Intimidation of nurses in the workforce continues to be a problem. Intimidating behavior affects not only the nurse but patient care as well. The nurse might be intimidated by peers, patients or physicians. Intimidating behavior is not healthy and should be addressed. In this paper the issue of nurse intimidation will be discussed. The discussion will include definitions of intimidation, the impact of intimidation on the nursing profession, the impact of intimidation on patient care, solutions for handling intimidation, implications for nursing curriculum, and future research possibilities regarding the topic of intimidation.
Definition of Intimidation
Intimidation is a form of bullying. Forms of intimidation can be behavior that belittles such as being shouted at or the use of profanities, and wrongly assigning blame (Edwards, 2007). Intimidation in the healthcare field among and between practitioners is most commonly in the form of verbal abuse. Verbal abuse may be an angry tone of voice, yelling and screaming, threats against a person or institution, or derogatory comments (Edwards, 2007). For the purpose of this paper, the terms intimidation, bullying, and disruptive behavior will be used interchangeably. The American Medical Association stated in 2002, “Personal conduct, whether verbal or physical, that affects or that potentially may affect patient care negatively constitutes disruptive behaviors”. Porto (2006) describes multiple types of disruptive behavior: profanity or disrespectful language, demeaning behavior, name-calling, throwing of instruments and charts, criticizing of other caregivers in front of patients or other staff, comments that undermine a caregiver’s confidence to provide care for a patient. While s...
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Horizontal violence is a form of workplace relational aggression, an experience that is rampant in the nursing profession (McKenna, Smith, Poole, & Coverdale, 2003). The expression, horizontal violence, is used to describe cruel behaviors between colleagues of comparable status, such as registered nurses, in the workplace. Research has shown a variety of destructive peer-to-peer behaviors that are detrimental to the profession and healthcare systems (Farrell, 2001). Nevertheless, little research has been done on “eating their young,” horizontal violence arising between those with unequal power, such as registered nurses and students (Thomas & Burk, 2009).
The paper will address the problem of nurse hostility toward each other. It will address the etiology of the problem, and suggest some possible solutions or therapy to the problem. It will be discovered if truly preventive programs such as violence-prevention programs
The trauma related to negative behavior can afflict the healthcare environment on many levels, from creating a hostile work environment in which job performance is affected, by increasing job turnover and causing nurses to leave the profession altogether. The Joint Commission states that in the United States 65.6 million workers have experienced or witnessed bullying, psychological harassment affects 38 percent of healthcare workers, and 44 percent of nurses are impacted by this behavior (The Joint Commission, 2016). Inclusively, this behavior can influence the way nurses care for their patients, staffing levels, and the healthcare organization’s
Horizontal violence is an action that has been reported and documented in nursing and other healthcare professions for many years. This type of behavior between nurses has provided very discouraging and truly serious outcomes for nursing professionals and unfortunately for their patients as well. Horizontal violence is “hostile, aggressive, and harmful behavior by a nurse or group of nurses via attitudes, actions words, and/or behaviors.”(Becher, J. & Visovsky, C (2012)). This can be done either overt or covert. Overt, done openly, is when the victim is experiencing name calling, bickering between colleagues, fault finding, c...
Wilson, B. L. (2013). Horizontal hostility a threat to patient safety. Jona’s Healthare Law, Ethics, and Regulation, 15, 51-57. doi:10.1097/NHL0B013e3182861503
Nurses are caring by nature. Nurses care for family members while at home, community members who may be neighbors, church members or friends from school and sports with children in common; however, nurses are known to display uncaring attitudes towards each other. When nurses are discourteous and disrespectful towards one another this may be known as workplace incivility. Incivility is defined by Merriam-Webster as, “the quality of state of being uncivil and a rude or discourteous act” (n.d.). Alexander (2017) related incivility to the events of the 2016 United States election as “rude and impolite behaviors that may be manifested when people feel fear or mistrust” (p. 79). Healthcare is subject to the same negative influence through communication between healthcare providers, educators and patients.
