According to West et al. [1
], organizations rely on employees innovative behavior to enhance efficiency and productivity, which in turn ensures continuous organizational growth, success, and survival [2
]. Innovative behavior results in the generation of a new idea, effective multitasking procedures, and increases job-related motivation [6
]. Martins & Terblanche [7
] argues that organizations invest a significant amount of time and money to enhance the employee innovative behavior. Innovative behavior generates new ideas, including effective multitasking processes and job-related managerial motivation [6
]. In order to organize the innovation process, firms take into consideration the various actors that assist them in the development of employees’ IB [7
], and employees are expected to improve their organization’s processes by producing and implementing innovative solutions that enhance both customer satisfaction and services [8
]. It is important to understand that employer–employee relationships can be classified as either economic exchange or social exchange. An economic exchange relationship is defined as a proper reward agreement, which endorses the particular amounts to be exchanged and required through legal approvals. Whereas a social exchange relationship has been considered as “one person does another a favor and while there is a general expectation of some future return, its exact nature is definitely not stipulated in advance” [9
] and is left to the discretion of the one who makes it.
Organizational culture is always considered a vital aspect influencing the firm’s performance in the healthcare sector [10
], although many researchers also believe that remarkable efforts have been made to comprehend the link between leadership, organizational culture, employees attitude, and healthcare organization outcomes. Moreover, previous studies have been conducted on cultural transformation as an effective way of increasing firm performance in the healthcare sector [18
The nursing profession in China has been under extreme pressure over the past three decades. Despite having a fast-growing economy and significant political and social reforms in health care, according to World Health Organization and You et al [21
], there exists a severe shortage of nurses as compared to a number of developed countries. Consequently, now there are two different types of nurses, permanently employed (bianzhi nurses) and contract-based employed (bianwai nurses) working in China [23
]. In the Chinese hospitals, the majority of the nurses, about 54%, are temporary or contract-based and it is estimated to rise as China continues its move towards a market-based economy [23
]. In recent years, newly employed nurses are contract-based, while permanent positions are kept for those who have political influence or higher qualifications (maintain their status) [24
]. Whereas, both types of nurses have the same job descriptions and job responsibilities, permanent nurses receive better salaries and additional benefits. In Chinese health care, the main cause of the shortage of nurses is their low professional and social status and salaries [25
]. Cooke & Zhan [24
] revealed that in China, nurses have a lack of respect and honor from their senior doctors, administration, and patients, and are being mistreated by patients, doctors, and also their family members.
Thus, nurses in China have a greater level of job stress. Zeng [26
] revealed the main factors of job stress, which are the low social status of the nursing profession, the disparity between effort-based rewards, a problem with supervisor relationship, and dealing with patients’ deaths. Especially in China, the majority of nurses are female. Another imperative reason for stress in nurses is the work-life imbalance and stress related to child-raising, which is the responsibility of the mother [27
]. The majority of the nurses have left their profession [24
]. For example, Shanghai alone lost 13% of its nurses from 2006 to 2010 [25
], who migrated to developed countries, for example, Canada, Australia, U.K., and USA, and those were well-qualified and easily communicate in English. Nurses are accountable for participating in global health concerns, but from a sustainability perspective, only a few studies have been conducted; consequently, it is essential to conduct significant theoretical and empirical studies [28
]. Goodman [29
] believes that nursing education must be changed fundamentally to fulfill the current demands of organizational culture and climate change. Moreover, there is a high demand for a “sustainability program” in nursing education.
Costello et al [30
] discussed that the World Health Organization (WHO) has the capability to ensure better health, and healthcare organizations should handle climate change and its effects seriously. Thus, it is important to work towards sustainable development for health care and overall society. We can discuss that in the nursing profession, the sustainability concept is vague, undiscoverable, and has not been speculated. It is necessary for nurses to perform their job in such a way that the environment should be kept safe, secure, and preserved. Climate change and its subsequent environmental concerns should be included in contemporary healthcare management. In this effort, nurses’ contribution is imperative. Furthermore, nurses should promote the understanding of health issues related to climate change and also evaluate the ensuing health risks [28
Moreover, nurses require access to knowledge resources for waste in healthcare organizations. The sustainability in healthcare organizations can be increased through the social relationships of supervisor–subordinate and with colleagues. This could be because of social desirability (nurses need to be recognized as being sustainable). Consequently, this could boost the understanding of their sustainability behavior in the hospitals and healthcare organization through social interaction and organizational support. It is vital to make sure that healthcare professional and nurses should be familiar with the effect of healthcare delivery on the environment, and in contrast, the influence of climate change and the paucity of resources on overall health.
In this study, we intend to utilize the social exchange theory (SET) for investigating IB, LMX, POS, affective commitment, and innovative organizational culture. According to SET, when employees and managers/supervisors create positive relationships at the workplace to create mutual understanding, which provides a working environment that is beneficial for both employees and their employer [31
]. In general, under perfect working conditions, employees perceive themselves to be supported and encouraged; consequently, they will be more likely to pay back their organization through embedding extra effort in the form of IB and affective commitment. Cropanzano & Mitchell [32
] proposed that such a perfect situation can only be created when individuals in a workplace follow the rules and regulations of exchange. Researchers studying the healthcare sector argue that important job attitudes are significantly associated with employees behavioral outcomes, for example, task performance and employee retention within the organization.
