A NURSES A P S ON INCIVILITY BULLYING AND WORKPLACE VIOLENCE

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III BACKGROUND, Incivility bullying and workplace violence are part of a larger complex phenomenon which includes a. constellation of harmful actions taken and those not taken in the workplace Saltzberg 2011 p 229 The. phrase actions taken and not taken provides an overarching framework that includes using explicit displays. of uncivil or threatening acts as well as failing to take action when action is warranted or required to address. incivility bullying or violence in the workplace, Some harmful actions may be more overt such as making demeaning comments or using intimidation to. undermine a coworker Other forms of incivility and bullying can be more covert such as failing to intervene. or withholding vital information when actions are clearly indicated and needed for work to be done in a safe. manner Actions taken and not taken occur along a continuum and range from the subtle and covert to the. overt and from less to more harmful Clark 2013a Einarsen Hoel Zapf Cooper 2011 World Health. Organization 2015, Unfortunately the full range of actions related to this complex phenomenon has negatively impacted RNs. globally and in some cases has been accepted and culturally condoned For nearly a century some form of. incivility bullying or violence has touched far too many members of the nursing profession They affect every. nursing specialty occur in virtually every practice and academic setting and extend into every educational and. organizational level of the profession Hader 2008 McKenna Smith Poole Cloverdale 2003. It is important to first acknowledge the existence of harmful actions taken and actions not taken in the. workplace in order to eliminate them Those who experience workplace incivility bullying or violence know. firsthand their detrimental effects especially when their experiences are not taken seriously by coworkers and. supervisors Those harmful effects have been described as additive in that they accumulate burden and can. become synergistic Moreover their combined effects can go beyond what each can do alone Bullying and. other harmful actions can be surrounded by a culture of silence fears of retaliation and the perception that. nothing will change Vessey DeMarco DiFazio 2011 p 142. Any form of workplace violence puts the nursing profession and nursing s contract with society in jeopardy. Saltzberg 2011 Those who witness workplace violence and do not acknowledge it who choose to ignore it. or who fail to report it Hutchinson 2009 are in fact perpetuating it Thus organizations that fail to address it. through formal systems are indirectly promoting it The Joint Commission 2008 Refusal to engage in addressing. what has become in some workplaces accepted norms surrounding workplace violence is no longer an option. because not all norms or values are moral norms or values Colby et al 1987 Taking action is a moral stance. consistent with the ANA Code of Ethics for Nurses with Interpretive Statements 2015a The entire nursing profession. must actively drive a cultural change to end incivility bullying and violence in the workplace. Incivility, RNs and their employers should acknowledge the various forms of workplace violence as well as the extent. to which each occurs in their work setting By differentiating the various forms of harmful actions taken and. of actions not taken the nursing profession can focus its collective wisdom and experience on leading the. campaign to create a culture of respect safety and effective interprofessional communication. Incivility can take the form of rude and discourteous actions of gossiping and spreading rumors and of refusing to. assist a coworker All of those are an affront to the dignity of a coworker and violate professional standards of respect. Such actions may also include name calling using a condescending tone and expressing public criticism Andersson. Pearson 1999 Read Spence Laschinger 2013 The negative impact of incivility can be significant and far. reaching and can affect not only the targets themselves but also bystanders peers stakeholders and organizations If. left unaddressed it may progress in some cases to threatening situations or violence Clark 2013a. 2 A merican Nurses Association Position Statement on Incivility Bullying and Workplace Violence. Oftentimes incivility is not directed at any specific person or persons However it may perpetuate or become. a precursor to bullying and workplace violence therefore it cannot be characterized as innocuous or. inconsequential Pearson Andersson Porath 2005 Studies have shown that incivility experienced through. email or other online forums affects targets in much the same way as face to face incivility does Clark 2013b. Clark Ahten Werth 2012 Clark Werth Ahten 2012 Giumetti et al 2013. Bullying is repeated unwanted harmful actions intended to humiliate offend and cause distress in the. recipient Bullying actions include those that harm undermine and degrade Actions may include but are. not limited to hostile remarks verbal attacks threats taunts intimidation and withholding of support. McNamara 2012 Such actions occur with greater frequency and intensity than do actions described as. uncivil Bullying actions present serious safety and health concerns and they can cause lasting physical and. psychological difficulties for targets Washington State Department of Labor and Industries Safety and Health. Assessment and Research for Prevention Program 2011. Bullying often involves an abuse or misuse of power creates feelings of defenselessness and injustice in the. target and undermines an individual s inherent right to dignity Bullying may be directed from the top down. employers against employees from the bottom up employees against employers or horizontally employees. against employees Top down bullying from organizational leaders allows bullying to become an accepted and. condoned workplace norm Deans 2004a Royal College of Nursing 2002 Vessey DeMarco DiFazio 2011. Hutchinson Wilkes Jackson and Vickers 2010 used structural equation modeling to test a model of bullying. Their survey data from 370 nurses revealed specific organizational characteristics including misuse of authority. certain policies and procedures organizational tolerance and informal alliances as the critical antecedents to. bullying and its frequency, RNs and employers must also be cognizant of workplace mobbing as a collective form of bullying and as an.
