Workplace violence is the current worldwide norm that encompasses different forms of violence in different working environments. In the nursing profession, health workers face the simultaneous occurrence of health hazards, such as injuries and contagious diseases, violence, and stress. In the nursing profession, prevalent bullying behaviors, which range from physical assault, sexual harassment, racial discrimination, and verbal abuse, pose a major threat to nursing practitioners. Etienne (2014) denotes that workplace bullying encompasses different aspects, such as harassment, violent behavior, and intimidation, resulting from senor officials' aggressive behavior to control everything in the work environment. Mostly, the people who face workplace bullying in the nursing profession are lower in the power scale relationship and usually have no force to defend themselves from the act. Workplace bullying in the nursing profession has devastating impacts on the health care system of different countries. According to Etienne (2014), the bullying acts in the nursing profession contribute to difficulties in recruitment and maintenance of stable nurse turnover rate in different health care facilities. The bullying act contributes to nurse shortage, leading to a decline in the quality of patient care.
In the health care system, workplace violence asserted to nurses forms the major source of discrimination, conflict, inequality, and discrimination in the working environment. Consequently, workplace violence disrupts interpersonal relationships, negatively impacting the working environment, and may instantly contribute to organizational failure. Ideally, the most affected population of workplace bullying are usually women. Wolf et al. (2018) explain that most women globally compound more than half of the population in the nursing profession and are usually prone to experience post-traumatic stress disorder associated with violent acts, such as rape and terrorism. Workplace violence asserted to nurses causes depression, self-doubt, irritability, sleep disturbance, absenteeism, and decreased motivation towards work. Nurses face violence not only from their seniors but also from clients who are usually health care receivers (Wolf et al., 2018). In most cases, nurses failed to report assault done on them due to fear of the employer's choice of action, lack of proper reporting channels, and the assumption that assault is part of the job. This aspect leads to ineffective service delivery and compromises the quality of health services.
The application of various actions can address workplace bullying and incivility in the nursing profession. In most health care facilities, there are no clear policies and guidelines on workplace violence. Etienne (2014) asserts that establishing appropriate legislation and policies will reduce workplace violence instances. These include zero tolerant behaviors on bullying acts and other uncivil acts, such as intimidation and discrimination. Accordingly, education should be offered to nurses to enhance capacity building and assist them in internalizing and understanding bullying norms and understanding ways of eliminating workplace bullying. Wolf et al. (2018) accord that education programs should be offered to students in universities to empower learners in establishing bullying behaviors as a strategy to solve bully activities. Corrective and remedial actions should be the main focus in eliminating incivility in the health care system. This can involve the punishment of the perpetrators in the bullying acts. Subsequently, shared responsibility can help solve incivility as the two parties can come together and address the bullying situation and come up with a shared solution capable of repairing and preventing future bullying activities.
References
Etienne, E. (2014). Exploring workplace bullying in nursing. Workplace Health & Safety, 62(1), 6-11. https://doi.org/10.1177/216507991406200102
Wolf, L. A., Perhats, C., Clark, P. R., Moon, M. D., & Zavotsky, K. E. (2018). Workplace bullying in emergency nursing: Development of a grounded theory using situational analysis. International Emergency Nursing, 39, 33-39. https://doi.org/10.1016/j.ienj.2017.09.002
Edited by Tabraue, Alexa on Jun 9 at 5:04pm

REPLY 2

Workplace bullying is defined as harmful, targeted behavior that happens at work (Raypole, 2019).  Some examples of workplace bullying are: targeted practical jokes; being purposely mislead about work duties, like incorrect deadlines or unclear directions; continued denial of requests for time off without an appropriate or valid reason; threats, humiliation, and other verbal abuse; excessive performance monitoring; and overly harsh or unjust criticism (Raypole, 2019).  It is unfortunate to know that over 60 million working people in American are affected by bullying.  The term incivility or lateral violence in the workplace is described as disruptive behavior or communication that creates a negative work environment, thus interfering with quality patient care and safety (Yoder-Wise, 2015).

In my organization unfortunately, I have witnessed firsthand workplace bullying.  There was a nurse that had been working for the organization for over 16 years.  She was a floor nurse as well as a charge nurse on my unit.  Although she was a great nurse and very sweet, at times she did show that she would get a little frazzled when our patient to nurse ration went up to six or seven to one.  This would be a normal reaction depending on the acuity of the patients.  Unfortunately, the nurse manager would single her out when having huddles and say that you shouldn’t look frazzled or stressed instead of pulling her aside and trying to talk with her to figure out why she is the way she is.  The nurse manager would also talk about her to other employees and criticize her on just about every aspect.  He was watching her under a microscope which he did not do for anyone else.  This particular nurse was very shy and did not know how to defend herself.  The nurse manager continued this behavior for over six months and the nurse cried just about on every shift.  The final straw was when the nurse found a deep pressure injury on the heal of a patient around 11:00 am and brought it to the nurse managers attention as she should have.  The nurse manager was very upset that she did not do a full skin assessment during change of shift report.  He asked her as to why it was not checked earlier in the shift, and she stated that she started with seven patients, and they had a very high acuity.  Later on that day, he questioned the night nurse as well to see if she had noticed the deep tissue injury on the patient.  The night nurse stated that she never checked the heals on the patient and that she reported to the day nurse that the skin was intact.  Unfortunately, since the day nurse was the one that has been under the microscope by the nurse manager, she was forced to resign, or she would have been fired.  The night nurse on the other hand was not given any form of corrective actions. 

  In order to help break the cycle of incivility, The Joint Commission has many suggested actions that should be taken.  Some of the actions suggested are: educate all team members on appropriate professional behavior; hold team members accountable for modeling desirable behaviors; develop and implement policies and procedures/processes appropriate for the organization; provide skills training and coaching for all leaders and managers in relationship-building and collaborative practice; and develop and implement a reporting/surveillance system (possibly anonymous) for detecting unprofessional behavior.  Since the nurse manager is usually the one to give corrective actions or fire nurses, it is necessary for nurses to be able to report anonymously if they see unjust behaviors by the nurse manager.  I tried to defend the nurse that found the deep tissue injury and my words were not received well.  Many of the members of our unit thought that there was a significant amount of inappropriate behaviors from the nurse manager, however, many of the staff members were scared to say anything due to the retaliation that may occur.

Reference

Raypole, Crystal. (2019, April 19). How to Identify and Manage Workplace Violence. Retrieved from: https://www.healthline.com/health/workplace-bullying (Links to an external site.)

Yoder-Wise, Patricia S. (2015). Leading and Managing in Nursing (6th ed). St. Louis, MO: Mosby, an imprint of Elsevier

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