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Creating Healthy Work Environments 2019

Check out these articles written by presenters at the 2019 Creating Healthy Work Environments conference.

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Is your work environment bully-free? It should be!

Alexis E. Smith |

Tolerating nurse bullies isn’t part of your job.

Is your work environment bully free? It should be!

Bullying doesn’t affect just the direct victim. It can harm other members of the healthcare team as well as patients.

Alexis E. Smith“Nurses eat their young,” they say, and there is enough evidence that experienced nurses often do mistreat less experienced nurses that the saying has become an accepted description of the profession’s culture. Sadly, bullying in nursing has become pervasive. Some reports estimate that up to 30 percent of nurses experience bullying in their workplaces, and what’s more, it often continues beyond the first few years of practice.

The unit, nurses station, break room, cafeteria, lounge, and locker room have become breeding grounds for hostility, intimidation, incivility, and bullying. If we don’t tolerate these behaviors amongst our kids on the schoolyard, why do we tolerate them in our workplace?             

Of course, words can hurt you!
Many of us have experienced the pain of being targeted by a nurse bully. The bullying may be obvious and outright, or it may occur in a more indirect and covert fashion. No matter how bullying presents, its impact transcends how it manifests. Loneliness, poor self-esteem, lack of confidence in practice, emotional exhaustion, and cynicism are all outcomes of bullying, whether isolated or chronic.

Despite a growing body of research that has identified nurse bullying as a significant problem, it continues unabated, accepted as “just part of the job.” It is as if nurses expect bullying and incivility to occur, so they overlook addressing the root cause when it happens. Work group leaders may turn a blind eye to what’s happening because of its widespread nature.

The impact of nurse bullying may extend far beyond its immediate victim. Bullying can harm nurse colleagues, other members of the healthcare team, and patients because it can lead to significant breakdown in communication, teamwork, practice, and quality of care. We aren’t at our best when we feel devalued and unsupported by our work group! Nursing is, after all, a team effort; we need one another to succeed.

To collaborate effectively, nurses need to feel safe
Interprofessional collaboration in healthcare has received significant attention in recent years. This work is crucial in advancing healthcare processes and outcomes, but as nurses, we should not neglect focusing on intraprofessional collaboration. If we cannot, as nurses, support and work with one another, how can we collaborate and support team members from other disciplines?

The same attributes and practices that contribute to successful interprofessional collaboration can be applied to working with our nurse colleagues, no matter the setting, degree, or certification. When a nursing team collaborates at a high level—which is vital within nursing work groups—it creates a foundation that improves collaborative teamwork across disciplines. Each nurse brings unique skill sets, experiences, expertise, qualifications, and education, and we should use the strengths of other team members to enhance our own practices.

There is an abundance of knowledge and skill within the nursing profession, and nurses should draw upon their colleagues to build capacity in their own practices and to elevate the nursing profession as a whole. To collaborate effectively, nurses need to feel safe and supported.

Effective leaders empower
A growing body of research provides evidence that nurse leaders play an important role in shaping the work environment, enhancing job satisfaction, empowering nurses with whom they work, decreasing burnout, and lowering turnover. Whether their leadership roles are informal within the work group or formal within a department or program, the actions of these leaders speak volumes.

In my experience, one of the most important ways leaders influence others is through role-modeling positive and desired behaviors. It encourages others to step up and contribute alongside them. When leaders acknowledge the presence of bullying in a department or unit, staff nurses are encouraged in their roles. By partnering with others to facilitate crucial conversations, effective leaders open the door for staff members to step forward, share their experiences, and help stop the bullying.

While these conversations may be difficult, emotionally intensive, and time-consuming, the nurse leader and work group reap benefits when the health of their work environment is restored. By collaborating with staff members to provide coaching and guidance for these difficult exchanges, nurse leaders not only address the specific issue at hand—they also equip staff with skills to deal with future problems more effectively. It’s a win-win situation. Nurse leaders who are proactive in addressing workplace violence help generate positive outcomes now and potentially influence better outcomes in the future.

When staff members see their leader address bullying instead of turning a blind eye, they are empowered to more actively identify bullying, step in when they witness nurse bullying, and initiate conversations that alert colleagues to hostile behaviors. Ending bullying is not an easy feat and requires a united front. But the well-being of staff, leaders, patients, and the overall healthcare system depends on us.           

Where to start
With increased awareness comes opportunity for nurse leaders and frontline nurses alike to collaborate in addressing nurse bullying. Here are some ideas for getting started:

  • Raise the issue with your colleagues, leaders, and unit councils—anyone who will listen. Everyone has a stake in combatting workplace bullying, and engaging colleagues to address the issue begins with awareness. Sharing this article with them is one way to open the doors to conversation!
  • Use stories to gain buy-in from stakeholders. Sharing your experiences of nurse bullying with leaders in your organization motivates them to step up alongside you and be change agents!
  • The American Nurses Association and the Canadian Nurses Association have initiatives that highlight the impact of bullying in the workplace. Click the foregoing links to learn more, and then share the information you discover with colleagues to start discussion and initiate action!
  • Seek opportunities within your organization to gain traction in addressing bullying and workplace violence. Perhaps you can align with others who have similar projects, goals, and initiatives already underway and help make nurse bullying a key issue in your organization.

All of us have an important role in addressing bullying in the workplace. Together, we can move closer to a future free of this destructive behavior. RNL

Alexis E. Smith, MScN, RN, is a professional practice consultant in London, Ontario, Canada.

Editor’s note: Alexis Smith presented The Effects of Authentic Leadership and Organizational Commitment on Job Turnover Intentions of Experienced Nurses on Saturday, 23 February 2019, at Sigma’s Creating Healthy Work Environments conference in New Orleans, Louisiana, USA. See the Virginia Henderson Global Nursing e-Repository for additional information.

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