Prevention of Workplace Bullying in Nursing

Problem Description

Workplace bullying is a significant issue which affects the nursing profession, and the victims are regarded as part of an oppressed group. Managers may execute bullying by engaging in the actual action or fail to support the victims. Nurses are not just victims of bullying but may also bully other colleagues hence bullying is not just done by the senior staff. Bullying is a complex phenomenon across all professions and requires an evaluation of the social, individual and organizational factors to gain an in-depth understanding about the vice (Lowenstein, 2013). It is vital that all organizations are aware of bullying as it affects the staff and also a patient as far as nursing is concerned.

There are various forms of violence at the workplace which include physical and verbal abuse, sexual harassment, mobbing and even bullying. Lowenstein (2013) reports that around 30% of nurses experienced bullying at the workplace. It has also been reported that approximately one-sixth of nurses had been bullied in the past six months. At least 85 percent of nurses have been verbally abused by fellow nurses as reported by researchers. A third of nurses who quit their job have attributed the action to bullying, and the vice is the leading cause of the global shortage of nurses.  Longstanding struggles for power is the primary cause of bullying and occurs due to organizational conditions and unsympathetic leadership styles. Racism which entails discrimination against overseas trained nurses and political interests can also lead to bullying at the workplace.

Bullying in the workplace in the nursing profession occurs across the globe and negatively affects work performance. The Stafford hospital in Virginia hit the newlines due to bullying executed by two nurses, Sharon Turner and Tracy White. The nurses were intimidated into obeying the orders of senior nurse’s failure to which they would be fined or even dismissed from work. At one incidence nurses were forced to forge documents indicating a record that meets waiting for targets at the emergency department. The nurses would be rebuked for spending more time with patients at the hospital. A nurse who acted as a whistleblower, Helene Donnely who emphasized on indicating the true waiting time reported that she was ostracized and experienced “bitchy” comments from other staff. Failure of staff to show a four-hour waiting time for patients made them, to be held accountable for their actions hence workers were forced to lie.

The victims of bullying feel intimidated and experience the adverse effects of the vice which include job dissatisfaction, physiological and psychological effects. Incivility and humiliations are the common forms of bullying while working. Predatory alliances work to cover bullying practices and even the people who execute bullying were often rewarded. Bullying is associated with the whole organization as the institution influences the existence of bullying and also whether the problem will be resolved. Bullying leads to physiological and psychological torture on the victim and also negatively affects the organization and patient care (Lowenstein, 2013). Low quality of care is provided by bullied nurses who also experience loss of self-confidence and self-image by the victims.

Zero Tolerance Policy on Bullying Among Nurses

Organizational restructuring is the primary intervention that can be used in the prevention of workplace bullying among nurses. As discussed above, organizational issues are the leading causes of workplace bullying and include matters such as poor leadership characterized by managers bullying subordinates or failing to punish the culprits of the vice. The vice negatively affects the health care system and causes the nurses to provide a low quality of work which causes poor patient outcomes and also affects the nurse psychologically (American Nurses Association, 2015). The nurse can also experience physical problems as a result of bullying.

It is important to eliminate all forms of bullying at the workplace through the implementation of the zero-tolerance policy. Dealing with zero tolerance policy may leave the impression that hospitals have no bullying incidences yet the problem exists in the place. Zero tolerance should be implemented among nurses and the obstacles to the strategy as the managers are mostly the bullies. Bullying behavior is condoned when nurses keep silent in the face of bullying and other uncivil behavior(American Nurses Association, 2015). Instances of harassment may also be condoned when the ringleader is productive in the environment, and it is hard to lose him or her.

It is vital that the nurse leaders embrace zero tolerance to bullying at the workplace through receiving evidence-based education on emerging issues such as bullying and incivility. The nurse should also examine his or her actions to determine whether they are bullying in nature. It is important that a nurse leader names any bullying action by a perpetrator in the open to be freely expressed(American Nurses Association, 2015). He or she should speak to other staff in meetings and teach them that bullying is not tolerated. The nurse leaders should engage in policy formulation and implementation such as the bullying zero tolerance policy.

