Essay Example on Workplace Violence, Bullying: ANA's Position

Workplace violence, bullying, and incivility are global phenomena (Cna-aiic, 2014). Research shows that among healthcare providers, nurses are the most at risk for this problem. Bullying and workplace violence have been found to negatively affect the physical and mental health of nurses, thus leading to low rates of recruiting and retaining registered nurses (RNs), high rates of absenteeism, and turnover. This essay will discuss the position of ANA concerning workplace violence, bullying, and incivility and compare it to the position of the Canadian Nurses Association concerning the same issue. It will also discuss the impacts of the problem on various stakeholders, and how a coach leader can help nurses overcome the problem. Workplace incivility, violence, and bullying are occupational health and safety hazards and inhibit optimal outcomes across the healthcare continuum.

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It is the responsibility of RNs and employers to develop and maintain a culture of respect without bullying, violence, and incivility ("Incivility, Bullying, and Workplace Violence - ANA Position Statement", 2015). The position of the American Nurses Association (ANA) regarding workplace violence, bullying, and incivility requires every nurse to develop an ethical workplace atmosphere and a culture of civility and kindness in handling students, colleagues, co-workers, employees, etc. with dignity and respect ("Incivility, Bullying, and Workplace Violence - ANA Position Statement", 2015). In the same manner, nurses should afford the same level of dignity and respect as others. As a result, the nursing profession does not tolerate any violence from any source. Strategies have also been formulated and executed to avoid and deal with incivility, workplace violence, and bullying.

The Canadian Nurses Association (CNA) supports violence-free workplaces (Cna-aiic, 2014). The position statement of CNAs concerning incivility, bullying, and workplace violence is that it is the right of all nurses to work in respectful workplaces without bullying and violence. It also holds that every workplace should have a culture that cultivates and promotes respect. It is unacceptable for nurses to work in, manage, govern, and manage healthcare workplaces with bullying, incivility, and violence (Cna-aiic, 2014). The position statements of ANA and CNA have similarities in that they both emphasize on developing and maintaining a respectful culture, free of bullying, workplace violence, and incivility. They also ensure that nurses are afforded high levels of respect and dignity, and that they do not work in workplaces where violence, incivility, and bullying exist. However, differences in both positions arise in how the associations handle workplace violence. ANA has developed best practice strategies to develop a culture free of violence, bullying, and incivility, while CNA believes that incidents of bullying and violence are under-reported.

A workplace culture full of violence, incivility, and bullying violates the QSEN competencies of safety and teamwork and collaboration ("QSEN Competencies", 2020). The safety competency requires the RNs and employers to minimize the risks to harm providers and patients through individual performance and system effectiveness. Nurses should know examining and describing human factors and other basic principles that create a culture of safety, including errors in the systems of reporting and strategies of communication ("QSEN Competencies", 2020). Similarly, they should possess communication skills to bring forth observations or concerns associated with hazards and errors to patients and healthcare providers. Besides, they should possess attitudes of appreciating the cognitive and physical limits related to individual performance and value their role in preventing errors. All safety competencies will ensure a culture of respect and to avoid incivility, violence, and bullying in workplaces.

On the other hand, teamwork and collaboration is a QSEN competency that is defined as the ability to function effectively within nursing and related teams ("QSEN Competencies", 2020). Teams collaborate to foster open communication, shared processes of decision-making, and mutual respect to attaining quality patient care. In cases where there is workplace violence, bullying, and incivility, the teams will not work effectively because the hostile environment is full of fear and hatred. This means that a workplace full of incivility, violence, and bullying will initiate lack of trust and respect among the team members and in return, they will be unable to provide high-quality care to the patients. The teamwork and collaboration competency requires the nurses to know about identifying barriers that hinder the effective functioning of the team and facilitators that can improve its effectiveness ("QSEN Competencies", 2020). Also, they should have the skills required for participation in designing systems that enhance an effective team. The nurses and inter-professional teams should also develop an attitude of valuing the effect of system solutions in accomplishing the effective functioning of the team.

Workplace violence, incivility, and bullying can have detrimental impacts on teams, individuals, and institutions (Clark, 2019). In the healthcare environment, these problems can provoke self-doubt and uncertainty, compromise moral courage, weaken self-confidence, and jeopardize the safety of patients. Under some circumstances, incivility can cause harm, life-threatening mistakes, or a patient's death (Hutchinson & Jackson, 2013). Laschinger (2014) found that incivility from physicians, supervisors, and nurses has indirect and direct impacts on unfavorable events based on nurses and perceptions on quality of patient care. A study by (Houck & Colbert, 2017) discussed the effect of incivility on healthcare institutions. It noted that medication errors arise from disruptive behaviours, and abuse of nurses from other nurses and physicians, resulting in increased turnover rates of nurses. Additionally, incivility causes disrespect in healthcare, leading to worse patient experience, lower chances of viewing patient care as high quality, reduced likelihood of going back to the organization and seeking care, increased risk of physical harm, and increased chances of staff absenteeism, turnover, and disengagement.

