Workplace Bullying as a Cause of Nurse Shortages

Introduction
What is the impact of nursing shortage around the globe? Not a lot of people know that this contributes to a worldwide problem. This is an issue that was not properly contemplated and it is saddening that it has been taken for granted. From a healthcare perspective, this is important to remind our community the importance of handling issues regarding nursing shortage. According to Haddad and Toney-Butler (2020), this happens due to the shortage of potential educators, a high turnover rate, and unequal distribution of  workforce in the nursing profession.Thus, applies continually as a part of a global problem (Haddad and Toney-Butler, 2020).

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Situating the Topic
There are many different reasons for nursing shortages. The goal of my essay is to emphasize the significance of nursing shortage, and to raise awareness of these retaining problems that are happening in our community which is workplace bullying.  It is very important to understand this undisclosed issue that links between bullying and nursing competence which is affecting the system. According to the Canadian Centre for Occupational Health and Safety(2020),
“Bullying applies as an aggression through assertion of power which could affect the physical, mental, and emotional state of mind. This may involve certain acts of verbal comments, and inappropriate negative physical contact. As this prolongs, this can isolate and hurt a person targeted in the workplace. This may entails repeated incidents or patterns of behavior usually intended to degrade, humiliate, intimidate and offend a particular person or a group of people (Canadian Centre for Occupational Health and Safety, 2020, p.1)”.
The Canadian Nurses Association and the Canadian Federation of Nurses Unions (2014) strongly support violence-free workplaces. Workplace violence and bullying threaten the delivery of effective client care; they compromise patient safety and may extend beyond the workplace (The Canadian Nurses Association and the Canadian Federation of Nurses Unions , 2014). At the end of this essay, it is important to uncover and solely understand that bullying has a staggering effect that affects the nursing shortage in our society.
Articulating the Topic
Nursing profession is mostly appreciated because of its strong code of ethical practices which is built on care and compassion. On the contrary, this field of work is not spared from any form of workplace violence which is bullying. Most of us think that bullying only applies to school kids, unknowingly workplace bullying is predominant in this line of work. It is quite distressing that even in our place of work this has become its common ground.
As workplace bullying progresses, Ariza-Montez, et al. (2013) explains that this could possibly lead to higher turnover rates resulting in staff shortages. Eventually, its rising demand for nurses had reached an on-going dilemma. If this continues, shortage of nurses can be a paramount concern of nursing leaders and healthcare organisations worldwide (Ariza-Montez, et al. 2013).
Analysis of the Issue
Haddad and Toney-Butler (2020),  mentioned that violence in the healthcare setting plays a big role in the nursing shortage. The presence of threat, emotional and, physical abuse adds to an already stressful environment. It affected job satisfaction and work effort negatively, as the physical and emotional insults take a toll on the well-being of the healthcare professional (Haddad and Toney-Butler, 2020).
Registered Nurses Association of Ontario (2019), emphasizes that bullying occurs within a health service organization and academic institution. This varies between nurses and their colleagues, colleagues between students and health workers, and between formal leaders and health workers (Registered Nurses Association of Ontario, 2019).
The article by Gaffney et al. (2013), contained six subcategories to nursing workplace bullying. These were the following categories discussed:
“Being a newbie (simply being new/novice nurse), bearing witness (as to being a witness of an event of bullying which means the behaviors of the perpetrators targets the bystanders), in the bull’s eye (a nurse is being targeted for public humiliation), nurses interrupted bullying (assignment manipulation, refusal of physical support and having information withheld), odd nurse out (harming another person’s self-esteem or social status as taking forms of verbal rejection or negative facial expressions) and, in the penalty box(nurses felt that they were being punished as they received sanctions or threats) (Gaffney et al., 2013)”.
As per the Canadian Centre for Occupational Health and Safety (2020), this does not include:
“Comments that were provided through the expression of different opinions, constructive feedback, guidance or advice about work-related behavior, and actions that were reasonable in account that were handled by the employer or supervisor in relation to management and direction of workers were all intended to objectively assist employees with their work. Considering this reason it is very challenging to determine between the bully and the target”(Canadian Centre for Occupational Health and Safety, 2020, p.1).
