Work engagement, defined in the occupational psychology literature as a positive, fulfilling state characterized by vigour, dedication and absorption, has long been recognized as a cornerstone of nursing performance. Engaged nurses deliver safer care, report higher job satisfaction and are less likely to leave the profession. Yet amid global nursing shortages and the lingering aftershocks of the COVID-19 pandemic, engagement levels have come under sustained pressure from excessive workloads, limited resources and chronic stress. Understanding what sustains engagement has therefore become a priority for both researchers and hospital administrators.

The new study, grounded in the Job Demands–Resources (JD-R) model, set out to test a pathway that has been largely unexplored in nursing contexts. The researchers distinguished between two related but distinct constructs: work capital, which describes the objective availability of resources an employee can access—economic means, professional skills and knowledge, social relationships, and organizational support—and decent work, which captures how employees subjectively evaluate the fairness, security and dignity of their conditions. The central question was whether decent work functions as the psychological bridge through which work capital translates into engagement.

To investigate, the team conducted a cross-sectional survey between August and November 2025, recruiting registered nurses from six hospitals in Zhejiang Province, including three tertiary, two secondary and one primary care facility. Of 593 questionnaires distributed, 535 valid responses were retained, a response rate of 90.2 per cent. The sample was overwhelmingly female (96.1 per cent), predominantly aged between 31 and 39, and highly qualified, with 92.7 per cent holding a bachelor’s degree and more than half serving as nurse practitioners-in-charge. Participants spanned medical, surgical, intensive care and emergency units.

The researchers used three validated instruments: a 16-item work capital scale covering economic, human, social and cultural dimensions; Duffy’s 15-item decent work scale, which assesses emotional safety, healthcare benefits, pay fairness, work–life balance and value alignment; and the widely used Utrecht Work Engagement Scale. All scales underwent forward and backward translation into Chinese and showed strong internal consistency in the final sample, with Cronbach’s alpha coefficients of 0.91, 0.93 and 0.92 respectively.

The statistical machinery was rigorous. Confirmatory factor analysis was used to refine the measurement model, with items showing weak factor loadings removed to yield a 35-item structure that fit the data well (CFI = 0.92, RMSEA = 0.056, SRMR = 0.046). Discriminant validity checks, including the Fornell–Larcker criterion and HTMT ratios, confirmed that work capital and decent work—despite their conceptual kinship—are statistically distinct constructs. Harman’s single-factor test suggested common method bias was not a serious concern.

The findings were striking. Work capital was strongly and positively associated with decent work (B = 0.74, p < 0.001), and decent work in turn was strongly associated with work engagement (B = 0.85, p < 0.001). The total association between work capital and engagement was significant, but when decent work entered the model, the direct association shrank dramatically. Bootstrap mediation analysis with 5,000 resamples showed a significant indirect effect of 0.63 (95 per cent confidence interval 0.53 to 0.74), meaning roughly 77 per cent of the total association between resources and engagement appeared to flow through nurses’ perceptions of decent work.

In practical terms, the message is that resources alone do not produce engagement—they must be experienced as decent. A hospital may fund training programmes, offer benefits and staff adequately, but if nurses do not perceive their treatment as fair, their pay as adequate or their work–life balance as protected, much of the motivational benefit is lost. Conversely, investments in resources that demonstrably improve perceptions of workplace dignity and fairness appear to pay a double dividend, boosting both perceived job quality and the engagement that follows from it.

The authors are careful to flag the study’s limits. As a cross-sectional design, it cannot establish causality; it is entirely plausible that highly engaged nurses simply perceive their conditions more favourably, or that reverse and reciprocal relationships operate. The sample, drawn from a single Chinese province and dominated by female, bachelor-educated respondents, may not generalize to other settings. Self-reported data are also vulnerable to social desirability bias, and factors such as job demands, emotional labour and organizational support were not modelled.

Even so, the study extends the JD-R framework in a meaningful direction by positioning decent work as a perceptual mechanism linking organizational resources to motivation. For hospital administrators, the takeaway is twofold: invest in the tangible foundations of nursing work—education, staffing, equipment and team support—but measure success not just by what is provided, by whether nurses genuinely feel their work is fair, secure and worthy of respect. In an era when retaining nurses has become a global emergency, that perceptual layer may be the most valuable resource of all.

Nurses operate in some of the most high-stress environments in healthcare. The ICU, characterized by its rapid pace and critical patient conditions, demands not only high technical proficiency but also emotional fortitude. The study found that a positive work environment was directly linked to lower levels of burnout and higher job satisfaction among nurses. This correlation highlights the urgent necessity of fostering a supportive atmosphere within ICU settings, which can dramatically impact both nurse retention rates and the quality of care patients receive.