Workplace bullying is increasingly being recognised as a serious problem in society. Reports from the general media and professional press suggest that there is increasing evidence that the scale of bullying, harassment and violence amongst health care staff is widespread (UNISON, 2003). Chaboyer, Najman, and Dunn (2001) explain that although nursing in Australia is now considered a profession, the use of horizontal violence, bullying and aggression in nursing interactions has been identified as a serious problem. Levett-Jones (as cited in Clare, White, Edwards, & van Loon, 2002) explains that the recipients or victims of bullying within the nursing profession are often graduate nurses, with 25% of graduates reporting negative experiences. Bullying behaviour often renders the workplace a harmful, fearful and abusive environment and has a devastating effect on the nurse, healthcare team and patient. This essay will discuss the issue of bullying within the nursing profession, with a particular focus on the experiences of graduate nurses. The contributing historical, social, political and economic factors will be explored in order to better understand the origins of this trend. The subsequent impact of bullying on nursing practice will be analysed and recommendations for practice, supported by current literature, will be provided.
Matt, S. B. (2012). Ethical and Legal Issues Associated With Bullying in the Nursing Profession. Journal Of Nursing Law, 15(1), 9-13. doi:10.1891/1073-7472.15.1.9
Acts of incivility can include discourteous or disdainful speech, public censure, character assassination, or lack of inclusion in patient care decisions (Lachman, 2014). Incivility, both lateral and hierarchal, has been found to occur at all levels of health care including academia and direct health care settings (Lachman, 2014). The prevalence of incivility in the health care work place is a disturbing problem. According to Nikstaitis and Simko (2014) 85% percent of nursing personnel report having experienced incivility in the workplace. Additionally, 39.6% state they intend to leave their place of work due to lateral violence (Nikstaitis & Simko, 2014). Incivility leads to an unhealthy work environment in which decreased morale and high nurse turn-over result in poor patient care and outcomes (McNamara, 2012). Lachman (2015) states that in addition to the effect on staff and patients, the cost of incivility is felt by the employer in cost of new staff training and in decreased insurance reimbursement due to poor patient outcomes and
Incivility is something that should not be acceptable anywhere, especially in healthcare. Everyone should be able to report this issue when it occurs because it creates friction among team members, management, and decreases patient care outcomes.
Frequently, nurses are confronted with the task of finding the balance between advocating for the patient, and remaining loyal to their hospital or institution (Hanks, 2007). Risks that are associated with patient advocacy are more on the institutional level (Bu & Jezewski, 2007). Risks such as accusations of insubordination, reputation slander, hostile work environment, and loss of job security are among some of the top reasons nurses tend to shy away for patient advocacy (Bu & Jezewski, 2007). Another problem with advocacy is that there isn’t a universal definition as to what being an advocate means, along with inconsistency of interpretations (Bu & Jezewski,
Assaults in the healthcare setting are recognized as a growing problem. In considering the violence and aggression in mental health units, the larger issue of violence and aggression in mainstream culture must not be ignored. It has been observed that physical attack in a mental health unit setting appear to be happening more frequently while the attacks include patient-to patient and patient-to-staff aggressive behavior. Most commonly, reporting of aggressive behavior toward healthcare staff is noted; however, it cannot be completely explained by patient characteristics or staff member behaviors (Foster, Bowers, & Nijman, 2006). To improve patient control of aggression and violence, an organization must better define the management and reporting of this behavior, identify appropriate management programs and training, and evaluate the frequency and precipitants.
It has various negative effects which are persistent in nature, and the individual victim realizes the behaviour as bullying (Wilson, 2016). Bullying is associated with physical and psychological problems among nurses leading to absenteeism, poor performance, low job satisfaction, and increased turnover (Ganz, et al., 2015). The issue of bullying among nurses further affects the entire health care team including patient outcomes and health care costs due to the declining level of nurses’ performance (Becher & Visovsky, 2012). Although bullying exists in the nursing work place, they are silent in nature, and goes undetected (Becher & Visovsky,2012). Hence, identifying and managing workplace bullying needs efforts of individual facing bullying and support of the
Abdollahzadeh, F., Asghari, E., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility?: Nurses' perspective. Iranian journal of nursing and midwifery research, 22(2), 157. Doi: 10.4103/1735-9066.205966
Nurses continually strive to bring holistic, efficient, and safe care to their patients. However, if the safety and well-being of the nurses are threatened or compromised, it is difficult for nurses to work effectively and efficiently. Therefore, the position of the American Nurses Association (ANA) advocate that every nursing professional have the right to work in a healthy work environment free of abusive behavior such as bullying, hostility, lateral abuse and violence, sexual harassment, intimidation, abuse of authority and position and reprisal for speaking out against abuses (American Nurses Association, 2012).