Nursing Literature Review

This nursing literature review examines the impact of unhealthy work environments on employee health and productivity. It discusses the suppression of anger, disability rights, and the role of employers in creating a positive work culture. The review emphasizes the need for further research and tailored interventions for different job types.

NURSING LITERATURE REVIEW
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Contents
INTRODUCTION.....................................................................................................................................2
LITERATURE REVIEW..............................................................................................................................2
CONCLUSION.........................................................................................................................................6

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INTRODUCTION
Healthy and positive environment in the work place is an absolute necessity in order
to increase productivity and promote efficiency. Lack of healthy work environment in a work
place leads to stress among the employees. Reports state that in across 35 countries, the
employees suffer from depression due to discrimination at work place or lack in motivation
while working. In Australia, 46% of the working population consider their work place as
unhealthy and among them 21% suffer from depression, anxiety, stress and have taken time
off from work in past 12 months. This phenomenon is also termed as Absenteeism (State of
(Workplace Mental Health in Australia, 2014). Various researchers have globally addressed
the issue of the unhealthy work environment and interventions have been developed to
address the problem (Joyce, Modini, Christensen, Mykletun, Bryant, Mitchell, 2016).
However, still this topic remains highly neglected in the aspect of implementation of the
researches and interventions in various sectors especially in the healthcare health care sector.
This review aims to focus on the aspects that are left neglected and
unaddressed in terms of unhealthy work environment, especially on the outlook of practical
execution of the interventions.
LITERATURE REVIEW
In order to address the aspect of lack of implementation, it is important to refer to
vital researches conducted by experienced professionals who brief various features and issues
related to unhealthy environment of work.

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In 2018, Eisenstadt & Geddes, discussed a common phenomenon observed in work
place that is suppression of anger by the employees. Often, this suppression of anger leads to
stress and subsequent mental illness of the concerned employee. This in turn leads to decline
of performance and subsequent productivity. Supressed anger, retaliation doctrine and
workplace culture are three interdisciplinary legal analyses that are linked to organisational
psychological research. Supressed anger deals with two employment retaliation doctrines- the
“reasonable belief” doctrine and “the manner of the complaint” doctrine. As per the
“reasonable belief” doctrine, the complaining party must be certain that the opposed practices
were unlawful as per the court. The “manner of the complaint” doctrine comes into
emergence in cases where the employer considers the employee’s complaints as unruly and
terminates the employment. In such cases, the court focuses primarily on the employer’s
belief that the employee’s behaviour was intolerable and ignores the situations leading to the
complaint. Due to both these legal doctrines, the employees are forced to remain silent and
supress their anger. This in turn affects the worker’s health and his/her productivity due to
accumulation of anger and thus hampers the workplace culture. The same law that protects
the employees’ rights simultaneously benefits the employer. As a solution, the court needs to
reframe its laws separately that would benefit both the employee and the employer.
Termination of employment after complains should be avoided till the court decides whether
the complaint is justified or whether it’s unruly.
Most of the times, employees are unaware of the laws and acts that protects their
rights. In 1990, Americans with Disability Act was passed which provides a legal structure
for people with disabilities to avoid discrimination by challenging discriminatory activities in
work place, places of public accommodation and, state and local government. This law aims
to provide equal opportunity, participation, etc to the individuals having disabilities. In order
to achieve full benefit of the act, an individual with disability and the employers hiring the

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disabled should have complete and advanced training and education regarding the ADA,
basic compliances has been observed to be insufficient. Education about the ADA should
give knowledge about the spirit of the law. There is a misconception that few disabilities
deserve to categorise under civil rights protections. But, regardless of the type of disability,
all individuals who come under the law are protected equally (Emens, 2012).
Reports suggest that disability issues can be addressed with hiring more people with
disabilities. Increasing experience of working with disable people will increase positive
viewpoint about hiring workers with disabilities and subsequent accommodations. This will
provide a better work environment for both the employees and the employers. However,
increasing working experience with the disabled workers is not sufficient alone for the
improvement. It is necessary to have trustworthy and authentic sources that will provide
information like ADA centres. More educational opportunity for gaining knowledge about
ADA is required (Gould,Harris,Caldwell, Fujiura, Jones, et al. (2015) 2015). There are
multiple factors that impact on inclusion of disable or differently able people in any
organisation. Workplace employees have multiple roles to play in that context and stereotype
attitude or prejudice is one of the greatest hindrance to inclusion of disable candidates at
workplace. Therefore, inclusion of disable people at workplace must not be a human resource
functionality rather it must be incorporated in work culture and organisational behaviour from
top to bottom down approach (Nelissen, Hülsheger, van Ruitenbeek, & Zijlstra, 2016).
Apart from gaining knowledge and providing opportunity for the disabled people it is
also important to protect the people with disabilities with important legal problems that they
are facing in an organisational environment. ADA amendment acts provide protection to
people with disabilities to gain financial stability on their own by working at difference
places around the world. This act also helps them from protecting themselves from
discrimination that they often experience in a work culture. Having proper knowledge and

