Bullying among nursing staff

OBJECTIVE To explore how workplace bullying is addressed by hospital nursing unit managers and organizational policies. BACKGROUND Although workplace bullying is costly to organizations, nurses report that managers do not consistently address the issue. METHODS This study used discourse analysis to analyze interview data and policy documents. RESULTS There were differences in the manner in which managers and the policy documents labeled bullying-type behaviors and discussed the roles and responsibilities of staff and managers. Policies did not clearly delineate how managers should respond to workplace bullying. CONCLUSIONS These differences can allow management variation, not sanctioned by policy. Unclear policy language can also offer insufficient guidance to managers, resulting in differential enforcement of policies.

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“…3 Workplace bullying has been associated with negative outcomes both for nurses 4–7 and patients. 1,8 …”

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confidence: 99%

Managerial and Organizational Discourses of Workplace Bullying

Johnson

Boutain

Tsai

et al. 2015

JONA: The Journal of Nursing Administration

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“…These include production pressures,51,52,59 resource mismanagement, supply shortages, and administrative inefficiencies 40,41,52. Working conditions may also be responsible1; for example, the operative context may comprise unfavourable conditions, such as long hours, few breaks, and large teams in cramped conditions.…”

Section: The Antecedentsmentioning

confidence: 99%

“…Males are more frequent instigators, and black and Asian doctors are more frequently victims 27,49,65. Certain situations also increase the risk,51,59,66 e.g., an operating room in a clinical crisis.…”

Section: The Antecedentsmentioning

confidence: 99%

Disruptive behaviour in the perioperative setting: a contemporary review

Villafranca

Hamlin

Enns

et al. 2016

Can J Anesth/J Can Anesth

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PurposeDisruptive behaviour, which we define as behaviour that does not show others an adequate level of respect and causes victims or witnesses to feel threatened, is a concern in the operating room. This review summarizes the current literature on disruptive behaviour as it applies to the perioperative domain.SourceSearches of MEDLINE®, Scopus™, and Google books identified articles and monographs of interest, with backreferencing used as a supplemental strategy.Principal findingsMuch of the data comes from studies outside the operating room and has significant methodological limitations. Disruptive behaviour has intrapersonal, interpersonal, and organizational causes. While fewer than 10% of clinicians display disruptive behaviour, up to 98% of clinicians report witnessing disruptive behaviour in the last year, 70% report being treated with incivility, and 36% report being bullied. This type of conduct can have many negative ramifications for clinicians, students, and institutions. Although the evidence regarding patient outcomes is primarily based on clinician perceptions, anecdotes, and expert opinion, this evidence supports the contention of an increase in morbidity and mortality. The plausible mechanism for this increase is social undermining of teamwork, communication, clinical decision-making, and technical performance. The behavioural responses of those who are exposed to such conduct can positively or adversely moderate the consequences of disruptive behaviour. All operating room professions are involved, with the rank order (from high to low) being surgeons, nurses, anesthesiologists, and “others”. The optimal approaches to the prevention and management of disruptive behaviour are uncertain, but they include preventative and professional development courses, training in soft skills and teamwork, institutional efforts to optimize the workplace, clinician contracts outlining the clinician’s (and institution’s) responsibilities, institutional policies that are monitored and enforced, regular performance feedback, and clinician coaching/remediation as required.ConclusionsDisruptive behaviour remains a part of operating room culture, with many associated deleterious effects. There is a widely accepted view that disruptive behaviour can lead to increased patient morbidity and mortality. This is mechanistically plausible, but more rigorous studies are required to confirm the effects and estimate their magnitude. An important measure that individual clinicians can take is to monitor and control their own behaviour, including their responses to disruptive behaviour.

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“…[5,12,14,16–22] These consequences ultimately affected the care nurses delivered to their patients including decreased quality of care, medication errors, and patient death. [23–27] Bullying among nurses previously garnered such national recognition The Joint Commission [28] issued a Sentinel Event Alert requiring all accredited hospitals to develop a code of conduct and implement processes to manage bullying. This alert has not eradicated the problem—in fact, bullying persisted leading the American Nurses Association [29] to convene a Special Issues Panel on Incivility, Bullying, and Workplace Violence to identify treatments for the problem.…”

Section: Introductionmentioning

confidence: 99%

“Nurses eat their young”: A novel bullying educational program for student nurses

Gillespie

Grubb

Brown

et al. 2017

JNEP

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Bullying is a known and ongoing problem against nurses. Interventions are needed to prepare nursing students to prevent and mitigate the bullying they will experience in their nursing practice. The purpose of this article is to describe the development process and utility of one such intervention for use by nursing faculty with nursing students prior to their students’ entry into the profession. The educational program was critiqued by an advisory board and deemed to be relevant, clear, simple, and non-ambiguous indicating the program to have adequate content validity. The program then was pilot tested on five university campuses. Faculty members who implemented the educational program discussed (1) the program having value to faculty members and students, (2) challenges to continued program adoption, and (3) recommendations for program delivery. The proposed multicomponent, multiyear bullying educational program has the potential to positively influence nursing education and ultimately nursing practice. Findings from the pilot implementation of the program indicate the need to incorporate the program into additional nursing courses beginning during the sophomore year of the nursing curricula.

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Bullying among nursing staff

Cited by 90 publications

References 24 publications

Managerial and Organizational Discourses of Workplace Bullying

Managerial and Organizational Discourses of Workplace Bullying

Disruptive behaviour in the perioperative setting: a contemporary review

“Nurses eat their young”: A novel bullying educational program for student nurses

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