The researchers meticulously designed their study to capture various dimensions of the work environment as experienced by Jordanian ICU nurses. They sought to understand not only the tangible aspects of the environment, such as staffing levels and resources, but also the intangible factors like leadership support and team cohesion. These elements collectively shape the psychosocial landscape in which nurses operate, influencing their overall well-being and professional efficacy.

One of the most striking findings of the study was the recognition that nurses themselves are often the best advocates for change within their workplaces. By examining their own experiences and articulating their needs, ICU nurses can play an essential role in shaping their environments. The use of the AACN assessment tool proved invaluable in this context, providing a structured framework through which these voices could be heard and validated. It demonstrates that empowering nurses not only contributes to their job satisfaction but also enhances the overall quality of care delivered to patients.

Moreover, the results indicated that factors such as recognition and appreciation from healthcare administration had a significant impact on nurses’ perceptions of their work environment. In many cases, nurses reported feeling undervalued despite their crucial roles in the care continuum. This discrepancy presents a matter of concern that health leaders must address proactively. By implementing recognition programs and more transparent communication channels, healthcare organizations can cultivate a culture of appreciation, which is essential for sustaining morale and improving retention.

The study also highlighted the importance of teamwork and interprofessional collaboration within the ICU setting. Nurses reported that when they felt supported by their colleagues and other health professionals, they were more likely to thrive in their roles. Team dynamics, therefore, should be a focal point for healthcare management, as developing a strong sense of community among staff can mitigate the pressures commonly associated with ICU work.

Furthermore, the research emphasizes the significance of ongoing professional development and training. Nurses expressed a desire for more opportunities to enhance their skills and competencies. Continuing education, mentorship programs, and simulation training can help foster a sense of competence and confidence among nursing staff. This investment in human capital not only benefits the individual nurse but also enhances team performance and patient care quality.

Understanding the emotional and psychological toll of working in ICUs is another vital aspect that the study addressed. Burnout and compassion fatigue are prevalent in high-stress healthcare environments, often leading to turnover and diminished patient care. The recognition of these challenges within the workplace allows for the implementation of tailored wellness programs and mental health resources for nurses. Institutions that prioritize emotional well-being tend to exhibit more resilient workforces, ultimately translating to better patient outcomes.

The application of evidence-based practices in nurturing a healthy work environment is crucial. The study’s insights can guide healthcare policy and decision-making processes focused on creating sustainable and supportive ICU settings. By employing data-driven approaches, healthcare administrators can make informed choices that align with the needs and expectations of their nursing staff.

As the global healthcare landscape continues to evolve amidst challenges such as the COVID-19 pandemic, it is imperative to continuously assess and adapt strategies to support nurses. The valuable perspectives captured in this study not only underscore the importance of nurturing work environments but also provide a roadmap for healthcare leaders aiming to improve the overall state of nursing practice.

In conclusion, AlZrigat, Nofal, and Darawad’s study shines a much-needed light on the factors that contribute to a healthy work environment within Jordanian ICUs. By prioritizing the voices and experiences of nurses, healthcare organizations can foster more effective and satisfying workspaces. As we move forward, it is essential that we heed the lessons from this research, recognizing that our nurses are our most valuable assets in the fight for improved healthcare delivery.

In understanding the broader implications of this research, it is clear that enhancing nurses’ work environments is not just a matter of institutional concern; it is a moral imperative that directly impacts patient care and overall health outcomes. Societies must ensure that those who care for the most vulnerable among us are themselves supported and empowered.

By transforming the ICU into a place where nurses can thrive, healthcare systems have the potential to revolutionize patient care. The voices of overworked and often overlooked nurses must be amplified, guiding systemic changes that prioritize their well-being for the betterment of all.

Ultimately, this research serves as a call to action for healthcare leaders everywhere. It is not enough to simply acknowledge the challenges nurses face; active steps must be taken to address these concerns. By aligning institutional goals with the needs of nursing staff, we can cultivate an environment that not only retains talent but also enhances the health and care of our communities.

Subject of Research: Healthy work environment from the perspective of Jordanian ICU nurses.

Article Title: Healthy work environment from the perspective of Jordanian ICU nurses: a descriptive cross-sectional study using the AACN assessment tool.

Article References:

AlZrigat, E., Nofal, B. & Darawad, M.W. Healthy work environment from the perspective of Jordanian ICU nurses: a descriptive cross-sectional study using the AACN assessment tool. BMC Nurs (2025). https://doi.org/10.1186/s12912-025-04133-2

Image Credits: AI Generated

DOI: 10.1186/s12912-025-04133-2

Keywords: Healthy work environment, ICU nurses, job satisfaction, burnout, teamwork, interprofessional collaboration, emotional well-being.