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nurses, patient safety, presenteeism, retaining nurses, work environment



  1. Rainbow, Jessica G.
  2. Gilbreath, Brad
  3. Steege, Linsey M.


Background: Nurses are a high-risk group for presenteeism: When one is present at work but not fully engaged. Presenteeism can occur because of multiple work, personal, and event factors and is linked to negative nurse, patient, and organizational outcomes. A model that accounts for the multiple antecedents that lead to presenteeism, as well as its consequences, is needed.


Objective: The aim of this study was to evaluate our proposed presenteeism in nursing model among registered nurses in the United States by examining the fit of the data with the model.


Methods: Four hundred forty-seven registered nurses who provide direct patient care completed a cross-sectional survey on presenteeism, its antecedents and consequences, and demographics. Structural equation modeling was used to test relationships in the proposed model and overall model fit.


Results: The presenteeism in nursing model holistically accounted for significant presenteeism antecedents and consequences. There were significant relationships between work environment, perceived stress and work-life balance, and presenteeism. There were also significant relationships between presenteeism and missed care, and burnout.


Discussion: These relationships align with prior research and identify antecedents and consequences of presenteeism. This model can be used by practitioners and researchers to develop interventions addressing presenteeism to improve health system, nurse, and patient outcomes.