Caring to confront in the workplace: An ethical perspective for nurses

DeMarco, Rosanna

doi:10.1016/s0029-6554(98)90040-9

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…All employees are responsible for fostering a moral work environment where ethical values are explicit, shared, and guide action [51, 52]. Bullying in the workplace runs counter to the espoused ethical values of health care organizations and must be challenged by managers and front-line nurses who we have been called “upstanders” in this study.…”

Section: Discussionmentioning

confidence: 99%

Making Things Right: Nurses' Experiences with Workplace Bullying—A Grounded Theory

Gaffney

DeMarco

Hofmeyer

et al. 2012

Nursing Research and Practice

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While bullying in the healthcare workplace has been recognized internationally, there is still a culture of silence in many institutions in the United States, perpetuating underreporting and insufficient and unproven interventions. The deliberate, repetitive, and aggressive behaviors of bullying can cause psychological and/or physical harm among professionals, disrupt nursing care, and threaten patient safety and quality outcomes. Much of the literature focuses on categories of bullying behaviors and nurse responses. This qualitative study reports on the experiences of nurses confronting workplace bullying. We collected data from the narratives of 99 nurses who completed an open-ended question embedded in an online survey in 2007. A constructivist grounded theory approach was used to analyze the data and shape a theory of how nurses make things right when confronted with bullying. In a four-step process, nurses place bullying in context, assess the situation, take action, and judge the outcomes of their actions. While many nurses do engage in a number of effective yet untested strategies, two additional concerns remain: inadequate support among nursing colleagues and silence and inaction by nurse administrators. Qualitative inquiry has the potential to guide researchers to a greater understanding of the complexities of bullying in the workplace.

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Section: Discussionmentioning

confidence: 99%

Making Things Right: Nurses' Experiences with Workplace Bullying—A Grounded Theory

Gaffney

DeMarco

Hofmeyer

et al. 2012

Nursing Research and Practice

Self Cite

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“…In part, this may be because these behaviors are learned in the schoolyard where most bullying among girls is relational, covert and socially toxic-ostracism, insults, divisive gossip, and so on-the same behaviors that are demonstrated in the workplace (Farrington, 1993;Rayner & Hoel, 1998;Vessey, DeMarco, Gaffney, & Budin, 2009). BHHV, surrounded by a "culture of silence," fears of retaliation, and the perception that "nothing will be changed," can also effectively shut down the exchange of information (DeMarco, 1998;Ferns, 2005;Stearley, 1997). Data support these assertions.…”

Section: Prevalence Of Bhhvmentioning

confidence: 99%

Bullying, Harassment, and Horizontal Violence in the Nursing Workforce The State of the Science

Vessey

DeMarco²,

DiFazio³

2010

Annu Rev Nurs Res

176

174

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In the complex health care workplace of nurses, intra/interprofessional ideals intersect with the expectations of patients, families, students, and coworkers in a context of managed care environments, academia, and other health care enterprises. Integral to quality assessment, management, and assurance is collegial and respectful communication. Decades of reported descriptive and anecdotal data on intra/inter professional and on client communication, describe the antithesis of these ideals. Specifically, increasing frequency and rates of persistent bullying, harassment, or horizontal violence (BHHV) have shown to yield detrimental effects on workplace satisfaction, workforce retention, and the psychological and physical health of nurses as well as implied effects on quality of patient care and risk of poor health outcomes. Persistent BHHV among nurses is a serious concern. In advancing the science of description and explanation to a level of prevention intervention, explanatory models from biology, developmental psychology, intra/interpersonal interactionism are described along with theoretical explanations for the prevalence of BHHV in nurse workplaces. Making the connection between explanatory models and creative solutions to address BHHV through multiple levels of behavioral influence such as individual, environmental, interpersonal, and cultural contexts is key to advancing the science of the relationship between professional behavior and client/family/community health care outcomes.

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“…Fieldwork studies on inter-professional relationships in, for example, medicine 20,21 have generally found a reluctance on the part of professionals to confront, challenge or discipline each other. In DeMarco’s 22 review of some studies on ‘constructive confrontation’ among nurses, she reported that nurses perceived an ethical dilemma in these situations, in which commitments to maintaining relationships conflicted with commitments to truth-telling. Nurses were often reluctant to confront colleagues and tended to shift responsibility for this to managerial personnel.…”

Section: Discussionmentioning

confidence: 99%

Negotiated ethical responsibility: Bruneian nurses’ ethical concerns in nursing practice

Zolkefli

2018

Nurs Ethics

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Background: There has been wide interest shown in the manner in which ethical dimensions in nursing practice are approached and addressed. As a result, a number of ethical decision-making models have been developed to tackle these problems. However, this study argued that the ethical dimensions of nursing practice are still not clearly understood and responded to in Brunei. Research aim: To explore how Bruneian nurses define ethical concerns they meet in everyday practice in the medical surgical wards of three Brunei hospitals. Research design: A qualitative study was employed. Interviews were conducted with 28 practising and administrative nurses of three hospitals. Interview data were analysed via a constant comparative method. Ethical consideration: The study’s protocol was reviewed and approved by the Ethical Committee of the School of Health in Social Science at the University of Edinburgh and the Medical Health Research Ethics Committee of the Ministry of Health, Brunei. Findings: The nurses described three ethical dimensions in their practice, namely: ‘nurse at work‘ which illustrates the ethical dimensions within the work environment; ‘nurse and doctor’ which elucidates the ethical dimensions in the nurse and doctor relationship; and ‘nurse and patient’ which further examines ethical aspects in patient care. Nurses responded to the ethical dimensions in the ward setting with the aim of avoiding the conflict and maintaining ward harmony. Discussion: The data provide new insights into how nurses respond to ethical dimension in the ward settings where it puts strong emphasis on the nurses’ understanding of responsibility placed upon them as professional nurses. Conclusion: With these findings, it is recommended that further support is needed for nurses to be aware of the ethical dimension in their practice and to respond to ethical concerns accordingly.

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Caring to confront in the workplace: An ethical perspective for nurses

Cited by 11 publications

References 10 publications

Making Things Right: Nurses' Experiences with Workplace Bullying—A Grounded Theory

Making Things Right: Nurses' Experiences with Workplace Bullying—A Grounded Theory

Bullying, Harassment, and Horizontal Violence in the Nursing Workforce The State of the Science

Negotiated ethical responsibility: Bruneian nurses’ ethical concerns in nursing practice

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