Helping others not always helps ourselves: the relationship between victim incivility and emergency workers' burnout through work-to-family conflict

• DOI: https://doi.org/10.1108/IJWHM-09-2021-0183
• Published date: 07 April 2022
• Date: 07 April 2022
• Pages: 467-492
• Subject Matter: Health & social care,Healthcare management,HR & organizational behaviour,Human resource policy,Employee welfare
• Author: Valentina Sommovigo,Chiara Bernuzzi,Ilaria Setti

Helping others not always helps

ourselves: the relationship

between victim incivility and

emergency workers’burnout

through work-to-family conflict

Valentina Sommovigo

Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy and

Department of Management, University of Bologna-Rimini, Rimini, Italy, and

Chiara Bernuzzi and Ilaria Setti

Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy

Abstract

Purpose –This study aims to analyse whether and when victim incivility may be related to work-to-family

conflict and then burnout among emergency workers.

Design/methodology/approach –A total of 304 Italian emergency workers from five firehouses and six

emergency rooms completed questionnaires, examining: victim incivility, work-to-family conflict, social

support seeking and burnout symptoms. Descriptive analyses, confirmatory factor analyses and structural

equation models were conducted.

Findings –Victim incivility was positively associated with burnout symptoms, both directly and indirectly, as

mediated by work-to-family conflict. Additionally, social support seeking exacerbated (rather than mitigated)

the impact of work-to-family conflict on burnout symptoms.

Practical implications –Organisationscan greatly benefit from implementing family-friendly practices and

providing their workers with training programmes on how to deal with difficult victims.

Originality/value –This study contributes to the existing literature on workplace incivility and work–life

interface by supporting for the first time the notion that victim incivility can spill over into emergency workers’

family domain and by clarifying how and when victim incivility is related to burnout symptoms.

Keywords Victim incivility, Emergency workers, Work-to-family conflict, Social support seeking, Burnout

symptoms

Paper type Research paper

1. Introduction

“By helping others, we help ourselves”(Scannell, 2021). Is this statement always true? What

does happen when the people we are trying to help not only do not show appreciation for what

we are doing, but they say rude things? Workplace incivility has become an alarmingly

common phenomenon (Vasconcelos, 2020) that has attracted growing attention in the health

sector. This is because, despite its low intensity, it occurs with an exceptionally high

Victim incivility

and emergency

workers’

burnout

467

© Valentina Sommovigo, Chiara Bernuzzi and Ilaria Setti. Published by Emerald Publishing Limited.

This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may

reproduce, distribute, translate and create derivative works of this article (for both commercial and non-

commercial purposes), subject to full attribution to the original publication and authors. The full terms of

this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Special thanks to Mr. Riccardo Svanella for helping the research team collect the data used in this

study. Sincere gratitude is expressed to each single emergency worker who contributed to this study.

Funding: Open access funding was provided by Universit

a degli Studi di Pavia within the CRUI-

CARE Agreement.

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/1753-8351.htm

Received 28 September 2021

Revised 7 December 2021

22 February 2022

Accepted 21 March 2022

InternationalJournal of Workplace

Health Management

Vol. 15 No. 4, 2022

pp. 467-492

Emerald Publishing Limited

1753-8351

DOI 10.1108/IJWHM-09-2021-0183

frequency, and the accumulation of uncivil incidents over time may negatively impact

healthcare providers’well-being (Abubakar, 2018), work functioning (Jiang et al., 2019) and

perception of the ethical climate of their work unit (Itzkovich et al., 2020). This may undermine

an emergency worker’s ability to provide high-quality care and patient safety (Alquwez,

2020;Armstrong, 2018). Moreover, incivility may “spiral”out of control and lead to more

serious forms of aggression (Kim and Qu, 2019).

To date, a large body ofhealthcare research has concentratedon workplace incivility from

intra-organisational members, while less attention has been paid to outsider incivility

(Sommovigo et al., 2020), even though patients and their families have been identified as the

main sourcesof incivility (Layne et al.,2019).Thus, more research is neededon victim incivility.

This term refers to a “low intensity deviant behaviour with an ambiguousintent to harm the

target,perpetrated by a victim –or the familyand friends of a victim –of a stressful situationin

which emergency services have been dispatched”(Sliter, 2012, p. 9). This is particularly

important because emergency workers (i.e. persons who work in emergency response

situations, such as firefighters, paramedics and emergency room nurses) are a high-risk

professionalgroup for outsider incivilitybecause their job is characterisedby a combination of

risk factors (Meacham et al., 2020). Unlike other “traditional”service providers, emergency

workers need to perform their job in stressful situations (i.e. emergency response situations,

such as fires, car accidents, medical emergencies), disregarding social niceties (Sliter, 2012).

This lack of “service witha smile”, along with contact with “victims”of emergencies who are

highly frustrated, makes these workersat particular risk of exposureto victim incivility (Sliter,

2012). Instances of victim incivility comprise a victim raising his/her voice at an emergency

worker or questioning his/her competence (Sliter, 2012). Because of its ambiguous intent,

incivility leaves some room for individual interpretation, such that the same action may be

perceiveddifferently by diverseworkers (Sommovigoet al.,2019a). Thus, given that emergency

workersare often confronted with severalstressors, such as contactwith human suffering, risk

of personal injury, heavy wor kloads, making life-and-deat h decisions in pressured

environments (Chang and Hu, 2022;de Wijn et al., 2022;Golding et al.,2017;Gray and Collie,

2017;Sandrin et al., 2020), they may be susceptible to victim incivility. Moreover, given that

burnoutis an occupational phenomenonresulting from chronicworkplace stress (WorldHealth

Organization, 2019), when occupational context stressors are not successfully managed,

emergencyworkers who are chronicallyexposed to them can graduallydeplete their resources

due to the need for ongoing resource investment, becoming burned out (Hobfoll et al., 2018).

To date, thereis only one study showingthat victim incivility iscommonly experienced and

positivelyassociated with burnoutamong firefighters (Sliterand Boyd, 2015). More researchis

available on the impact of outsider mistreatment on healthcare providers employed in

emergencyrooms. In this context, outsidermistreatment is frequentlyviewed as part of the job,

and outsiderincivility is the mostfrequent form of mistreatmentreported by emergencyhealth

workers (Touzet et al., 2019). Additionally, there is evidence that when emergency health

workers feel treated unfairly or be systematically under-considered at work, they are more

likely to experience burnout symptoms (Jarzynkowski et al., 2022;Oliphant et al., 2022).

However,there are many unanswered questionsto be addressed. For instance,it is still unclear

whethervictim incivility canspill over onto emergency workers’familylives, resultingin work-

to-familyconflict (i.e. a form of inter-role conflictin which job demands interfere with workers’

capability to meet the family role; Bernuzzi et al.,2021). Additionally, although the study by

Sliter and Boyd(2015) showed that victim incivilitypredicts emotional exhaustion (i.e. feelings

of being depletedof one’s emotional resourcesdue to job stressors; Montgomeryand Maslach,

2019), no singlestudy exists that examines the link betweenvictim incivility and cynicism(i.e.

excessively detached responses to the recipients of one’sservice;Montgomery and Maslach,

2019). Although emotional exhaustion is considered the core dimension of burnout, the

cynicism component is probably the most distinguishing facet of this stress response

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