Question:
Discuss about the Bullying in Nursing.
Bullying can be defined as the recurrent, unwanted harmful actions intended to humiliate, offend as well as cause the distress in the recipient. Bullying in nursing can have extensive adverse effects on nurses at work and hence actions are needed in urgent terms to deal with this destructive conduct or behavior. It remains a serious issues which threatens patient safety, registered nurse and the entire nursing professionals. Forty-five percent of the nurses have either been verbally bullied or harassed by other nurses whereas forty-one have been harassed or bullied by their managers or administrators based on RNnetwork survey.
Albeit the hurdle in being the objective of the venting of the co-worker, it is classified as the workplace violence, bullying has been effected through three main components: Bullying is targeted, it is meant to trigger harm and it takes place over time. Certain kinds of mistreatment or unkind behavior or acts on job can really be categorized as incivility, yet not essentially bullying. Such act include eye rolling, disrespect, gossip or generally, unfriendliness. A great percentage of bullying is nurse-to-nurse, however, other healthcare staff can further be bullies: the nursing assistant who has been on unit for forty years can target the novel registered nurse, or the unit secretariats who victimize a given nurse (Tarkan 2013).
Most nurses are bullied by other nurses, and a great share frequently face verbal abuse. Some study carried out in December 2006 by Cole Edmondson about workplace violence against nurses unraveled that eighty-two of the Texas nurses who were surveyed had experienced workplace violence that ranged from verbal abuse to physical acts. It was further added that bullying could target cohort and individuals and remains actually a group phenomenon: 1 unit taking out their aggressions on another unit, or the nurses on a particular unit bullying novel hires or novel graduates. Nurses in certain areas or specialties cold perceive or believe they are superior or even better than another given unit or specialty and hence degrade them, their care, education or even specialty as a whole.
Bullying in nursing remains a significance issue in nursing profession. Bullying is never merely detrimental to the person being targeted. Bullying for example could lead to one nurse withholding information from another and hence causes the nurse to make a mistake with the patient. Also, yelling at one nurse or even criticizing him in front of the patient will potentially harm the patient care (Murray 2009). A nurse who is treated in a manner that is making him feel badly will stop the flow of the information. When nurses are never freely communicating with the members of the healthcare team, it will eventually impact outcomes.
In both literature and practice, it is known that bullying among nurse eventually influences the quality and safety of the patient care being provided. Studies have shown that 75% of the nurses state that they in knowledge of errors in patient care or even issues established when nurse bullying takes place. A great portion of the organizations have decided to take the journey to Magnet destinations to work on the improvement of nurse work environment, empowering the nurses as well as creating excellent outcomes. The bullying must be tackled at each level to ensure that the safety and security of both nurses and patients are guaranteed to ensure minimal errors which goes into the core heart of treatment and hence the recovery process.
The patient safety is greatly influence by bullying. For example, a nurse who is being bullying cannot offer effective care and even treatment. The nurses who feel that they are never safe and secure have cannot give the right healthcare delivery to the patients. The patients will be dealt a big blow as the nurses will be disrupted and this goes deep into mental disruption and even feeling of valueless in the organization. The nurses who are looked down upon cannot feel that their inputs are appreciated and hence will definitely be less productive. The quality of care will greatly be hampered.
The aspects central to quality of care for the patient encompass effective teamwork and communication alongside a collaborative work environment. Bullying leads to disruptive and corrosive impact behavior which is great magnification in the healthcare sector (Etienne 2014). Hence, a dysfunctional team environment will invariably lead to errors and preventable adverse outcome.
Bullying culture will led to demoralized workforce working the caring profession making patients to suffer extremely. Bullying will also lead to changes on nurses’ perception of the employer and thus decreasing nurse commitment to the organization which trickles down to hurt the patients. The nurses will not be retained and hence the commitment of the nurses to their patient will be greatly lowered leading to prolonged recovery process.
It is time to take a stand on bullying. Some healthcare institutions are increasingly facing bullying head on, whereas others are decreasing the bullying incidence via cultivation of particular culture to deal with bullying. Organizations with caring cultures which adhere to the code of ethics as well as practice shared governance have reported lower incidence of the perceived bullying. These institutions would experience less grievances overall sine staff feel increasingly valued (Lieber 2010).
The leadership must handle bullying by empowering nurses and other workers via the policies and procedures, making them more aware that bullying is never an acceptable behavior. One reason why bullying endures is that frequently those who experiences or suspect the adverse conduct or behavior look the other way or even decline to become engaged. Nurses can and need to stop the malicious pattern to take a stand on bullying. This means that any nurse who sees a co-worker being bullied, must step in and say wait a minute- time out. Such interventions is significant and will greatly decrease bullying.