There is uncertainty in recognizing the bully or perpetrator in this field. As there is a thin line between strong management and bullying. Nevertheless, in clarification between bullying and harassing behavior.
Rocker (2008) suggests that this creates a problem as the person in authority or position appears to not recognize bullying or mostly rejects this concern. This dilemma drains nurses both energy and productivity. Until now, there is neither an effective way to address this issue nor adequate methods to check for nurses affected by this problem (Rocker, 2008).
Social Cultural Perspective
Registered Nurses Association of Ontario (2019), reiterates that social factors of the organizations were related to climate, culture and their values. Nurses support organizational stability, communication practices and structures, labour management relations, and a culture of continuous learning and support (Registered Nurses Association of Ontario, 2019).
In addition, Rocker (2008) mentioned that the problem of bullying may originate in three factors: individual factors which include mental illnesses, female gender workers, and drug and alcohol habits. Another one is environmental factors that include poor lighting, lack of safety measures, and working with violent or hostile patients and families. Lastly, is the organizational factors that comprises lack of resources, understaffing due to the nursing shortage, poor workgroup relationships, changes in composition of work groups, low supervisor support, increased workload, downsizing, and organizational restructuring (Rocker, 2008).
Economic Perspective
The Canadian Bureau of National Affairs, Individual Employee Rights Newsletter (2000) clarified that race and gender is not related to bullying. Instead nurses felt emotionally distress such as burnt out when controlling the bullying behavior of other nurses. As a result, these have driven nurses that felt helpless on these kind of situation to an increase absenteeism, stress leave, and resignations; which is a contributing factor to nursing shortage that cost the healthcare system millions of dollars each year in employee benefits, retention, and recruitment costs (The Canadian Bureau of National Affairs, Individual Employee Rights Newsletter, 2000).
Political Perspective
The Canadian Nurses Association and the Canadian Federation of Nurses Unions (2014) continue to support governments and agencies that can assist organizations that have strategies in promoting and maintaining violence and bullying-free workplaces. In combination, they have created prevention programs, policies, legislation that address workplace violence, and bullying in healthcare organizations. They also promote mental health awareness and training which created standards for workplace mental health. The risk of workplace violence may increase due to these issues circumstances as the government increasingly shifts the workforce away from acute care settings that emphasizes more to community-based or long-term care aid. (The Canadian Nurses Association and the Canadian Federation of Nurses Unions, 2014).
Barriers to Resolution
Hutchinson et al. (2006) recorded that targeted nurses lacks focus of attention as they found themselves labeled as less capable and stupid. At the same time, the actions of the bully left unnoticed making them legitimate due to built-in power structures claimed by the bully in order to normalize the abuse. This occurrence of workplace bullying usually lasts between six months to seven years (Hutchinson et al.,2006).
As per Salin (2003), he observed that most large organizations with lots of formality and lengthy decision-making processes would make excellent shelters in which bullies may hide and go unrecognized. Meanwhile, the victim and others may suffer from isolation, fear, and stress-related illnesses, or commit suicide. Each of these possible consequences will be described below. Many nurses face challenges in their work environments such as excessive workload, high rates of overtime, illness, injury, and burnout may in fact contribute to workplace violence and bullying. The effects of such violence may also be detrimental to nurses’ own health, to the quality of care they provide and to the employer’s ability to retain and recruit them. A conflict between upholding the code of ethics and workplace violence and bullying is a source of moral distress for nurses, who are accountable to safeguard their client’s health as well as their own.
Strategies of resolution
Gaffney et al. (2013), states that there were three distinct problem-focused subcategories of taking action these are giving and getting support, speaking up (which included speaking out and whistle blowing), and moving out of the toxic environment by resigning or transferring from the work setting. Most nurses have resulted in confronting the bully as they expressed their efforts making the situation better for themselves, their colleagues, and patients. This strategy had made things right, as respondents had identified the consequences of bullying and mistreatment in the workplace. Frequently, nurses were not victims or silent witnesses as they mostly overcome the negative emotions and continue their stance as they took in the situation (Gaffney et al., 2013).
