Why Bother Studying Workplace Bullying?

[compassionresearcher]

Quote

Now that I am off orientation, I constantly fear getting fired. I swear I hear monitors in my sleep. One time in the last few months, a manager said "good job", it helped. I'm at the mercy of whoever is charge nurse that shift. I never realized it would be this hard to find a mentor. -First-year nurse

The old saying goes "if you want to hear God laugh tell him your plans." Early in my doctoral program, I had planned on studying healthy aging, as in what do people who age well do that the rest of us don't. But an assignment in a theory class changed my course. We had to interview and write up a case study of one participant and I interviewed the novice nurse quoted above. It was sad and disheartening and made me want to hug her and tell her it would all be okay soon, but I couldn't promise that. Of course, she reminded me of myself as a new grad.

My own experience

When I got into nursing I had no idea about the potential for mistreatment. Perhaps I was young and naive, but I can't be accused of having preconceived notions or self-fulfilling prophesies for bullying. I had taken a job 1500 miles from home where I didn't know a soul except for the guy I moved there with. There was no work for new graduates in the mid-'90s, in the city where I lived. I took a job on nights in the float-pool -- what was I thinking? Again, had no idea that float nurses notoriously get very difficult assignments with minimal orientation. I won't bore you with the details but it was the hardest year of my life. Things at home were bad, things at work were unbearable, and I had bad insomnia because I couldn't sleep during the day. I'm pretty sure there were some patients and their families that didn't get the best possible care because of all these factors, though I meant well. Luckily after my one year, I got a new job in a much healthier environment and could recover.

Not everyone is that lucky. Nurses leave their units, hospitals, and careers because of scenarios like these. And in extreme cases hurt or kill themselves. You never know what someone is going through outside of work, and it takes little effort to make them feel cared for or like they don't matter. I know there are nurses out there who hate this topic because they think it's untrue, exaggerated, or gives nursing a bad rap. I myself cringe when people say women can't work together. Even if it's 10 percent of us who face it, that's 300,000 people's lives and the patients and families that are touched by this!

It's not enough to be neutral

To do no harm is extremely important, but what about kindness and be compassion for our co-workers? We must lift each other up. Have you ever seen two firefighters meet each other for the first time? Instant brothers, no matter where they work. Why can't nursing be that way? A study (Barsade & O'Neill, 2014) out of Wharton School of Business studied compassion in nursing home employees. Units scored by staff as compassionate demonstrated less absenteeism and more favorable reviews from residents and family.

The numbers are in

The current study I'm working on (Exploring Nurse Bullying [horizontal violence, lateral violence, incivility] and Quality Patient Care Survey) combines these two concepts, bullying and compassionate environment. I'm looking to see if patient care is affected by either or both. Preliminary results show nurses from all over the country and outside the country, with wide ranges of age and years of experience, are reporting being bullied. And it is impacting the care they can give. I'm still collecting surveys, so if you care to join please see my post on allnurses: Bullying at Work: What is Your Experience?

And, share with any nurses you know. I will give a final report when the study is concluded.

Reference

Barsade, S. G., & O'Neill, O. A. (2014). What's love got to do with it? A longitudinal study of the culture of compassionate love and employee and client outcomes in a long-term care setting. Administrative Science Quarterly, 59(4), 551-551. doi:10.1177/0001839214538636

[Susie2310]

Nursing is a competitive field: competitive to gain admittance to nursing school, succeed in school, find employment, navigate the steps from beginning nurse through to becoming a competent practitioner. There is great competition for internships, hospital jobs at prestigious facilities (especially where the nurses have unionized), desirable schedules, very good to excellent pay, supportive management, good benefits, and opportunities for career advancement, and there are a huge number of new nursing graduates being turned out regularly and a finite number of employers, especially the more desirable employers who offer many of the above conditions. On top of all this, nursing is a very stressful job mentally and physically, where short staffing is common, and the fear of being fired can all too easily become a reality, where the people who can compete the best will be more likely to secure the best jobs at the most desired facilities with the best schedules, best pay, best benefits, best opportunities for advancement, best job security, etc. Add to this that many people become nurses not really wanting to nurse, that is, actually take care of patients, but seeing nursing as a springboard to their true desired destination. Additionally, many new graduates are very unprepared by their nursing education to function at a level of basic clinical competence and require prolonged orientations. Health care is a business that works unsocial hours - another factor that many new nurses are ill at ease with. Taken altogether you have conditions that can easily give rise to uncivil behavior in the workplace and sometimes bullying and to perceptions (valid or not) of being bullied.

I sometimes wonder if people thinking of going into nursing really stop and ask themselves why they are doing this. It seems that a cosy ideal of nursing is perpetuated that often falls so far short of expectations. Yes, bullying exists in nursing, as it exists in other jobs/professions, and is amplified in a high pressure environment where there is little to no room for error and where patients lives are at stake. I really think it wise for those contemplating joining the profession to consider before they begin costly, time consuming education/training if their own personalities/ablilities/life experience make it likely that they will be comfortable in the nursing workplace, which for the majority of nurses is working in hospitals.

[compassionresearcher]

I appreciate your point of view. Again, I know it's a polarizing topic. Some people are relieved to share their experiences with me and others take the point of view similar to the commenters above. I'm a student trying to learn how to perform research and hope to in some way improve work environments.

Although the article above doesn't resonate with your experience it may be meaningful for someone else. I'm just asking people share it with other nurses so I can finish the project and let the results speak for themselves.

[Wuzzie]

Okay but if your premise is mis-identified then how can your research be valid?

