Eradicating bullying in the nursing profession

6 June 2017

Eradicating Bullying in the Nursing Profession December 07, 2013 Bullying has become a huge problem in the nursing world, affecting the working environment, and possibly the way care is given due to uncomfortable working conditions. The plan is to eradicate this problem through education and consequences put into place to deter bullying from all employees. Through conferences with those who are reportedly creating the problem and also an in- service explaining bullying, this will equip the staff with knowledge on how to handle a situation they may be the victim of, or one they may have observed.

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Contribution to the Future of Healthcare Bullying in nursing needs to stop, it’s limiting the nurses we do have, and taking away potentially good nurses that need the training to become great nurses. There is already a severe nursing shortage, why allow the nurses causing these issues to continue this behavior and contribute to that shortage. Having this plan to stop bullying in the nursing profession will give nurses currently in the profession and new nurses coming into the profession a great working environment and team that anyone would want to be a part of, a place to learn and drama free environment gain reat learning experiences.

This project contributes to the future of nursing by providing all staff the proper education on what bullying is, and what they can do to stop it if they are the victim, or witness to this behavior. Creating a zero-tolerance policy against workplace bullying enforced by all management staff, explaining to employees that termination from their Job will be their reward if found participating or encouraging this behavior. The only way for this behavior to cease is to instruct strict rules and regulations against it; making sure everyone is aware and educated on it.

There should be mutual respect between nurses, and camaraderie with in the team to help those who need it, there needs to be more building up of nurses and less tearing down. This will help further the profession, and create an environment that will promote growth in the profession and in individual units. Change Model Overview The Rosswurm and Larrabee’s change model is a guide for nurses and other healthcare professionals through the process of change to evidence-based practice, integration of an evidence-based protocol (Rosswurm & Larrabee, 1999, Para. ). Nurses should use this change model to assist them with identifying and nderstanding the problem. Using the steps described within the model; solutions can be found, or changes can be made to eradicate the problem based on evidence- based practice. Step 1: Asses the Need for Change P = Nurse to nurse bullying I = Incorporate a zero-tolerance policy for bullying for the facility, ensure that all staff familiarizes themselves with it, and are aware of the ramifications (termination of employment) if involved in or found encouraging such behavior.

C = Standing up to the aggressor, which may escalate the situation further O = Deter bullying. Allowing for a healing and, learning, work environment T = 3 months (good time-frame for implementation and evaluation of the policy) Why is nurse to nurse bullying so prominent in the profession, and mainly between new nurses and experienced nurses? This problem is only recently catching attention, however; it’s been a growing problem from years ago that has been overlooked; no one got involved to stop the nurses that were doing it and now it’s become national problem in the nursing world.

According to Rocker, The literature reveals both victims and witnesses of bullying uffer silently and are often confused as to what to do when presented with bullying behavior. This confusion frequently contributes to nurses leaving their chosen profession (Rocker, 2008). This problem is Jeopardizing the retention of nurses, causing the new nurses to reevaluate their decision on becoming a nurse, increasing turnover rates with 60% of new nurses leaving their first Job in six months time due to bullying (Bullen, 2013, Para. ), adding to the shortage the profession already faces, and scaring up and coming nurses who will read about this problem; wondering will hey be a victim of this abuse. According to Rocker, in an article she cited by (Chiders, 2004) called, “The Nurses in Hostile Work Environment’s 2003 Report”, it stated that in the US 70% of bullied victims resign from their Jobs, 33% leave due to medical issues, and 37% leave due to yearly manipulated evaluations that show poor work ethic or habits. With these types of stats there will always be a nursing shortage.

Discuss the clinical environmental problem of nurse bullying with the manager, assistant manager and nursing staff. Reviewed peer-reviewed articles providing data on what he lasting effects this type of problem could have if no resolution is found. Compared internal data from staff to external data from other medical facilities that have experienced this problem amongst their nursing staff. Identified through meeting with staff the need for education on what nurse bullying is or looks like.

Step 2: Link the problem, interventions, and outcomes Nurse bullying, a serious issue within the nursing profession is a current problem threatening the nursing world. Verbal and physical abuses are contributors to this “war” between nurses. There is such a lack of disrespect within the profession, iscrimination against nurses based on lack of experience and/or lack of knowledge whether new to the profession or not. A way of confronting this problem and ridding this horrid behavior from nursing is to implement an intervention to stop the behavior.

This intervention could be to create a policy that expresses zero-tolerance for bullying, with serious consequences such as loss of employment. This policy could that will try their luck to see how serious the implementation of the policy will be, and those individuals will be the example to other staff how serious this policy is to be taken. Linked nurse bullying with the intervention zero-tolerance policy to enforce that the behavior will not be tolerated.

Identified outcomes the bullies will be deterred from engaging in this behavior in fear of the ramifications (i. e. Job loss), decreasing the problem. Step 3: Synthesize the Best Evidence Horizontal violence, nurse to nurse bullying, nurses eating their young; no matter the term used they all mean the same things violence in working environments and the nursing professionals are some of the worst (Mckenna, Smith, Poole, & Coverdale, 2003, p. 90) (Hutchinsom, Vikers, Wilkes, & Jackson, 2010, p. 321).

