Linking Workplace Ostracism, Psychological Contract Violation, Emotional Exhaustion and Nurses’ Deviant Behaviour: A serial mediation framework

Abstract

Purpose: Nurses form the backbone of healthcare delivery, yet their effectiveness is often undermined by adverse workplace dynamics. This study investigates how workplace ostracism (WO) translates into deviant behaviour (DB) among nurses in Indian public hospitals, with psychological contract violation (PCV) and emotional exhaustion (EE) as serial mediators.

Method: Using survey data from 381 nurses selected from public hospitals across four metropolitan Indian cities. The theoretical model was tested through Partial Least Squares Structural Equation Modelling (PLS-SEM) and the serial mediational analysis was tested through the Variance Accounted For (VAF) technique

Results: The PLS-SEM results confirmed that WO positively predicts DB both directly and indirectly through PCV and EE in sequence. Findings extend Social Exchange Theory (SET) by demonstrating that deviance arises not merely as an immediate retaliatory response but through a progressive erosion of trust and depletion of emotional resources. This dual-path mechanism offers a nuanced explanation of how negative social exchanges culminate in counterproductive outcomes in resource-constrained healthcare contexts.

Conclusion: The study advances existing literature by elucidating the ‘partial serial mediation effect’ of psychological contract violation and emotional exhaustion in the workplace ostracism–deviant behaviour relationship, thereby offering a more nuanced and theoretically enriched understanding of this dynamic. Theoretically, the study advances SET by integrating relational contract breaches with resource depletion processes. Practically, it highlights the urgent need for reforms in Indian public hospitals, including dedicated human resource leadership, mandated nurse-patient ratios, inclusive workplace policies, psychological support systems, and leadership development for nurse supervisors. Strengthening reciprocity and fairness in professional relationships is not only central to workforce well-being but also critical for patient safety and healthcare quality.