Bullying, Evidence Based Practice #Magnet

As nurses, we want evidence-based practice in order to improve our care. As we all know, there are multiple barriers to providing excellent care and experiencing workplace violence or bullying is definitely an impediment. Nurses Relations Event

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Bullying, Evidence Based Practice #Magnet

We have all heard of the concept bullying. A sometimes over-used word but one that needs to be addressed. AllNurses staff recently attended the 2017 Magnet Conference in Houston. We were fortunate to catch a presentation by Jay Parchment, PhD, RN, NE-BC, Arnold Palmer Medical Center about evidence-based practice as it relates to the workplace bullying.

Dr. Parchment presented research study results involving over 200 nursing managers. Nursing leaders are often caught in the middle and squeezed from the clinical staff on one hand and THEIR nursing leaders on the other. He presented research study results involving over 200 nursing managers. Here are the demographics of the respondents:

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Many nursing organizations have addressed this in one way or another. In 2015, the American Nurses Association penned a position paper that states:

1 ) The nursing profession will not tolerate violence of any kind from any source

2 ) RNs and employers must collaborate to create a culture of respect

3 ) Evidence-based strategies that prevent and mitigate incivility, bullying, and workplace violence promote RN health, safety, and wellness and optimal outcomes in health care

4 ) The strategies are listed and categorized by primary, secondary, and tertiary prevention

5 ) The statement is relevant for all healthcare professionals and stakeholders

And in 2016, The Joint Commision on Hospitals identified the following categories of workplace violence:

1 ) Threat to professional status (public humiliation)

2) Threat to personal standing (name calling, insults, teasing) Isolation (withholding information)

3 ) Overwork (impossible deadlines)

4 ) Destabilization (failing to give credit where credit is due)

So, how do we work to prevent bullying or incivility? ANA has also published information in a paper, Breaking the Bullying Cycle:

1 ) Remember what it was like to be a new nurse. Treat new nurses as you would have wanted to be treated as a "newbie."

2 ) Make an effort to welcome new nurses and help them feel they're part of the group.

3 ) If you're being bullied, address the behavior immediately. Bullying might be so ingrained in the workplace culture that bullies may not be aware of their behavior.

4 ) Use conflict-management strategies when confronting a bully.

5 ) Identify the problem clearly when it occurs, and raise the issue at staff meetings.

6 ) Serve as a role model for professional behaviors.

allNurses has also addressed bullying. A well-received article from TheCommuter addressed the "why" of bullying in her article Why Do People Bully Me? She also offers suggestions on how to get the bullying to stop.

In another article, the author offers concrete suggestions about how to stop bullying. Break the Silence, Report Bullying. One of the suggestions in this article is to have exit interviews with staff leaving a unit or hospital and to ask about incivility. Addressing a unit culture can be difficult from within the unit. However, when administration is feeling the financial pinch of repeatedly hiring staff for a unit, staff consistently leaving a unit after a short while, and resulting staff shortages, this issue will rise to their attention.

Bullies make the lives of staff as a whole miserable. Who likes to go to work and listen to negativity all shift? Who likes to dread going to work? Who likes to wonder if you will get help when you need it? Who will have your back? Should you look for another job? Why is the bully so unhappy that they feel they must share their unhappiness with others? And this has all been shown to affect patient care and not for the better! Break the chain - report bullying.

So, is our culture as a whole becoming ruder, meaner and just overall, less caring? Maybe, maybe not. However, we must all as individuals answer for our own actions. Stop bullying now!

Its simple - BE NICE! Treat others as YOU would like to be treated.

How does your facility address bullying? What do YOU do individually to help foster an environment of caring, not only for your patients but your co-workers?

2 Votes
traumaRUs

About traumaRUs, MSN, APRN

Trauma Columnist

ER, ICU, pre-hospital RN, Nephrology APRN.

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Start anti-bullying education in school....NURSING SCHOOL.

1 Votes

Fire Bullies! Zero tolerance!

1 Votes

So what happens when the institution is the bully? On my first day at my last travel assignment I was given a beautiful algorithm showing the pathways taken to determine if an action merited re-education, counseling, safety reporting, or punitive action. I thought "great! They can't just decide who they do and don't hold accountable" 2 weeks later I was terminated without notice, counseling, or due process based on second hand accounts of events. They had no documentation to back them up, never asked me about it, and my documentation directly contradicted what was said.

Other bullies hide behind concern for patient safety. They make false accusations about victims leadership has no choice but to investigate. I once saw a great nurse leave my unit, because a clique of nurses had each accused her of diverting drugs, falsifying documentation, being impaired at work, and other board reportable infractions every couple of weeks. Since the same nurse never made a complaint twice, no one could prove it was harassment. The nurse was cleared every time because she had never done anything. But she still quite because of the gossip and stigma that was starting to build up. She was also afraid the accusations would eventually make everyone think the stories were true and keep her from advancing.

I've seen leadership members come down hard on staff members right after they graduate from grad school, because they are now more qualified for their job than the leadership member.

Honestly so much of this has gone on in so many hospitals I've worked in, right now I'm trying to find a new field all together after 10 years in nursing.

It should be noted that every example I gave took place in a Magnet Recognised Hospital.

1 Votes

Am very sorry to hear that you are thinking about leaving nursing. I empathize with you completely. I have heard these kinds of stories way too many times. Maybe instead of leaving nursing, you can start your own business? That way you control the corporate personality and culture.

1 Votes

The culture of bullying is so disheartening and personal to me. I am an experienced nurse, but I treat all new graduates and other nurses with respect. As nurses, we need to adhere to professionalism and behave in such ways. The unit I am working on 7 South ICU Neurosciences and Neuro-Surgical Unit at Keck USC is notorious for bullying. When I was first hired there was interim manager and she told me that I better have thick skin, she informed me that the same day I was interviewing 2 years ago, she was conducting a meeting with all staff to address the bullying that she and others witnessed on the unit. This unit has a group of nurses that have been there a long while, they are union protected (as am I) but they group up on people.

