diseases nursing in 2006. She has been Head of the Department of Nursing and Health Services at Eskisehir Osmangazi University since 2017.

Irfan Akkoç received his bachelor’s degree in management from the Turkish Military Academy and his Ph.D. in business administration from Dumlupınar University. In 2020, he received the title of Associate Professor in the field of Management and Strategy.

Korhan Arun received his bachelor’s degree in mathematics and his Ph.D. in business administration from Ataturk University/Turkey. His research areas include innovation, organisational behaviour, strategic management and logistics.

Abdullah çalişkan completed his undergraduate education in the field of business administration in 1990, his master’s degree in business management and organization in 1999, and his doctorate in business management and organization in 2007. Subsequently, he became an Associate Professor in the field of management and strategy in 2015, and a Professor in the same field in 2020.

Footnotes

Author contributions: AT: Study conception and design, Data collection, and Critical revision of the article.

İA: Study conception and design, Data analysis and interpretation, Drafting of the article.

KA: Study conception and design, data analysis and interpretation, draft and critical revision of the article.

AÇ: Critical revision of the article.

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical approval: Ethical permission for this research was approved by the Scientific Research and Publication Ethics Committee of Toros University/Turkiye with the ethical number of 7 date 05.01.2021.

The authors confirmed that all the participants gave written informed consent.

Contributor Information

Aysun Türe, Associate Professor, Department of Nursing Management, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Turkey.

İrfan Akkoç, Associate Professor, İzmir Tınaztepe University, Izmir, Turkey.

Korhan Arun, Associate Professor, Faculty of Economics and Administrative Sciences, Tekirdağ Namik Kemal University, Tekirdağ, Turkey.

Abdullah Çalışkan, Professor, Department of Health Management, Faculty of Health Sciences, Toros University, Mersin, Turkey.

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