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Guided by structurational divergence (SD) theory, this study examined the presence and impact of unresolved tensions surrounding safety issues among hospital workers. Using a two-study design, data were gathered for Study 1 from focus groups and interviews involving 40 hospital employees at two hospitals. Thematic analysis indicated workers experienced SD-cycles marked by unresolved conflict, immobilization, and erosion of development. Study 2 surveyed ( N  = 303) workers within the same hospital network to examine the impact of unresolvable safety issues as both the outcome of SD and the antecedent to workers’ intent to leave. The conceptual model tested shows the destructive outcomes of SD on safety climate, where higher levels of SD lead to lower perceptions of safety climate.

Structurational divergence, safety climate, and intentions to leave: An examination of health care workers’ experiences of abuse