The American Nurses Association (2015) defines zero tolerance to bullying refers to the elimination of all forms of bullying at the hospital. As the name suggests, zero implies taking the intimidation levels to none at any given hospital the policy will ensure that there is no bullying in the workplace and that all staff is free to care for their patients. The leaders should be fully committed to removing bullying at the workplace through the removal of the bully regardless of how productive they are. He or she should actively check out for clues to bullying at the workplace and ensure that bullying victims are aware of the employee assistance programs.

The zero-tolerance policy for bullying in nursing is the most effective strategy for eliminating bullying when properly implemented. The system ensures that all individuals involved in bullying are removed from the hospital, and there is a conducive environment for the provision of nursing services. Staff in the hospital planning to engage in bullying will get warning signs from the removal of bully nurses from work(American Nurses Association, 2015). The chances of bullying will thus be minimized since everyone is interested in preserving his or her position at the workplace.

Strengths and Weaknesses of Research Evidence

All the seven articles have outlined their problem statement in a clear way. The main issue highlighted in the articles is issues of bullying among nurses, and the researchers stated that they are investigating the vice. The researchers also set out establish the causes of workplace bullying and identify how the issue can be addressed and managed. Felblinger (2008) aimed at determining the interventions that were suitable for the reduction of workplace violence among which zero tolerance policy was a priority. Murray (2009) emphasized the vitality of addressing bullying in the workplace through various strategies. Cleary, Hunt &Horsfall, (2010) researched the identification, prevention, and management of bullying at the workplace. Lachman (2014) identified ethical issues surrounding the problem of bullying in the workplace.

The operational definition of variables in the various research works was done. Most of the terms used in the study include bullying, incivility, nursing and zero tolerance policies which were the commonest keywords among the research. Felblinger in her study defined all variables which she used and included incivility and bullying. Murray also provided an operational definition of variables for the research, and so did other researchers. Melanie et al. performed an operational definition of all the concepts used in the study including bullying, zero tolerance policies, and upward bullying. Hutchinson (2009) defined the keywords which included harassment, nursing, restorative justice, workplace violence, shared responsibility and working teams. Hutchinson aimed to collect data about what is known about bullying in the workplace.

All the studies were cross-sectional in that they examined the occurrence of workplace bullying at a given point in time. Data were collected from among nurses who were willing to disclose information on the existence of workplace bullying and the possible solution which can be used to resolve the vice. Data collected from cross-sectional studies have a lower strength in comparison to experimental and quasi-experimental studies but stronger evidence than surveys. All the seven studies involved the selection of large sample sizes which correlate with the collection of diverse data. The data is therefore reliable and can be applied to the nursing profession due to the strength of evidence. A lot of data is collected for a large sample hence these studies are relevant enough to offer adequate data which is generalizable to other areas of nursing (Etienne, 2014). The research conducted by Melanie involved an analysis of the previous literature and concluded that upward bullying was relatively a new concept in the nursing profession yet it affects so many people.

Most of the studies employed questionnaires in the collection of data which were administered to nurses and nurse managers. The questionnaires were self-administered, and thus the individuals would answer the questions themselves which would later be analyzed. Electronic methods of data analysis were employed in the various studies examined. The use of an electronic system in data analysis provides accurate data without errors and present information in a clear manner quickly. The above research studies are significant in that they can be applied to the nursing profession as the recommendations were given can be employed in practice. Zero tolerance policies were a key point of emphasis for the research studies. The authors suggested the vitality of implementing legislation aimed at addressing the challenge of workplace bullying and therefore zero-tolerance policies will be useful in dealing with the vice of bullying as indicated. Results of the study conducted by Melanie et al. (2014) show that bullying in the workplace emerges from attempts to manage stress and frustration at the workplace. They recommended that zero tolerance policies should be adopted. Felblinger emphasized the role of regulatory interventions for bullying which include legislation.