[compassionresearcher]

Okay but if your premise is mis-identified then how can your research be valid?

I don't follow, misidentified?

[Wuzzie]

There different definitions of bullying in the literature as to what constitutes it. I'm actually looking at the continuum of mistreatment from incivility to bullying. I use the term here because it is recognizable by more people than workplace mistreatment.

Right there in your own words. You are lumping all negative behaviors into the category of bullying. You are mis-identifying behaviors as bullying when they aren't and in a research project of all things. This is how your paper has become severely and irreparably biased.

[compassionresearcher]

Right there in your own words. You are lumping all negative behaviors into the category of bullying. You are mis-identifying behaviors as bullying when they aren't and in a research project of all things. This is how your paper has become severely and irreparably biased.

The quote you posted above was in response to the comment about the Webster's dictionary. There are different definitions of bullying in the literature, both within and outside of nursing, some of which include the spectrum that I previously mentioned some. I'm not misidentifying anything. My research paper uses "workplace mistreatment", the article here uses "bullying" because I don't think people know the other term as well. Those who click on the study will have to decide if their experience meets the criteria.

All studies that recruit people having a particular experience are vulnerable to self-selection bias. Your use of severe and irreparable are hyperbolic.

[Horseshoe, BSN, RN]

Right there in your own words. You are lumping all negative behaviors into the category of bullying. You are mis-identifying behaviors as bullying when they aren't and in a research project of all things. This is how your paper has become severely and irreparably biased.

I agree. How valuable or insightful would a study on influenza be if anything on the continuum of mild viral illnesses with low grade fevers was lumped in with the actual severe illness that is influenza? I think the OP really dilutes the subject by using a "continuum of behaviors" such as "incivility" all the way up to systemic bullying and treating one the same as the other. JMO.

[Wuzzie]

My research paper uses "workplace mistreatment", the article here uses "bullying" because I don't think people know the other term as well.

Given the fact that we are all graduates of a rigorous education I'm pretty sure we understand the meaning of the words "workplace mistreatment". To think otherwise is academic snobbery. Using the term "bullying" to draw people in seems disingenuous and, as you have discovered, is inflammatory. Be that as it may, this discussion is going in circles. I still think your study is flawed without getting both sides of the story (there's your bias) you obviously disagree and I'm clearly not going to change your mind.

[compassionresearcher]

It's not snobbery, it's just that it's typically not a term used frequently -- yet. I myself had not used it prior to someone bringing it to my attention. Bullying is more likely to be put in as a search term when people are using the search box on this site or Google.

You're right, we will not convince each other but I thank you for the dialogue and wish you well.

[Ruby Vee, BSN]

Right there in your own words. You are lumping all negative behaviors into the category of bullying. You are mis-identifying behaviors as bullying when they aren't and in a research project of all things. This is how your paper has become severely and irreparably biased.

And this is why we have so much discussion of bullying when the behavior described isn't really bullying.

[albachiara]

At a start of any career it is difficult for anyone, but not only even for an experienced nurse that is a new hired employee. Transition from a student to a nurse it is difficult. We all know that and experienced it. I did more then 15 years ago still remember it. But I did not ever thought of anyone being a bully to me during this transition. Believe me some nurses were tough, and brutal with their teaching. It was a learning process, and I thank God for those nurses who thought me because I would not be here at this point of my career if it were not for those nurses. I am strong, efficient, and able to navigate the system and function independently. Yes, some were rude, or did not like me but after all I did not have to go home with them. I also learned to stay away from them. If I needed them for an advice I would be very professional and make them understand that they were not helping me but helping the patient. A new graduate nurse or any other profession is new to the environment and the profession. In this environment there are people that have learned how to interact with each other, and formed some sort of relation either friendship or strictly professional. The new hires or graduate should already have this understanding. It is her/his effort to try to blend in and earn their trust. Throughout my career I seen it all: unbelievable behavior from new grads, and experienced nurse, injustice from the organization, and management feeling powerful of their position. All of this is not about bully but it is more of a culture. Cultures of miss behaving and ignorance. I am not going to list any of it because already others have made some great examples, which I agree with them.

[SnowShoeRN]

I certainly think there is a place for your work, but I think that you need to be very careful with how your define certain things. While the behaviors that one typically encounters with lateral violence (gossiping, intimidation, gas lighting, whatever) may not fall under the dictionary's definition of bullying, they do fall under the ANA's definition. Of which you are probably aware.

Lateral Violence and Bullying in Nursing

I personally believe that one of the biggest problems when it comes to bullying, lateral violence, workplace violence, etc IS the ambiguous terms. It's incredibly difficult to address a topic, examine why it's happening, and work toward a solution if people (or identities) are making up their own definitions for things. I think this may pertain to people's concern about the validity of your study. Are the terms you use clearly defined enough in order to draw valid conclusions? For instance.

This is not to say that things like gossip and libel and so forth *aren't* upsetting or damaging. They certainly can be. I have encountered bullying and lateral violence so severe I've quit a position because of it. And in certain circumstances, it can severely affect patient care to the point of harm. BUT... the behaviors aren't bullying. Not according to the dictionary.

So, until everyone everywhere can agree on exactly what these terms mean so we can work on properly addressing the issues, we're going to have people who disagree with whether or not they are happening and the extent to which they are happening.

Mix that in with people who think they are completely entitled and not saying hi is bullying and people who firmly believe that there's nothing wrong with name calling or yelling and all kinds of people in between and we just have a recipe for the continuance of workplace discord.

And that's my 2 cents.