The Canadian Initiatives on Workplace Bullying (2007) found the need for nurse leaders to understand the relationship between nurse-to-nurse bullying in the workplace and economic costs associated with nurse resignation. Nursing leaders can play an important role in communicating that bullying behavior will be replaced with respect; while the perpetrators of bullying behavior receive help. Thus creating a safe working environment for nurses. This elimination of workplace bullying includes education, policy, and celebration.
Conclusion
Therefore, the impact of violence has serious repercussions not only on the health of bullied victims but also on the structure and financial spending of the organisation. More importantly, the potential latent impacts on the patient’s safety and health is of great concern. As per Koh (2016), the contributing factors towards violence are mainly due to characteristics of perpetrators, victim’s reaction to bullying, and organisation’s characteristics. To mitigate the impact of lateral violence among young and inexperienced nurses, a cognitive rehearsal scripted response is proposed to prevent harassment and bullying incidents from becoming a feature at the workplace for nurses (Koh, 2016).
The problem of nurse-to-nurse bullying in the workplace has gained considerable attention as nurse leaders struggle to recruit and retain nursing staff. As role models and creators of the work group culture, nurse leaders should play a key role in combating bullying in the workplace. It is not enough to simply help the victims, rather programs and policies need to be developed to address bullying behaviors. Bullying must become unfashionable. Education, policy development, celebration, and support encouraged a whole generation of smokers to “butt out.” The same efforts must be initiated to stop bullying in the workplace.
References

Ariza-Montes, A., Muniz, N. M., Montero-Simó, M. J., & Araque-Padilla, R. A. (2013). Workplace bullying among healthcare workers. International journal of environmental research and public health, 10(8), 3121–3139. https://doi.org/10.3390/ijerph10083121
https://www.ccohs.ca/oshanswers/psychosocial/bullying.html
The Canadian Bureau of National Affairs. (2000). Focus on workplace bullying. Individual Employee Rights Newsletter Herald. Available: www.bullybusters.org/press/bna1.html
Canadian Centre for Occupational Health and Safety. (2007). Bullying in the workplace. Available: www.ccohs.ca/oshanswers/psychosocial/bullying.html
Canadian Initiative on Workplace Violence. (2007). Legislative and legal updates. Available: www.workplaceviolence.ca/legal/legal-intro.html
Gaffney, D. A., Demarco, R. F., Hofmeyer, A., Vessey, J. A., & Budin, W. C. (2012). Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nursing research and practice, 2012, 243210. https://doi.org/10.1155/2012/243210
Haddad LM, Toney-Butler TJ. Nursing Shortage. [Updated 2020 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/
Rocker, C., (August 29, 2008) “Addressing Nurse-to-Nurse Bullying to Promote Nurse Retention” OJIN: The Online Journal of Issues in Nursing Vol 13 No 3. Retrieved from https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/vol132008/No3Sept08/ArticlePreviousTopic/NursetoNurseBullying.html#Rocker
Koh, W.M.S.(2016). Management of workplace bullying in hospital: A review of the use of cognitive rehearsal as an alternative management strategy. International Journal of Nursing Sciences. Vol 3 Issue 2. ISSN 2352-0132.  Pages 213-222. Retrieved from https://doi.org/10.1016/j.ijnss.2016.04.010. (http://www.sciencedirect.com/science/article/pii/S2352013215300247)
Registered Nurses of Onario. (2019). Best Practice Guideline: Preventing violence, harassment and bullying against health workers. 2nd ed. Toronto (ON): RNAO; 2019. Retrieved from https://rnao.ca/sites/rnao-ca/files/bpg/VPW_FINAL_WEB_July_2.pdf
Salin, D. (2003). Ways of explaining workplace bullying: A review of enabling, motivating and precipitating structures and processes in the work environment. Human Relations, 56(10), 1213. Available: http://proquest.umi.com.ezproxy.apollolibrary.com/pqdweb?index=0&did=532653361&SrchMode=1&sid=6&Fmt=4&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1213856928&clientId=13118