1918: Healthcare Heroes’ Shield of Armor: Causes and Consequences of Callousness in Healthcare Workers (21017)

Callousness—the display of impersonal, insensitive, and cynical behavior towards others—is increasing among healthcare professionals, yet there is little theoretical or empirical investigation of callousness. In this work, we distinguish callousness from related interpersonal factors and develop theory-derived hypotheses about organizational conditions associated with healthcare professionals becoming more or less callous, and the consequences of these professionals’ increasing their callousness for themselves and for the quality of care that their workgroups provide to patients. We tested our hypotheses with survey and performance data collected at two times for professionals in 20 intensive care units (N=557 and N=153). We find that work-life balance and psychological safety are negatively associated with callousness and that the strength of their mitigating effect varies by the type of work (providing mixed versus specialized care). Additionally, callousness is negatively associated with intent to stay in one’s job and proactive behavior, a persistent effect across time for the former but not the latter. We find no effect of unit-level callousness on patient mortality rates. We discuss these results and suggest the need for continuing research on callousness and addressing it in healthcare organizations through at least improving work-life balance and psychological safety to maintain the workforce.

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