Plan for Implementation

The implementation of zero tolerance policies for bullying at the workplace in Stafford hospital will begin with a restructuring of the hospital management. Zero tolerance to bullying cannot occur in an environment where the management is involved in bullying practices of any form or tolerate the culprits of the vice. The management should be evaluated to determine the presence of any individuals who entertain bullying and terminated them from work immediately (Etienne, 2014). A new management which upholds ethics and is strict about bullying should then be put in place at the facility. The reorganization of the hospital management will take two weeks since existing staff will replace the outgoing managers and the burden will be left for recruiting junior staff.

The main strategies employed in the change process will include communication, policy-making and the inclusion of all individuals regardless of their background. The process will be followed by raising awareness about the existence of a new policy concerning the issue of bullying in the workplace. The knowledge creation will take one month after which any individual caught violating the policy measures will be held accountable. The protocol is that severe cases of bullying will lead to an immediate termination of an employee. Other forms will involve a one-time verbal warning followed by termination if a repeat of the vice is observed. As per the zero-tolerance policy, no staff is expected to engage in any form of bullying failure to which a disciplinary action will be taken against him or her.

The personnel needed for the implementation of the policy involves mostly the willing nurses. I will make an invitation for nurses who would like to join the movement on achieving zero bullying rates at the hospital. People who have a history of being bullied at the hospital will be highly accepted since they will get an opportunity to see justice served on the culprits. The main role of the personnel will be to create awareness on the negative impacts of bullying at the workplace and also the future policy of zero tolerance (Lowenstein, 2013). I will seek great support from the first hospital management whom I believe will be willing to participate as long as they are not bullies themselves. I think that the strategy will work and workplace-based violence will diminish given all the dedication and awareness creation that will be done.

Zero tolerance policies on bullying in the nursing profession will ensure that there is no bullying in the workplace. The vice leads to not only physical but also psychological consequences hence the effects will be abolished, and nurses will gain more confidence to work. A high quality of care will also be witnessed with the policy implementation since there is no one to intimidate nurses into doing his or her will. Harmony will prevail at the workplace as no staff will be living in fear of another human being which could lead to poor outcomes.

Conclusion

Bullying in the workplace is a worldwide phenomenon and nurses are not just bullied by the senior staff but can also bully each other. The ability to provide high-quality care by a nurse is affected by bullying. The structure of an organization may enhance bullying by creating a conducive negative environment where it can thrive. It is crucial that policies for preventing the possibility of harassment at the workplace are formulated and implemented such as the zero-tolerance policy. It is a high time that nurses should embrace the concept of zero tolerance of bullying is that there is not intimidation at the workplace. Adopting the strategy contributes to harmony at the workplace, ensures the emotional health, job satisfaction and also improved patient outcomes.

References

American Nurses Association. (2015). ANA Sets ‘Zero Tolerance’Policy for Workplace, Violence, Bullying. New Mexico Nurse, 60(4), 13-13.

Birks, M., Budden, L. M., Stewart, L., & Chapman, Y. (2014).Turning the tables: The growth of upward bullying in nursing academia. Journal of advanced nursing, 70(8), 1685-1687.

Cleary, M., Hunt, G. E., &Horsfall, J. (2010). Identifying and addressing bullying in nursing. Issues in mental health nursing, 31(5), 331-335.

Etienne, E. (2014). Exploring workplace bullying in nursing. Workplace health & safety, 62(1), 6-11.

Felblinger, D. M. (2009). Bullying, incivility, and disruptive behaviors in the healthcare setting: identification, impact, and intervention. Frontiers of health services management, 25(4), 13.

Hutchinson, M. (2009). Restorative approaches to workplace bullying: Educating nurses towards shared responsibility.

Lachman, V. D. (2014).Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Medsurg nursing, 23(1), 56.

Lowenstein, L. F. (2013). Bullying in nursing and ways of dealing with it. Nursing times, 109(11), 22-25.

Murray, J. S. (2009). Workplace bullying in nursing: A problem that can’t be ignored. Medsurg Nursing, 18(5), 273.