expression of aggression aimed at ostracizing marginalizing or expelling an individual from a group Bowling. Beehr 2006 Galen Underwood 1997 Harper 2013 As Griffin and Clark 2014 state workplace. mobbing occurs when more than one person commits egregious acts to control harm and eliminate a targeted. individual p 536 Mobbing is linked to physical psychological social and emotional damage and it can. have devastating economic consequences as the targeted individuals fight to keep their jobs and careers DiRosa. et al 2009 Hutchinson Vickers Jackson Wilkes 2006 Monteleone et al 2009 Vessey DeMarco Gaffney. Budin 2009, When investigating experiences of workplace mobbing and comparing those experiences with indicators on. various scales Balducci Alfano and Fraccaroli 2009 found positive and significant correlations between the. frequency of exposure to mobbing and the appearance of various indicators including posttraumatic stress The. authors found that the frequency of exposure to mobbing predicted suicidal ideation and behavior. In 1990 Leymann described workplace mobbing as the adult form of bullying It is characterized by employees. ganging up on a target employee and subjecting that individual to psychological harassment that may result. in severe psychological and occupational consequences In some cases targets of workplace mobbing may. be exceptional employees For example Westhues 2004 suggested that mobbing among faculty members in. academic workplaces may be related to envy of excellence and to jealousy associated with the achievements. of others Mobbing may thus occur in such workplaces in an attempt to maintain group mediocrity and. compliance with the status quo so that the high performer is targeted to keep that person in line with. prevailing workplace norms, A merican Nurses Association Position Statement on Incivility Bullying and Workplace Violence 3. Workplace Violence, Workplace violence consists of physically and psychologically damaging actions that occur in the workplace. or while on duty National Institute for Occupational Safety and Health NIOSH 2002 The Bureau of. Labor Statistics releases an annual report about injuries and illnesses resulting in time away from work in the. United States In the health care and social assistance sectors 13 of days away from work were the result. of violence in 2013 and this rate has increased in recent years U S Department of Labor DOL Bureau of. Labor Statistics 2014 According to a recent ANA survey of 3 765 registered nurses and nursing students 43. of respondents have been verbally and or physically threatened by a patient or family member of a patient. Additionally 24 of respondents have been physically assaulted by a patient or family member of a patient. while at work ANA LCWA Research Group 2014, Workplace violence is referred to by some as endemic which from a public health perspective means. it is commonly found in certain settings Lipscomb London 2015 Such settings include emergency. departments psychiatric hospitals nursing homes long term care facilities and others Hodgson et al 2004. describe how employees who float from one unit to another experience assault three times more often than. do permanent employees Wolf Delao and Perhats 2014 provide evidence of the prevailing attitude that. workplace violence is a culturally accepted and expected part of one s occupation Oftentimes patient safety. is given priority over employee safety when in fact both are integral to quality and safe care Lipscomb. London 2015, Workplace violence can lead to emotional distress temporary or permanent injury or even death Tarkan 2008.
Examples of workplace violence include direct physical assaults with or without weapons written or verbal. threats physical or verbal harassment and homicide Occupational Safety and Health Administration 2015. NIOSH classifies workplace violence into four basic types Types II and III are the most common in the health. care industry Types I and IV are not addressed in this position statement. Type I involves criminal intent In this type of workplace violence individuals with criminal. intent have no relationship to the business or its employees. Type II involves a customer client or patient In this type an individual has a relationship with. the business and becomes violent while receiving services. Type III violence involves a worker on worker relationship and includes employees who attack. or threaten another employee, Type IV violence involves personal relationships It includes individuals who have interpersonal. relationships with the intended target but no relationship to the business Iowa Prevention. Research Center 2001 NIOSH 2006 2013,Detrimental Effects on the Nursing Profession. An overview of relevant literature indicates that incivility bullying and workplace violence are concerns. for the nursing profession health care field and beyond Spector Zhou Che 2013 Kaplan Mestel. and Feldman 2010 suggest that nurses ignore or tolerate incivility and bullying because of fear or lack of. knowledge However incivility and bullying are also reasons nurses leave or plan to leave the profession. Johnson Rea 2009 Simons 2008 Vessey DeMarco DiFazio 2010 Other negative effects include. decreased job satisfaction reduced organizational commitment decreased personal health and added direct. and indirect costs to employers and RNs Rodwell Brunetto Demir Shacklock Farr Wharton 2014 Smith. Andrusyszyn Spence Laschinger 2010, 4 A merican Nurses Association Position Statement on Incivility Bullying and Workplace Violence. Financial R amifications, Decreased productivity can occur following incidents of incivility bullying or workplace violence Employee. retention can also become more difficult Yet the total financial cost of such actions is very difficult to calculate. Berry Gillespie Gates Schafer 2012 Chapman Styles Perry Combs 2010 D Ambra Andrews 2014. Edward Ousey Warelow Lui 2014 Gates Gillespie Succop 2011 Hegney Tuckett Parker Eley. 2010 Spence Laschinger 2014 According to one study lost productivity related to workplace incivility was. calculated at 11 581 per nurse annually Lewis Malecha 2011. Another study of a U S hospital employing 5 000 nurses estimated the cost of workplace violence treatment at. 94 156 annually 78 924 for treatment and 15 232 for indemnity for the 2 1 of the hospital s nurses who. reported injuries Speroni Fitch Dawson Dugan Atherton 2014. The costs of incivility increase when one takes into account the expenses associated with supervising the uncivil. employee managing the situation consulting with attorneys interviewing witnesses and recruiting hiring and. training new employees Griffin Clark 2014 Lipscomb London 2015 Pearson Porath 2009 2013. RN Health Patient Safety and Career Consequences, Incivility bullying and workplace violence harm a person s intrinsic sense of self worth and self confidence.
which may result in physical symptoms such as headaches interrupted sleep and intestinal problems Those. actions may also be associated with psychological conditions including heightened levels of psychological. Incivility bullying and workplace violence are part of a larger complex phenomenon which includes a constellation of harmful actions taken and those not taken in the workplace Saltzberg 2011 p 229 The phrase actions taken and not taken provides an overarching framework that includes using explicit displays of uncivil or threatening acts as well as failing to take action

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