Affective commitment and employees’ IB have been under study for quite some time now. Researchers studying the healthcare sector argue that due to an important job attitude that has been significantly associated with employee’s behavioral outcomes, for example, task performance and employee retention within the organization. In this research, we examine whether LMX relationships and tie strengths between colleagues affects employee’s affective commitment and IB through organizational support (POS). The presence of POS as a mediator provides us an opportunity to examine the applicability of the social exchange theory in the Chinese context. POS refers to the degree to which employees perceive that their organization cares about their welfare and values their contribution and should also boost employee’s willingness to respond in the shape of positive attitudes towards their organization [33
]. Consequently, POS can motivate employees to be entirely devoted and put their extra effort to participate in organizational innovation activities [34
]. It is argued that if employees perceive that their organizations are providing high organizational support, this will not only increase the affective commitment but also foster their IB. Employees can support and contribute toward their organization development by implementing innovative ideas [34
]. Specifically, this paper contributes to increase the understanding about nurses IB and their commitment and also provide managers and leaders an opportunity to understand the role of organizational factors that may increase their creativity and commitment.
In the current competitive business environment, organizations have taken some actions to boost employee innovative behavior through selecting employees with creativity features, engaging employees in the decision-making process, developing criteria for job performance, and providing constructive feedback, but some other factors hindered employees’ creativeness in the organization. Organizational culture might be a facilitating factor to promote creativity in the organization [7
]. There is a lack of empirical research exploring the relationship between organizational culture, LMX, POS, employee commitment, and IB. This paper adds to these variables based on the idea that, there is very little evidence as to how organizational culture plays out in the localized/provincialized context, as most of the research on it is carried out in the Western cultural context. This research is empirical in nature and has two research questions. First, are LMX, tie strength, and POS ideas from the western cultural context effective in the Chinese cultural context? Second, this paper investigates the relationship between innovative organizational culture, tie strength, POS, affective commitment, and employees’ IB. Employee IB is an important construct that not only ensures long-term survival and knowledge creation within the organization, but also has implications for short-term organizational performance [38
]. The main purpose of this study is to reveal the similarities and differences in the scopes of supervisor–subordinate relationship, organizational culture, and its relationship with IB and affective commitment in the Chinese organizational context, thus, proposing practical managerial recommendations for research and practice. Researchers have argued that culture may have a minor impact on methods chosen to determine results; however, it has a significant impact on the way in which these methods are executed [39
3. Managerial Implications
This study has made a substantial contribution toward examining the employee LMX, tie strength, organization culture, and its effect on POS, affective commitment, and IB in organizations related to a human aspect of organizational sustainability. Current research has practical implications for managers to understand that boosting employees’ IB is particularly useful for HRM practices. It can be recognized that IB positively supports to an individual’s capability to resolve workplace problems [45
]. In this way, HR managers looking to boost employees’ IB will create practices that motivate an employee to be effectively committed towards their organization and are expected to show IB. Subsequently, it has been observed that employees’ IB is imperative for organizational sustainability [121
However, organizations need to consider approaches in which the employee’s affective commitment towards their organization can be improved considering that it seems to be the main factor of the employees’ IB. Moreover, addressing tie strength, LMX, innovative organization culture, and POS can enhance employee’s commitment and IB by boosting social interactions between employees [46
] and also work-related interactions; as a result, an individual will intentionally consolidate a relationship of specific groups into their social identity when those relationships are important and genuinely significant to them [149
]. To achieve the desired goals, organizations could instigate creating special opportunities for their employees and encourage supervisors to play an active role by interacting with each other outside the workplace [58
In particular, human resource managers must consider either making or amending HR strategies like innovative culture, organization support, interpersonal relationship, and rewards for IB, which are related to enhancing employee performance as well as organizational performance to build sustainable organizations, for example, those employees who have realistic, unique, and novel ideas, and have a passion for converting those into real products and services. Consequently, organizations might consider offering those employees with exceptional opportunities to boost organizational performance in the long run.
5. Limitation and Future Research
There may be some limitations related to this research that need some attention. First, in this study, we used cross-sectional data; thus, we could not deduce causation relationships between any two variables. A longitudinal data would be suitable for testing causation and give more generalizable results [153
]. Thus, the relationships tested in this research should be examined further, including other factors embedded within social exchange theory, such as the influence of LMX, trust, justice dimensions on organizational citizenship behavior (OCB), and employees’ innovative behavior. Second, quantitative data can only be utilized to conclude what the relationship between two different variables is, but this type of data cannot describe why such relationships exist or do not exist [154
]. In this study, qualitative data could have been helpful for concluding why the association between tie strength and POS, as well as innovative organizational culture and affective commitment, were not significant; consequently, the mixed method could deliver a comprehensive investigation of innovative behavior and organizational commitment of nursing employees in the Chinese context. Furthermore, a third possible limitation was employees self-reported data because nursing employees who contributed to the current research were mainly female; in contrast, male registered nurses were only 10% of the workforce [156
This study covers only public sector hospitals operating in the Jiangsu province China. Therefore, for future research, other national and international regions might be selected endeavoring to produce a greater sample size. However, this empirical model has shown to be very beneficial and convincing, and future research would include other variables that might have a key influence on employees’ tendency to be innovative, such as leadership style, knowledge sharing, organizational performance, and employees’ voice behavior. Consequently, in the future, more gender-balanced organizations in different sectors, such as hospitality, telecommunication, banking, manufacturing, and information technology would be useful to compare the existing findings. However, it could be very difficult to increase male nurses in any future research because the majority of the nurses’ are female worldwide [157
]. Finally, to explain the proposed framework in this study, we applied a social exchange theory, which was developed in a Western cultural context. It has always been a questionable issue in the research regarding whether the theories developed in the Western culture are suitable to a Chinese organizational context. Although, SET has been extensively tested in Chinese organizational contexts, and we accept that this concern could have an influence on the current findings of this study, however it is not believed to have a substantial impact.