Bullying in a healthcare institution disrupts the accomplishment of patients’ needs (Keber et al, 2015). Workplace bullying results from work turnover, dissatisfaction, and the intention to leave. It results in errors in medication administration and treatment, patient falls, and delayed care. Adams and Maykut (2015) also found that bullying interfered with collaboration, teamwork, and communication, which are essential in providing safe, timely, and accurate patient care. Additionally, many victims of bullying in healthcare institutions suffer from post-traumatic stress disorder and experience symptoms such as sleep disturbance, anxiety, low self-esteem, somatic challenges, recurrent nightmares, irritability, concentration problems, and depression, among others (Felblinger, 2008). It is, therefore, important to develop a deeper understanding of nurses’ reactions to incivility, violence, and bullying due to the clinical and personal outcomes involved.

Several strategies can be used by a coach leader to foster a workplace free of incivility, bullying, and violence. Some preventive measures would include increasing awareness of this problem among the nurses, administrators, and managers, performing educative and informative campaigns to implement prevention, and providing the nurses with skills of conflict management and assertive communication to face bullying (Bambi et al., 2017). Another preventive measure would be strategies of zero tolerance toward every kind of abuse. However, the leader can train the nurses on personal techniques to handle this problem, particularly bullying (Bambi et al., 2017). Firstly, the use of verbal techniques such as expressing their feelings to the perpetrator and informing him or her to stop bullying or talking with the human resource department about the incidents. Secondly, a nurse can use non-verbal techniques such as taking a physical distance from the bullying person. Thirdly, the nurses and other providers can be advised to take a registration of data and written memories for safety reasons.

Conclusion

Workplace violence, bullying, and incivility are occupational health and safety hazards and prevent optimal outcomes across the healthcare sector. The position statement of ANA concerning this problem requires every nurse to develop an ethical workplace and a culture of kindness and civility in the workplace. CNA's position regarding the same issue states that it is the right of all nurses to work in a respectful workplace without violence and bullying. The problem of bullying, incivility, and workplace violence violates the QSEN competencies of safety teamwork, and collaboration. Bullying, incivility, and workplace violence have adverse effects on nurses, patients, physicians, and other healthcare workers. A leader can use preventive measures and personal techniques to train nurses on how they can cope with workplace violence and bullying.

References

Adams, L. Y., & Maykut, C. A. (2015). Bullying: The antithesis of caring, acknowledging the dark side of the nursing profession. International Journal of Caring Sciences, 8(3), 765.

Bambi, S., Guazzini, A., De Felippis, C., Lucchini, A., & Rasero, L. (2017). Preventing workplace incivility, lateral violence and bullying between nurses. A narrative literature review. Acta Bio Medica: Atenei Parmensis, 88(Suppl 5), 39.

Clark, C. M. (2019). Fostering a culture of civility and respect in nursing. Journal of Nursing Regulation, 10(1), 44-52.

Cna-aiic.ca. (2014). Retrieved 26 August 2020, from https://cna-aiic.ca/~/media/cna/page-content/pdf-en/Workplace-Violence-and-Bullying_joint-position-statement.pdf.

Felblinger, D. M. (2008). Incivility and bullying in the workplace and nurses’ shame responses. Journal of Obstetric, Gynecologic & Neonatal Nursing, 37(2), 234-242.

Houck, N. M., & Colbert, A. M. (2017). Patient safety and workplace bullying: An integrative review. Journal of Nursing Care Quality, 32(2), 164-171.

Hutchinson, M., & Jackson, D. (2013). Hostile clinician behaviors in the nursing work environment and implications for patient care: a mixed-methods systematic review. BMC nursing, 12(1), 25.

Incivility, Bullying, and Workplace Violence - ANA Position Statement. ANA. (2015). Retrieved 26 August 2020, from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/.

Kerber, C., Woith, W. M., Jenkins, S. H., & Astroth, K. S. (2015). Perceptions of new nurses concerning incivility in the workplace. The Journal of Continuing Education in Nursing, 46(11), 522-527.

Laschinger, H. K. S. (2014). Impact of workplace mistreatment on patient safety risk and nurse-assessed patient outcomes. JONA: The Journal of Nursing Administration, 44(5), 284-290.

QSEN Competencies. Qsen.org. (2020). Retrieved 26 August 2020, from https://qsen.org/competencies/pre-licensure-ksas/.