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proper implementation of this act will help in providing a healthy working environment to the
employees with disabilities (Kaminer, 2016).This resonates with qualitative work by Conway
(2018) where he has emphasised despite 25 years on ADA enacted, why it is yet to be a
successful act. The author recommends the failure and success factors must be studied
simultaneously to understand how disability rights has not been able to move out from
medical boundaries that is stigmatising and traumatic too (Conway, 2018). Therefore, it is
imperative to critically reflect on disability definition too.
In order to improve the work environment, employers have the authority and position
to the lead and help create a positive culture of heath in a workplace. Employers have
permission to conduct various programs that would be beneficial for the health of the
employee. Health improvement of the employees will leave to financial gain for the
employees; knowledge of this fact will motivate the employers to conduct health programs.
But, at the same time there are possible risks in involvement of an employer into such
programs. Health costs enforced by the employee, possible employment unfairness and
invasion into privacy can be possible risks that coexist with health programs. A fragmented
functioning regime has included a final rule under which ADA has been created to address
such risks. This regime’s aim is to balance the benefits of wellness program with risks
attached to the program. A proper successful work culture can be achieved employers can use
these regimes and help improving the culture of health of the employees. This regime is
considered as a positive effect for the culture health but it lacks complete information. To
obtain proper balance between program benefits and risks associated to employer and
employee, further improvement of the regulatory regime is required (Madison, 2016).
These days incorporation of multiple levels of employee health analysis has gained
significant focus by conducting wellbeing research, surveying interplay between individuals,
workgroups, etc. But organisational involvement research has at the same time has been

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observed to be limited to focus on single problems, researches lack focus on multiple level
analysis. As per reports, to gain proper understanding of work-related influencers of
employee’s mental health needs understanding and addressing of multiple factors and can be
achieved by ways like providing logic for regular multilevel evaluation of mental work
environment, discussing perspectives that can improve organisational interposition,
highlighting major theories and methods that aim to achieve proper health culture in
workplace. Multilevel research designing, justification of group level constructs development
of group level ways, expansion of investigations to higher level and development of multi-
level methods to approach and evaluate issues. So, researches that focus of wide range of
factors besides just focusing on an individual is required to initiate healthy work environment
(Martin, Karanika-Murray, Biron & Sanderson, 2016).
There was a study that evaluated a central theoretical presumption of stress and job
strain models that elevates in employee’s dominance and gives support to promote well being
in work environment. This study suggests that recognition and improvement of quality
intervention and organisational research should be focused by scholars to promote the basic
factors and the changes that promote well-being of workers (Moen, Kelly, Fan, Lee, Almeida,
Kossek & Buxton, 2016).
CONCLUSION
However, the studies done by researchers are specific to a particular job field or a
particular country. Situations and problems depend and vary as per the job type. So, the
research focused is not sufficient to address all the employment problems and thus cannot
address work health environment for every profession. Detailed research needs to be done for
specific employment types to address problems in a more refined way. So, in order to

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implement healthy work environmentally universally, detailed research in all job types and
the application of those researches should be done.

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References
Conway, M. A. (2018). Embodying the Law: Negotiating Disability Identity and Civil
Rights. In Special Issue: Law and the Imagining of Difference (pp. 43-78). Emerald
Publishing Limited.
Joyce S, Modini M, Christensen H, Mykletun A, Bryant R, Mitchell PB, et al. (2016).
Workplace interventions for common mental disorders: A systematic meta-
review. Psychological Medicine,46:683–97.
Eisenstadt, L., & Geddes, D. (2018). Suppressed Anger, Retaliation Doctrine, and Workplace
Culture. U. Pa. J. Bus. L., 20, 147.
Emens, E. F. (2012). Disabling attitudes: US disability law and the ADA Amendments
Act. The American Journal of Comparative Law, 60(1), 205-234.
Gould, R., Harris, S.P., Caldwell, K., Fujiura, G., Jones, R., et al. (2015). Beyond the Law: A
Review of Knowledge, Attitudes and Perceptions in ADA Employment Research.
Disability studies Quaterly, 35 (3).
Kaminer, D.N. (2016) Mentally ill employees in the workplace: Does the ADA Amendments
Act provide adequate protection. Health Matrix, 26, 205.
Madison, K. M. (2016). The risks of using workplace wellness programs to foster a culture of
health. Health Affairs, 35(11), 2068-2074.
Martin, A., Karanika‐Murray, M., Biron, C., & Sanderson, K. (2016). The psychosocial work
environment, employee mental health and organizational interventions: Improving
research and practice by taking a multilevel approach. Stress and health, 32(3), 201-
215.

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Moen, P., Kelly, E. L., Fan, W., Lee, S. R., Almeida, D., Kossek, E. E., & Buxton, O. M.
(2016). Does a flexibility/support organizational initiative improve high-tech
employees’ well-being? Evidence from the work, family, and health
network. American Sociological Review, 81(1), 134-164.
Nelissen, P. T., Hülsheger, U. R., van Ruitenbeek, G. M., & Zijlstra, F. R. (2016). How and when
stereotypes relate to inclusive behavior toward people with disabilities. The International
Journal of Human Resource Management, 27(14), 1610-1625.
State of Workplace Mental Health in Australia, (2014), Beyond Blue: Depression and
Anxiety, Retrieved on 05.04.2019,
https://www.headsup.org.au/docs/default-source/resources/bl1270-report---tns-the-
state-of-mental-health-in-australian-workplaces-hr.pdf?sfvrsn=8