workplace bullying and nursing

WORKPLACE BULLYING AND

NURSING

Bayfront Health Spring Hill Nursing department

Rachel Provau RN MSNA CNML

Objectives Define Bullying and 3 forms found in Nursing

List 5 recognized categories of workplace violence/bullying

Name 3 stress related complications related to bullying and 3 resources that are available to staff

Explore how bullying behavior affect Patient safety

Review personality types and how to recognize them

Discuss four Charge Nurse leadership styles

Define Civility and discuss ANA recommendations

Discuss 3 actions that address prevention of bullying behaviors

List strategies that can be used in your unit

Bullying Repeated, health-harming mistreatment of one or

more persons (the targets) by one or more perpetrators.

Verbal abuse

Threatening, intimidating or humiliating behaviors (including nonverbal)

Work interference – sabotage – which prevents work from getting done

Males vs Females Conflict styles Men – Direct, aggressive, and/orintimidating.Women – Passive, indirect, and/orManipulative

Relational Aggression-(female bullying)

Relational Aggression Gossip Manipulation Intimidation Exclusion Gestures

Ridicule Teasing Cliques Campaigns Name calling

Click icon to add picture Examples in Nursing:

1. Ignoring- Passive aggressive

2. Rolling of the eyes ( body language)

3. Refusal to answer a question

4. Social media post about a co worker that are not nice

5. Texting 6. Condescending tone of

voice

27% of Adults report they have been bullied at work

One in six Nurses report they have been Bullied in the past Six months

Statistics WBI Instant Polls 817 respondents

(bullied targets and witnesses)

QUESTION:Of the workplace perpetrators of bullying I’ve known, they?

© 2014 Workplace Bullying Institute

82% acted with the deliberate personal intention to harm others

8.6% harmed others but were not aware of the consequences

7.8% followed instructions of superiors in ways that hurt others

1.5% never meant to harm others; were misunderstood

Categories of Workplace Violence Threat to

professional status (public humiliation)

Threat to personal standing (name calling, insults, teasing)

Isolation (withholding information)

Overwork (impossible deadlines)

Destabilization (failing to give credit where credit is due)

How does this affect the work environment of a nursing unit? Lower morale, lower

productivity and increased absenteeism

Rapid and increased turnover

Negative impact on organizational reputation

Contribute to poor patient satisfaction and to preventable adverse outcomes

Increase the cost of care

Bullying and Patient Safety Failing to tell

another nurse that the patients lab results were called to you

Refusing to answer other’s nurses call lights because “those are not my patients”

Nurses eating their young or new orientees – Staffing compromised because no one hired stays

Indifference or ignoring – “That doesn’t mean I have to do it” BSR/HR

Stress complications related to bullying

Physiological Reduced immunity

to infection Headaches and

migraines High blood pressure Waking up more

tired than when you went to bed

Psychological Behavioral Anxiety reactive depression Forgetfulness angry outbursts at

home Increased reliance

on drugs/self medicating

Resources for staff American Nurses

Association (ANA) PACERS CDC Workplace

Violence prevention for Nurses

www.stopbullyingnurses.com

Human Resources TJC RN2RN CNO, HR, ERS EAP Compliance hotline

The Charge nurse and Prevention of Bullying of staff on the unit

What personalities are on your unit?

Divergent Book Series Factions Abnegation

Dauntless

Erudite

Candor

Amity

Which Faction are you? ERUDITE-Characterized by great

knowledge; learned or scholarly (know it alls)

AMITY-cultivating strong relationships and trying to understand each other. (softies)

Which Faction are you? ABNEGATION-active forms of stripping

things from your life.(Stiffs)

DAUNTLESS-Courageously resolute, especially in the face of danger or difficulty; not discouraged. (Toughies)

CANDOR-freedom from bias; fairness; impartiality ( truthsayers)

Leadership and Bullying?

4 quadrants of leadership Obnoxious Aggression-

always challenging directly but don’t care personally what the consequences are

Ruinous Empathy- Destructive Sympathy, Sparing someone's feeling and then having to intervene because of not holding someone accountable

https://youtube/Y9VW7wGO4vY

4 quadrants of leadership Manipulative Insincerity-

Very Sneaky, Manipulative, Pot Stirrer

Radical Candor- using Civility as a communication tool to set expectations of behavior and responsibilities

Bullying and leadership

Radical Candor and Civility The 5 ‘C’s”

Clear Expectations

Clear Capability

Clear Measurement

Clear Feedback

Clear Consequences

Examples

Time Management

Right skills

Outcomes

Fact based to give and to take from others

Repeat, Reward or Release

How Radical Candor is effective to prevent Bullying Being willing as a Leader to: ANA

handout review Set Clear expectations- Clear capability- Clear Measurement – Clear feedback- Clear Consequences-

Actions that address prevention of bullying behaviors

Zero tolerance AIDET S.A.F.E. Educate all team

members Hold all team

members accountable for modeling desirable behaviors

Bullying prevention Strategies Prevention of Bullying-

Responding tp being bullied – Chain of command, HR, Hotline

Responding when being bullied-

What strategies can you suggest?

American Nurses Association (ANA) Code of Ethics (ANA,2001) that states professional nurses have an ethical mandate to become skilled communicators.

References Institute of Medicine.

Keeping Patients Safe: Transforming the Work Environment of Nurses. Nov. 3, 2003

Occupational Safety and Health Administration. Workplace violence in health care: Understanding the challenge. OSHA 3826, 12/2015

Workplace Bullying Institute. The Healthy Workplace Campaign. Healthy Workplace Bill website

The Joint Commission. Behaviors that undermine a culture of safety. Sentinel Event Alert, July 8, 2008;40

American Nurses Association. Incivility, Bullying, and Workplace Violence. ANA Position statement 7/2015

Nursing Times. Bullying in Nursing and ways to deal with it. March 2013

References

Kimmalonescott.com J. Mill- On Liberty ISBN 1-59986-973-X 1859 G. Robins- 25 Rules of Civility + Radical Candor +

Ruinous Empathy LinkedIn Blog 2/10/2016 P.M. Forni- Choosing Civility: The 25 rules of

Considerate Conduct 11/2003 D. Huber- Leadership and Nursing Care

Management ISBN 978-1-4557-4071-0 1996 R. A. Patronis-Jones- Nursing Leadership and

management: Theories, Processes and Practice ISBN 0803613628 9780803613621 2007