Bullying in Nursing - Research Paper Example

? Review of the Literature of a Researchable Problem Bullying remains a major problem in the health care sectors owing toits prevalence among the nursing practitioners and its adverse effects on individual nurses, patients and the organizations. The problem has been attributed to several factors including the lack of balance in power, ravage, untamed aggression behaviors, structural organization, poor interpersonal relationships and lack of awareness. Several studies have revealed that bullying in nursing is real, with majority of the nurses reporting having at least experienced or witnessed bullying during their practice. Bullying in nursing manifests in different ways including false accusations aimed tainting someone’s reputation and competency, personal attacks, allocation of roles beyond one’s skills and lack of assistance from the seniors, and lastly intimidation among other ways. The bullying behavior translates into psychological and physiological effects on the victims, poor bedside patient outcomes as well as compromise in the organizational effectiveness and efficiency. The menace can be controlled through cognitive rehearsal training programs, implementation of code of conduct, creation of awareness and zero tolerance on bullying in all health care organizations. Keywords (Bullying, interpersonal relationships, intimidation, reputation, competency, code of conduct, cognitive rehearsal) Review of the Literature of a Researchable Problem Workplace bullying has emerged as global issue in healthcare organization, particularly affecting the nursing practitioners. Owing to the seriousness of this problem and its effects on the performance of nurses, several studies have been conducted with the aim of understanding and establishing strategies to avert or control its occurrence. Despite the existence of aggression and harassment behaviors in almost health care organization, bullying is viewed as form of repeated behaviors resulting in creation of a hostile working environment (Hutchinson, Wilkes, Vickers & Jackson, 2008). Researchers have proposed numerous strategies of dealing with bullying in nursing including training programs, establishment of stringent measure to protect nurses, and counseling programs. This paper entails review of literature from different scholarly articles on bullying in nursing. Simons, S. (2010). Bullying in the workplace-a qualitative study of new licensed registered nurses. American Association of Occupational Health Nurses, 58 (7), 305-311. This article entails a qualitative study of bullying among nurses to establish the different ways in which bullying manifests in the field of nursing. Simons (2010) examined the individual experiences of nurses as well as incidences of bullying witnessed during their practice. The study applied a descriptive qualitative research design to examine bullying behavior among newly licensed nurse. A survey study was conducted in the State of Massachusetts targeting nurses registered between 2001 and 2003 and about 511 responses were obtained through the email survey (Simons, 2010). The results of study revealed that about 139 nurses had been bullied and 14 others witnessed bullying incidences. Several themes describing the bullying behavior were identified including feeling out of the group, structural bullying, senior or old nurses exploiting newly registered nurses and the feeling of quitting the occupation (Simons, 2010). The phrase ‘nurses eat their young’ was particularly used to describe the hostility subjected to new nurses by their seniors. Senior nurses propagated bullying in the working area through subjecting the newly registered nurses to ridicule, lack of information sharing and lack of assistance from the experienced nurses. Bullying in nursing accounted for a significant percentage of the employee turnover in the nursing field. Some of the respondents reported having left their jobs due to unbearable bullying in their working environments. Most of the bullying behavior manifests during the orientation of new nurses with majority of them becoming targets of the bullying actions from the existing colleagues. The recommended ways of addressing the identified bullying actions included the need for occupational health nurses to intervene in controlling the problem through advocacy for friendly working environments (Simons, 2010). Such interventions could include initiation of education and counseling programs, promotion of positive structural organization change, support of victims and creation of an organizational culture free from bullying actions. However, the study faced two major limitations including failure to reflect the rigorous activities of a qualitative and application of qualitative analysis methods while the research did not adhere to the requirements of a qualitative design (Simons, 2010). Other limitations included failure to define acts of bullying in the survey guide and the focus on a single State. Stagg, S., Sheridan, D., Jones, R., & Speroni, K. (2011). Evaluation of a workplace bullying cognitive rehearsal program in a hospital setting. The Journal of Continuing Education in Nursing, 42(9), 395-401. Owing to the increased concerns on the issue bullying in health care working environments, the study was conducted to examine the frequency at which the phenomenon occurs and the effectiveness of training programs aimed at enhancing management of the problem. Training of nurses in cognitive rehearsal plays a crucial role in enhancing skills of managing bullying incidents among the nurses. This form of training enables nurses to identify nursing behaviors which at time go unnoticed as well as creating a culture of reporting such occurrences (Stagg, Sheridan, Jones & Speroni, 2011). The study involved a pilot study, internet-based survey on medical and surgical nurse and evaluation of results from the training program. According to Stagg, Sheridan, Jones and Speroni (2011), 80% of the nurses involved in the study had at least once or twice encountered bullying in their workplace. In addition, results from the training program indicated that nurses who went through the program had enhanced knowledge on how to deal with the problem and expressed willingness to identify and report such incidents. The study focused on bullying behaviors such as allocation of duties beyond one’s skills, false allegations aimed at tainting someone’s image, failure to recognize individual achievements, lack assistance on challenging duties, and unnecessarily questioning of someone’s capability (Stagg, Sheridan, Jones & Speroni, 2011). Training nurses on cognitive rehearsal emerged as one of the promising ways of dealing with bullying in nursing. Limitations in this study included the use of a small sample of participants creating room for the type II error, the application of self-report survey, and measurement of short-term impacts of the training program (Stagg, Sheridan, Jones & Speroni, 2011). Foster, B., Mackie, B., & Barnett, N. (2004). Bullying in the health sector: A study of bullying of nursing students. New Zealand Journal of Employment Relations, 29 (2), 67- 83. This article entails a study on the bullying of nursing students during their placement with the aim of examining the prevalence, the source and the perception of students on the phenomenon. The study was based on the hypothesis that high percentage of nursing students are likely to face bullying activities while on clinical placement in the health care organizations. Researchers in this study used nursing students from a lower North Island tertiary institution in New Zealand as the sample population for the study (Foster, Mackie & Barnett, 2004). Both qualitative and quantitative survey analysis methods were applied in the study. Results from the study indicated that 95% of the participants had experienced bullying during their placement. The common bullying behaviors identified by this study included intimidation and being ignored, with anxiety and shuttered self-confidence as the most prominent negative effects of bullying. Majority of the victims expressed Ignorance on existing policy on bullying while a good number reported having shared their experiences with others (Foster, Mackie & Barnett, 2004). The study also established that majority of the incidences were propagated by female nurses. The bullying behavior was associated with the poor balance of power between the trainees, trainers and the practicing nurses. Foster, Mackie and Barnett (2004) recommended the need for government agencies to be proactive in fighting the menace as well as the need for health care organization to device ways of identifying and preventing the behavior. Hutchinson, M., Vickers, M., Wilkes, L., & Jackson, D. (2009). “The worse you behave, the more you seem to be rewarded”: Bullying in nursing as organizational corruption. Employees Response Rights Journal, 21, 213-229. The article introduces a new perspective in the view of bullying in workplaces where the phenomenon is seen as a corrupt behavior as well as a group activity. Findings in this study sought to challenge existing assumptions in the view of bullying such as its view as events that can be singled out of the organization and attributed to interpersonal conflicts. The main objective of this study included the support for view of bullying in organizations as corruption and the need for it to be treated like other corruption activities. Researchers in this study report and analyze findings from 26 nurses with past bullying experiences from the Australian public health sector (Hutchinson, Vickers, Wilkes & Jackson, 2009). The study involved as qualitative research design in which the selected sample of participants was interviewed to examine their experiences, perceptions of the bullying actions and possible causes. Respondents described the bullying activities, their perpetrators, and organizations where they are condoned as evil corrupt and unethical. The view of bullying as part of the corruption vice introduced a new requirement for all stakeholders in the health care organizations to join hands in efforts to fight menace. Several corruption traits including silence and censorship, corrupting legitimate routines and processes, networks of predatory alliances, protection from detection and reward and promotion were associated with the bullying behaviors (Hutchinson, Vickers, Wilkes & Jackson, 2009). The study compares the bullying behavior with corruption by citing that bullies can be seen as misusing their office or organizational position, protection of perpetrators and its unethical nature. Hutchinson, Vickers, Wilkes and Jackson (2009), recommended that bullying should be approached as a strong, secret and hard to detect act similar to corruption, hence the need ensure collective responsibility in efforts to eliminate it in organizations. Broome, B., & William, S. (2011). Bullying in a caring profession: Reasons, results and recommendations. Journal of Psychosocial Nursing, 49(1), 30-35. This article explores factors associated with the bullying behavior in health care organizations, results and possible ways of averting the behavior. Bullying results in both psychological and physiological effects on the victims as well as negative implications on the quality of service delivered to the patient and the organization at large. Numerous studies have associated bullying with negative effects on the ability of organizations to retain