Characteristically, no one is speaking up and this is making bullying to blossom at a terrifying speed. The number on most powerful behavior is the witness to speak up assertively and support the person is being targeted. Instead of turning away, the witness must reach out to the fellow who is the target of the bully (Spector, Zhou and Che 2014). This is in essence means that nurses can all be “upstanders” when they intervene in situation and reaching out to the peers who are the targets of bully.
These contexts do not merely halt when the bullying conduct or behavior is over. They have lasting impacts on the mental health as well as one’s feelings of security and safety. As the nurses learn to identify as well as confront the harmful behaviors towards themselves alongside coworkers, the workplace violence, encompassing bullying of the nurses, shall never be allowed to endure. Nurses as well as patients shall be safer as well as secure.
Nurses should be a proactive when being bullied. Based on stopbullyingtoolkit.org fact sheet, twenty-one percent of nurses exit their work because of the incivility as well as bullying. Thus instead of becoming a part of this cohort of nurses exiting their work, the problem has to be confronted at each level across the institution. It establishes an untenable context for the nurses as well as the ones who witnesses it, including visitors and patients. Where a nurse feels she or he is being bullied, it is imperative to let the bully know how such a behavior makes her feel. The nurses should always think of themselves as professionals with the primary goal of being educated regarding the bullying as well as how to handles this unwarranted behavior.
Nurses must always pause as well as take the deep breath and act professionally by not letting the bullying situation trigger their decompensation. The practice of self-awareness, observing how the context is provoking an emotional reactions is always recommended. Where a nurse is comfortable doing so, he can address it straight with the person. Where this is never feasible, there is a need to practice a reaction or response using role play on her own or with a peer.
Where the nurse is never comfortable with such a direct approach or if the direct deliberation is never working, the nurse needs to report to the manager, supervisor or even preceptor. Where the manager is the problem, the nurse must reach out for support of someone else, like educator or someone in human resources (Seibel, 2014). The nurse must find out the policy of the organization which address the behavior which undermine a culture of safety and hence ensure he is clear on how the individual has violated such a policy. Then the nurse must document the experiences with such person.
The nurses must always document the context: what took place, who said what and who witnessed the incident. Documenting needs to take place immediately because one’s impression as well as memories are frequently less clear over time. The new nurses are an effortless target for bullies, because they are novel. Prevention of bullying among the novel nurses begins with the job hunt, so novel nurses must do their homework regarding healthcare organization to which they are making an application.
They must check whether the organization have caring culture, a code of ethics, policies as well as procedure well documented and put in place. The applicants must check whether the organization has a shared governance and if yes, the nurses must check the likelihood of bullying is probably lower (Johnson and Trad 2014).
The applicants must be aware of the toxicity of certain units by asking right questions in the interview process like how scheduling conflicts are handled. It remains a positive sign where the unit nursing staff are integral part of the interviewing process because it indicates the organization is empowering the staff to make rational decisions regarding colleagues (Wright and Khatri 2015). The interviewee must ask if the organization has policies and procedures for the violence and proceed to look at their orientation especially what the organization is doing to guarantee healthy work environment.
The organization must as well practice prevention personality by knowing what bullies look for in the target (Dunn 2000). Bullies are looking for nurses who they do not think shall confront or challenge them, who appear insecure or even nervous, who are passive communicators, anything which makes them different.
References
Dunn, K. 2000. Bullying in the Workplace Often Goes Unnoticed. Workforce, 79(4), 28-29.
Etienne, E., 2014. Exploring workplace bullying in nursing. Workplace health & safety, 62(1), pp.6-11.
Johnson, J., and Trad, M. (2014). Bullying Behavior Among Radiation Therapists and Its Effects on Personal Health. Radiation Therapist, 23(1).
Lieber, L. D. 2010. How workplace bullying affects the bottom line. Employment Relations Today, 37(3), 91-101.
Murray, J.S. 2009. Workplace Bullying in Nursing: A Problem That Can’t Be Ignored. MEDSURG Nursing, 18 (5), pp. 273-276.
Seibel, M., 2014. For us or against us? Perceptions of faculty bullying of students during undergraduate nursing education clinical experiences. Nurse education in practice, 14(3), pp.271-274.
Spector, P. E., Zhou, Z. E., and Che, X. X. 2014. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies, 51(1), 72-84.
Tarkan, L. 2013. How to cope with bullying in the workplace. Retrieved from: https://www.foxnews.com/health/2013/04/25/how-to-cope-with-bullying-in-workplace/
Wright, W. and Khatri, N., 2015. Bullying among nursing staff: Relationship with psychological/behavioral responses of nurses and medical errors. Health care management review, 40(2), pp.139-147.
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