The bullying is hard to address because it is in forms of isolation, back-stabbing, and gossiping. One British Charge Nurse reinforces and facilitates the drama by making up lies and runs to management with anything and everything if she does not like someone. The bullying is so ingrained in the culture on that unit that everyone in the hospital knows it. Other nurses always comment and when I was first being hired on the unit, other nurses would say, "yuck, why do you want to go onto that unit?" those nurses are the worst." The manager, in his attempts at fitting in and not trying to become an outsider to these women (who have extreme power in numbers) will not do anything to protect the ones being bullied. Furthermore, the newer assistant manager that was hired was a staff nurse for 9-11 years on the unit and is one of the main people in the group of bullies. Some of the other long-time nurses there will purposefully isolate others, leave people out of conversations and invites, which is such a subtle but very real form of bullying. The type of bullying that is hard to prove and not a direct confrontation that makes one question his/herself and as mentioned, makes the bullying hard to prove. One particular nurse that is one of the worst bullies literally will start drama and tell the managers anything and everything. She gets to work an hour early too and then picks her assigments so she usually has a 1:1 paitent and an easier one. Then she will go through other nurses charting, rooms, and notify management if caps are not on the IV or there is a gap in charting, even though the other nurse may be extremely busy with multiple patients and going off the unit for procedures. This type of behavior creates a very punitive and toxic atmospherew.

The artificial, passive-aggressive, aggressive, behavior has left me feeling depressed, anxious, physically ill, and compeltely isolated. I am strong person and I have gone through many difficulties in my life, when I was first warned of this behavior, I like many assumed I would beat the odds, ignore the bullies, and focus on my patient care. However, they have gone out of their way to seek and find ways to torment me and a few others. I am talking arbitraty, unnecessary, and blatant singling out. Why as nurses do we do this to each other?

We can not move forward as a profession with this type of behavior. I am here for my patients and I love being a nurse, I have never dreaded or hated going into work and I have lost a certain spark and sparkle from within due to this consistent and terrible behavior. I did not want to be the one being forced off the unit, I wanted to learn and I got onto that unit for personal family reasons in the first place, I am not leaving a facility either. I had worked on other units previously and I have applied for graduate school and in order to pay for the tuitition I will need to stay at that hospital, so leaving the hospital is not that easy. Plus, why should the ones being toremented always have to be the ones having to make all the sacrifices too. Yes, mental sanity has been a strong forethought for me for a long while but I have tried so hard to make things more tolerable. I have already had a private discussion with both managers regarding the bullying and they both acted like this was "new" news. Another nurse whom is also bullied on the unit, had a meeting with our director and was met with the same response. I have ignored, isolated myself, and professionallly confronted, to no avail. Nursing is a hard career. We have so much fall onto us daily between the lab, doctors, patients, families, pharamacy, OT/PT, dietary, etc. We are the patients advocates, liasons, shoulders to cry on, so to place extra, added, unncessary harrassment, incivility, workplace shunning is so beyond cruel. Find other ways to displace, re-direct, and channel your energies.

How can others look at us as professionals if we do not act that way amongst ourselves? We are trained, college-educated, and have clinical knowledge we must collaborate to create a healthier workforce, enviornement, and image. Please do not contribute to this hate and bullying in the culture of nursing. If you are experiencing an issue with someone or you see someone being bullied try to remember what it would feel like to be that target. Try to find compassion in your heart and take a deep breathe, at the very least try to not partake in any mean activity until you can find a place of compassion in your heart. If you do not have any desire or room for compassion in your heart, then sorry to say, you are in the wrong profession or you need a seroiusly long vacation. Lets do this together and act as the professionals we are!

1 Votes
Specializes in Psych, Addictions, SOL (Student of Life).

I am not sure I would openly name the facility I work for on an open forum and I for sure would not mention the unit I worked on. Facilities hire companies to follow forums and report back on posts that may reflect badly on the facility. Nurses have been fired for this. Be careful.

Hppy

1 Votes

Thank you so much for this article, traumaRUs! I hear so many people calling bullying out as BS, at the same time admitting it's never happened to them on another thread. So glad you started this one. I never thought it would happen to me until it did. It was all enabled, which just as well have been encouragement, by an unethical non-nurse manager. It is what it is! Bullying! Stop it. Follow the 'Golden Rule'. Let people come to work in peace and not feeling threatened at every turn.

1 Votes

There was a lot of bullying in my BSN program. I had to take a break after graduating because I felt lonely and like I needed to nurture my supportive relationships after having had no time for anything but studying while in school. I also just needed a change of scenery since, while in school, I felt like I was surrounded by mostly ruthless and petty people going into the profession for the wrong reasons. I know this sounds super negative, but honestly this was my experience with the students I encountered most regularly. I was worried that I would have a hard time getting a good job and moving up in my career over time because in school I resented the competitive atmosphere. I realized, though, that I felt lonely and annoyed most of the time because many people did not seem to value community and teamwork, the importance of which was a primary reason why I wanted to change careers and enter the nursing profession in the first place. Whenever I put the success of the group first, I felt like my strong communication, teamwork and even leadership skills weren't valued. Any sincerely kind or helpful gesture on my part seemed to go unnoticed or be taken advantage of. I took a break after school, regained my confidence (and sanity), passed the NCLEX and am looking for a job now. I worry about encountering horizontal violence and bullying in the workplace, but I feel more prepared than ever to stand up for myself and others and, when necessary, let things roll off me like water off a duck's back. :yes:

1 Votes
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