Aim: To examine the impact of display rules on nurses' caring behaviors and emotional exhaustion and the mediating role of emotional labor (surface/deep acting).
Background: Hospitals often implement emotional display rules for nurses with the expectation of performance benefits. However, these rules may have an impact on nurses' caring behaviors and emotional exhaustion.
Methods: This cross-sectional correlational study included a sample of 746 nurses from five hospitals and used the STROBE checklist. Relationships between display rules, emotional labor, caring behaviors, and emotional exhaustion were analyzed using structural equation modeling.
Results: Display rules did not directly affect caring behaviors or emotional exhaustion. Emotional labor mediated the relationships. Display rules were associated more with surface acting. Deep acting increased caring behaviors and reduced emotional exhaustion; surface acting had the opposite effect.
Conclusions: Findings challenge the assumption that display rules effectively promote caring behaviors. Display rules lead to emotional labor and emotional exhaustion. Reducing display rules, emotional labor, and surface acting while supporting deep acting may alleviate emotional exhaustion.
Implications for nursing and health policy: Nurse managers should review the nature and implementation of emotional display rules and explore ways to reduce emotional labor, encourage deep acting, mitigate the negative impact of surface acting, and ultimately improve nursing caring behaviors.
Keywords: Caring behaviors; emotional exhaustion; emotional labor; nurse; organizational display rules.
© 2023 International Council of Nurses.