nurses and poor bedside and patient outcomes (Broome & William, 2011). Workplace hostility associated with the bullying behavior has been used to support decisions by most nurses who quit the profession. Incidences of bullying have been explained through imbalances in power and the desire by some individuals to dominate in some interpersonal relationships. Other reasons used to explain the bullying behavior include tendencies to ravage against aggressors, unfair and punitive actions by the leaders, increased divisiveness in an organization (Broome & William, 2011). Some the ways that could resolve the bullying behavior in nursing include implementation of a code of conduct against the vice and other disruptive behaviors in the health care setting, strategies for identifying the problem and education programs to increase awareness about the vice. Development of the code of conduct must involve all stakeholders including nurses as the targeted individuals. In addition, proper track of the bullying behaviors must be kept and strategies for helping the affected victims outlined. Establishment of a zero tolerance policy on the bullying behavior in health care organizations emerges as the most potential way of dealing the problem amicably. Hutchinson, M., Wilkes, L., Vickers, M., & Jackson, D. (2008). The development and validation of a bullying inventory for the nursing workplace. Nurse Researcher, 15(2), 19-29. This article entails an inventory for the bullying behavior among the Australian nursing workforce conducted through a mixed study. The study involved in-depth interviews to establish different aspects of bullying including common bullying acts, results and the different ways applied to deal with the problem. Five hundred nurses from the metropolitan area health service in New South Wales were involved in the study with only 102 surveys returned (Hutchinson, Wilkes, Vickers & Jackson, 2008). According to Hutchinson, Wilkes, Vickers and Jackson (2008), analysis of the study data revealed personal attack and attack through work tasks as some the ways in which bullying was identified. On the other hand, attacks upon reputation and competence were significantly associated with the workplace bullying stereotype. Attacks on individual reputation and competence were applied by some colleagues to render their fellow workers powerless in the battle of supremacy in the interpersonal relationships among the nurses (Hutchinson, Wilkes, Vickers & Jackson, 2008). Inventory of the different aspects of the bullying behavior arises as an important step in addressing the problem bullying in nursing. The process further provides nurses with the opportunity to make known their experiences and assist the management in strategizing on the way to intervene in their bad experiences. However, the study faced some limitations including the use of a small sample that limits the comparison of the results with other areas. The survey response went way below the recommended sample of 500 nurses thereby limiting the validity and credibility of the research. Summative Conclusion Bullying in nursing is defined as forms of repeated behaviors resulting in creation of a hostile and unpleasant working environment. The bullying behavior has been attributed to several factors including the battle for supremacy in interpersonal relationships, ravage, power differences, limited awareness on how the vice manifests. Studies indicate that bullying in nursing is rampant and requires adequate attention if friendly and efficient working environs in nursing are to be attained. Bullying in nursing manifests itself in different ways including personal attack, attack on individual reputation and competence, failure to get assistance from senior nurses, allocation of roles beyond one’s skills, and ridicule from colleagues. The bullying behavior in nursing results in numerous negative effects touching on not only the targeted individuals but also the patients and the organization at large. Bullying in nursing results in both psychological and physiological effects on the victims, bedside and patient’s outcomes and increased employee turnover rates in the health sector. Different scholars have suggested different strategies of dealing with the bullying menace including cognitive rehearsal programs, implementation of codes of conduct to tame the problem, treatment of bullying like any other corruption activity, enactment of a zero tolerance policy on bullying in health care organizations and lastly government involvement in promoting working environments free from the bullying behavior. References Broome, B., & William, S. (2011). Bullying in a caring profession: Reasons, results and recommendations. Journal of Psychosocial Nursing, 49(1), 30-35. Foster, B., Mackie, B., & Barnett, N. (2004). Bullying in the health sector: A study of bullying of nursing students. New Zealand Journal of Employment Relations, 29 (2), 67- 83. Hutchinson, M., Vickers, M., Wilkes, L. & Jackson, D. (2009). “The worse you behave, the more you seem to be rewarded”: Bullying in nursing as organizational corruption. Employees Response Rights Journal, 21, 213-229. Hutchinson, M., Wilkes, L., Vickers, M., & Jackson, D. (2008). The development and validation of a bullying inventory for the nursing workplace. Nurse Researcher, 15(2), 19-29. Simons, S. (2010). Bullying in the workplace-a qualitative study of new licensed registered nurses. American Association of Occupational Health Nurses, 58 (7), 305-311. Stagg, S., Sheridan, D., Jones, R., & Speroni, K. (2011). Evaluation of a workplace bullying cognitive rehearsal program in a hospital setting. The Journal of Continuing Education in Nursing, 42(9), 395-401. 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