Trickle-down incivility in healthcare: a self-control perspective on supervisor-to-nurse incivility

Nursing incivility remains a pervasive issue in healthcare settings, impacting nursing individuals and organizational dynamics. Drawing on ego-depletion theory, we investigate the trickle-down effects of nursing supervisor incivility on nursing employee incivility toward coworkers. It further examines state self-control resource depletion as a mediating mechanism and trait self-control as a boundary condition moderating this indirect relationship.

A three-wave, time-lagged and single-source data was administered to nursing staff across seven major public and private sector hospitals to empirically test the proposed moderated mediation model.

Mediation analyses reveal that supervisor incivility depletes nursing employees' state self-control resources, which in turn leads to coworker-directed incivility. Moderated mediation results further demonstrate that this indirect effect is attenuated for employees with high trait self-control, suggesting that trait self-control buffers against the depletion process and reduces the trickle-down effect.

We advance the nursing incivility literature by identifying a self-regulatory mechanism through which incivility cascades within healthcare teams and by emphasizing the protective role of individual differences in trait self-control. These findings offer both theoretical insights and practical implications for managing interpersonal mistreatment in hierarchical healthcare settings.