There is a silence that continues in many US facilities that contribute to the underreported encounters, and unproven working of trialed interventions (Gaffney, Demarco, Hofmeyer, Vessey, & Budin, 2012, Para. 1). This behavior can affect the working environment, safety of the patient and the quality of care given. Educate staff about respect of colleagues; explain the zero-tolerance policy for all staff to abide by, an encouraging staff or victims of bullying to document and report all events as they happen (Rocker, 2008, Para. 21) (Stokowski, 2010, p. 5).

According to Jackson, It is important that health professionals feel safe to disclose any perceived breaches of care or other wrongdoing, especially when they believe there is any actual or potential threat to patients or colleagues Oackson, 2008, Para. 7). Bullying has been around for a long time within the nursing profession; however, no one wants to blow the whistle on another colleague and have that affect their Job, reputation, or relationship with colleagues. Everyone’s mouths are sealed not wanting to tell on anyone because of fear; fear for their future at the Job once they do.

According to Stokowski, each organization has the responsibility to develop processes for managing threatening and intimidating behaviors. In 2008, the Joint Commission issued a standard on intimidating and disruptive behaviors at work, citing concerns about increased medical errors, poor patient satisfaction, adverse outcomes, higher costs, and loss of qualified staff (Stokowski, 2010, p. 5). Step 4: Design Practice Change In order for the bullying issue to cease from the facility every employee must be held accountable if found engaging in this behavior.

Managers from all units will eet with the employee education department to put together a presentation/in- service. The information will touch on what bullying is; the policy that will be put into place against it, and explanations of what the break in this policy can lead to in the future (i. e. Job termination). The managers of each department will be in charge of setting up an in-service schedule for all their employees to attend and will be responsible for educating their staff.

Step 5: Implement and Evaluate the Change in Practice All staff will be on a warning period during the implementation and evaluation ime of 3 months, allowing everyone to become familiar with the new policy. During this time, there will be a reportable events box that staff can anonymously report personally experienced events or observed events of bullying; providing numerical data of how the policy in place is deterring the bullying behavior now versus before the implementation of the policy. After 3 months the facility will evaluate how the that have taken place in relation to bullying during the 3 month time period.

The people reported about in the events box will also be re-educated to reiterate the olicy and reminded that there is no further warning period and they as well as any other staff members will be held accountable for their actions moving forward. Step 6: Integrate and Maintain the Change in Practice The change will be maintained by having yearly mandatory in-services for all staff reminding them of what bullying is, re-education to the staff on the policy put into place of zero-tolerance, and continued reminding of the serious consequences any employee will suffer if found going against the policy.

Implement & Evaluation Plan The steps for implementation are Step 1. There will be an implementation and evaluation time of 3 months for this policy; allowing staff to become more familiar with this new policy. Step 2. Incorporating a warning for all staff during this 3 month period, however; an anonymous reportable event box will be placed in different places throughout the facility for anyone to give information of them being victimized or observation of someone as the victim which will be handled during the 3 months time period and after. Step 3.

After the 3 months the policy will be evaluated for anything that may need changing before the policy is put into full effect. Step 4. All taff that was reported about in the anonymous box will be re-educated and informed that the warning is over, and termination of employment will be in full effect. Step 5. The data will be reviewed to determine how much of an effect this policy has had thus far in deterring bullying and will continue to be collected as boxes will remain in place, to monitor effect and continue to tweak this policy over time to gain the best results.

Steps to Maintain Change To maintain this proposed change for the far and near future the steps needed are: Step 1 . Continued enforcement of the policy by all management staff; Step 2. Periodic analysis of the information provided through re-education, so that it is relevant to the current time; Step 3. Make sure all changes to the policy are reported to staff in a timely manner to keep policy valid; Step 4. Create a brief summary of the plan and the responsibilities of the employees’ to be readily available to everyone in the organization; Step 5.

Develop measures to deal with issues before they arise; Step 6. Prepare quarterly progress reports of the number of incidents to compare, to make decipher if the current policy is still working or needs revamping. Conclusion The Rosswurm and Larrabee’s change model is a step-by-step guide to assist in developing a plan for change in any situation, or to revamp the current practice through the six steps. Step 1: Assess the Need for Change- The problem that is affecting the nursing profession is nurse to nurse bullying.

Bullying has long since been a problem within the nursing profession; it’s Just never been talked about much until recent years. Nurse bullying in the profession is causing hostile working environments that are not patient centered, and patients are deprived of good nursing care due to uncomfortable working conditions. Step 2: Link the problem, interventions, and outcomes-Nurse bullying is verbal and physical abuse that is creating issues between nurses; implementing a policy that will deter nurse from create a better workplace.

Step 3: Synthesize the Best Evidence-Based on the evidence found many nurse are leaving the profession because of the abuse, retention of nurses is low and some fear coming into work or resign altogether Just to not have to deal with the constant derogatory remarks. 60% present of new nurses leave their first Job after only six months, and 70% on US nurses resign from the Jobs due to bullying. These numbers are really contributing to the shortage we suffer from.

Step 4: Design Practice Change-creating a zero-tolerance policy that implements strict laws for termination if found to be engaging in bullying behavior is a direction to take to eradicate this problem. Step 5: Implement and Evaluate the Change in Practice-Implementation and evaluation of this plan for change would be a 3 month time frame, which allows for teaching to be given to all employees, and this will be the warning time as well. We will evaluate the current policy after the 3 month time frame and revamp as needed.

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