Abstract
AIM: This study aimed to explore factors contributing to organizational silence, drawing upon the framework of the choice to remain silent by Milliken, Morrison, and Hewlin. BACKGROUND: The promotion of open communication and the enabling of open discourse amongst nursing professionals are essential for the enhancement of health service quality and the assurance of patient safety. METHODS: A cross-sectional descriptive survey was conducted from August 14, 2023, to September 15, 2023. Data were collected from 170 rotating shift nurses at a tertiary hospital in South Korea. The hypotheses were tested using multiple regression and the PROCESS macro, Version 4.2, Model 4. RESULTS: Leader-member exchange not only had a direct effect on organizational silence but also had a significant indirect effect mediated by workplace bullying (β = -0.03, 95% CI: [-0.074, -0.001]). The total effect was confirmed to be β = -0.23 (95% CI: [-0.345, -0.129]). CONCLUSION: Organizational silence is shaped by both individual characteristics and organizational conditions. Workplace bullying not only has a direct effect on organizational silence but also mediates the relationship between leader-member exchange and organizational silence. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should be sensitive to negative cultures such as bullying and actively promote leader-member and team-member exchange. When nurse managers actively maintain and support relationships with members, members are more likely to disclose issues and express their opinions.