Distress, Support, and Occupational Functioning: Predictors of Turnover Intentions and Absenteeism Among Israeli Nurses Following Adverse Events

Background: The global healthcare system is grappling with a severe shortage of nursing staff, a deficit exacerbated by the prevalent Second Victim Phenomenon (SVP), where nurses experience significant emotional, physical, and professional distress after involvement in adverse events (AEs). Research consistently links SVP to nurse absenteeism and turnover, underscoring the critical need for effective support systems. Unlike many countries with established SVP support, Israel lacks systemic national and organizational level strategies, leading to potential underreporting of AEs and a hidden burden of distress among caregivers. This study examined the association between SVP and absenteeism and turnover intentions among Israeli nurses, specifically investigating the roles of direct managers and the organization. Methods: A culturally diverse sample of 174 postgraduate nurses who reported experiencing an adverse event the Hebrew-validated Second Victim Experience and Support Tool (H-SVEST), assessing psychosocial factors and employment outcomes (turnover intentions, absenteeism). Results: Over 90% of nurses reported psychological and physical distress following AEs. Physical distress emerged as a primary driver for both turnover intentions and absenteeism. In contrast, professional self-efficacy and various forms of organizational support (from colleagues, supervisors, and the institution) acted as critical protective factors, significantly reducing these negative outcomes. The path analysis model explained 52.7% of the variance in turnover intentions and 39.2% in absenteeism. Notably, supervisor support significantly and negatively predicted absenteeism (B = -0.243, p < .01). Conclusions: This study provides the first quantitative examination of SVP among Israeli nurses, affirming its profound impact on workforce stability. Our findings highlight the significant role of physical distress in predicting turnover and absenteeism in the Israeli context. The crucial role of various forms of organizational support and professional self-efficacy as mitigating factors underscores the urgent need for structured, systematic support systems within Israeli healthcare