Make a brief Group discussion about the below topic: Workplace Violence and Incivility -Cite a brief example as reported in the literature.The word limit is 500 words. Please make sure to provide citations and references (in APA format)
Workplace Violence and Incivility
Zero Tolerance for Workplace Violence and Incivility
Violence in health care, whether from persons external or internal to an organization, has been shown to have negative effects: increased job stress, reduced productive work time, decreased morale, increased staff turnover, and loss of trust in the organization and its management (Buttaccio, 2017; Evans, 2017). Not all healthcare workplace violence is of a physical nature; like any other business, the workplace is subject to intradisciplinary and interdisciplinary incivility or bullying. The ANA Position Statement: Incivility, Bullying and Workplace Violence (2015b) describes incivility as one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them. Bullying is “repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient” (ANA, 2015b). Workplace violence in any form creates a serious threat to patient safety, nurse safety, and the nursing profession as a whole (Wilson, 2016). Incivility and bullying, whether subtle, covert, or overt, affects every nursing setting from academia to practice (Box 14.6).
BOX 14.6
Range of Bullying Behaviors
Overt
• Aggressive behaviors such as shouting or threatening harm
• Being accused of making errors made by someone else
• Nonverbal intimidation
• Eye rolling
• Physical harm
Covert
• Being sabotaged
• Having information or resources withheld that affects performance
• Moving the “goal post” in a person’s work without informing them
• Giving confusing or inaccurate information
• Being told tasks were urgent when they were not
• Not responding when a response is called for
Subtle
• Being excluded from activities
• Being gossiped about
• Having opinions ignored
• Assigned unreasonable unpleasant or impossible tasks, targets, or deadlines
• Being humiliated at work
• Having key areas of responsibility removed or replaced with trivial or unpleasant tasks
• Having all decisions challenged
• Being manipulated into taking on roles or tasks that were not in the nurse’s best interest
Copyright © 2018 by American Nurses Association. Reprinted with permission. All rights reserved.
For the victims, studies report that bullying can result in psychological symptoms, such as anxiety, sleep problems, depression, burnout, or increased substance use, and can negatively impact job satisfaction and effective engagement (Box 14.7). Any type of violence in health care interferes with optimal job performance and has negative effects on the delivery of high-quality patient care (Evans, 2017; Magnavita, 2016). Data about the incidence of workplace violence is underreported (Kvas & Seljak, 2014), because most victims feel it is part of the job or that reporting will do nothing to change the situation. Workplace violence in nursing is so prevalent (Wolf, Delao, & Perhats, 2014) that all members of the profession must be acquainted with the types and degrees of violence and learn how to manage it.
Box 14.7
Negative Impacts of Workplace Violence
For the individual:
• The suffering and humiliation resulting from violence, which usually lead to a lack of motivation, loss of confidence, and reduced self-esteem.
• If the situation persists, consequences such as physical illness; psychological disorders; or tobacco, alcohol, and drug abuse often observed.
• Potential of workplace violence leading to nurses leaving the workforce.
For the workplace:
• Immediate and often long-term disruption to interpersonal relationships, the organization of work, and the overall working environment.
• Deterioration in the quality of service provided.
• Direct costs of legal liabilities.
• Indirect cost of reduced efficiency and productivity.
• Difficulty in recruiting or retaining qualified personnel.
• Loss in company image and a reduction in the number of clients.
• Unemployment and retraining costs for victims who lose or leave their jobs as a result of such violence.
• Disability costs if the working capacities of the victims are impaired by psychological or physical violence at work.
• The need for expensive security measures.
For the community:
• Access to quality health services threatened.
Data from Wilson, J.L. (2016). An exploration of bullying behaviors in nursing: A review of the literature. British Journal of Nursing, 25(6), 303-306.
In 2015, the ANA created a Professional Issues Panel on Incivility, Bullying, and Workplace Violence. The panel revised a previous position statement that charges all registered nurses to “create a culture of respect that is free of incivility, bullying and workplace violence” (para 1). The position statement stresses that any form of workplace violence threatens nursing’s contract with society (ANA, 2015b) and that any nurses who choose to ignore or fail to report such violence is perpetuating it. Widespread support has been noted from both professional and accrediting organizations to adopt and enforce zero-tolerance policies for bullying behaviors (Plonien, 2016). Violence is not a part of the profession, and nurses deserve to work in a safe working environment. No organization can completely prevent or eliminate workplace violence. Planning effective programs can dramatically reduce the chances of violence or incivility (Fig. 14.3).
FIG. 14-3 Participating in violence prevention education can prepare staff to deal with situations that contribute to bullying or intimidation.
Workplace violence is not an isolated, individual problem but a structural, strategic problem rooted in social, economic, organizational, and cultural factors. Consequently interventions should be developed that attack the problem at its roots. This involves all concerned, taking into account the organizational, cultural, and gender dimensions of the problem. Organizational strategies designed to create and sustain new cultural norms are essential (Evans, 2017). This requires sharing a common vision and goals, actively promoting the development of socialization processes, sharing problems, and supporting group problem solving. A clear policy statement should be issued from top management in consultation with stakeholders, recognizing the importance of the fight against workplace violence. The statement should contain a clear definition of violence and an organizational commitment to zero tolerance for any form of violence. Raising awareness about the negative effects of workplace violence can help gain support for planned interventions. The Clark Workplace Civility Index (Clark, 2013) is a tool that can be used to raise awareness and identify strengths and areas for improvement.
Preventive measures designed to improve the work environment, work organization, and interpersonal relationships have been shown to have small effect, and more research is needed, because no one strategy addresses all problems (Escartín, 2016; Gillen, Sinclair, Kernohan, Begley, & Luyben, 2017). When management exemplifies positive attitudes and behaviors in the workplace, the entire organization is likely to follow suit. A management style based on openness, communication, and dialogue can greatly contribute to the diffusion and elimination of workplace violence. Particular attention should be paid to new nurses in their transitional year when they are at highest risk for incivility (Chang & Cho, 2016; D’Ambra & Andrews, 2014).
Exercise 14.5
Think about your behavior in the workplace. Have you ever acted in a way that could be described as bullying or incivility? How might you guard against such behaviors? Do you think you would confront a coworker participating in bullying? If you were a manager, how would you handle incivility on your unit?
Conclusion
Nurses play a valuable role in the delivery of health care. Attracting and retaining quality nurses is good for patients and good for healthcare organizations. Improved patient outcomes, lower costs, and increased job satisfaction are possible when nurses participate in decision making that shapes their practice and creates positive change in the work environment. Engaging and empowering nurses in the workplace through shared governance, collective action, and collective bargaining is key. Shared governance is an ongoing evolving process that requires continuous support and attention from nurses and nurse leaders. Progress and gains may stall over time and require support and innovation to be productive. True shared governance must have shared participation in decision making. Collective action is when nurses work together to create an impact. An understanding of collective action and the roles of leaders and followers can help the individual nurse navigate in today’s complex healthcare organizations. Negotiations may be competitive or collaborative, and collaborative negotiations generally have more positive outcomes. Nurses must understand the rules and regulations that apply to workplace and workforce engagement strategies to make informed decisions about where they would like to work. Leaders and managers should facilitate nurse input and create a safe space for nurses to voice their opinions and effect change. Healthy workplace environments require the active participation of all members and can be an avenue for organizations to attract the most qualified workforce. Efforts toward creating healthy work environments benefit everyone involved.