Historical Overview of Bullying in Nursing (08:40)
It is difficult to understand how some individuals can possess attributes of both a caregiver and a bully. Objectives include learning how to recognize common expressions, evaluate theories, and understand how organizations change due to bullying. In the late 1970s, incivility in nursing started being mentioned in journals and textbook.
Scope of the Problem (03:28)
A study found that 45% of nurses surveyed felt they were verbally harassed by other nurses during their career; 25% felt they might leave the occupation as a result.
Expressions of Bullying (07:06)
Bullying is persistent, abusive, and hinders the person from performing their job. Categories include silence, violence, and mobbing. Individuals fear confrontation.
Bullying may revoke a nurse's license. Horizontal violence is peer to peer. Theresa Puckett provides examples of bullying in healthcare and academia.
Professional Values and Bullying (03:21)
The American Nursing Association code of ethics dictates that all nurses should be compassionate and show respect for the inherent dignity and attributes of all human beings. Bullying leads to poorer patient outcomes. The six Cs include compassion, courage, competence, communication, care, and commitment.
Theories of Bullying in Nursing (04:50)
Review Glasser's Choice, Oppression, and Nurse as Wounded Healer theories. Behavior is needs driven; disruptive behavior should be explored. Nurses may experience a minimization of self.
How Are the Victims Chosen? (01:02)
Severe understaffing can cause bullying. Individual factors include new to the profession or organization or someone who recently received a promotion.
Consequences of Bullying (01:58)
Consequences include additional sick time, illness, emotional distress, PTSD, poor morale, decreased job satisfaction and high rates of turnover.
Addressing Bullying: Individual Interventions (18:29)
The bully may feel the need to become aggressive before another nurse becomes aggressive towards him or her. Interventions include recognizing super nurses, backstabbers, and green-with-envy nurses, "carefronting," forming connections, and incorporating communication tools. Assistants may bully nursing students.
Overcoming Difficult Conversations (06:47)
Keys to a safe conversation include showing respect, explaining a mutual goal, trying not to us the word "you," and asking them to explain their position. In "Carefronting" ask about the situation, acknowledge the other person's feelings, advocate, and problem-solve. The outcome will rely on what was said and how the individuals act; models include IMPROVE, SBI, DESC, and BEE.
Addressing Bullying: Organizational Interventions (14:58)
Supervisors should initiate a zero bullying tolerance and open door policies. Examine a person's nonverbal communication; avoid asking "why." Interventions include the Stop Bullying Toolkit, nursing incivility scale, civility index dashboard, and float survey questions.
Future Directions (06:45)
Emotional intelligence is the capacity to be aware of, control, and express one's emotions. Daniel Coleman identifies domains such as self-awareness, social awareness, self-management, and relationship management. Puckett's study found that experienced nurses scored lowest in self-management.
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