Bullying in the workplace is still prevalent especially in health care workplaces.
Problem
Workplace bullying in healthcare has became a widespread and serious issue in this society. Bullying in the workplace defines as “offensive behavior through vindictive, cruel, malicious, or humiliating attempts to undermine an individual or groups of employees” ( Lee et al., 2014). It is currently being considered as one of the factors that affect not only patient outcomes but also increases occupational stress and staff turnover. In fact, reports show that employees are often victims of bullying than they are to gender discrimination, racial, or sexual assault and harassment (Carter, et al., 2013).
Significance
Bullying in the healthcare system is a quite a great and persistent challenge as the individuals who are victimized can suffer serious implications such as physical and mental health including depression, anxiety, helplessness, and despair. It can also lead to psychosomatic complaints and musculoskeletal complaints, suicide ideation and exposure to cardiovascular problems (Carter, et al., 2013). Bullying in healthcare poses negative effects to both patient care and nursing practice. Research shows that nurses who have been victims of bullying have higher chances of having committed one or more serious medical errors. Nurses who are bullied exhibit increased stress which leads to poor job performance which in turn could detrimentally affect patient care (Etienne, 2014).
Theoretical Changes
Bullying in the health care sector was initially perceived to be the result of an escalated conflict between colleagues. Nonetheless, subsequent research has indicated that environmental factors such as leadership methods, low job control, and oppressive working conditions contribute to the cases of bullying in the healthcare sector (Johnson, 2015).Studies also point out that heath care management can unintentionally reward acts of bullying by handing promotions to nurses who engage in such behaviors or by permitting bullying to operate in the form of ‘informal organization authority.’ Further research suggests that interventions at the organizational level to preclude workplace bullying may prove more effective than interventions at the individual level that tend to address bullying behavior after it has already occurred(Johnson, 2015).
Presence
The first leadership change that can be employed in the healthcare setting to curb bullying is the physical presence. The physical presence of managers in the nursing setting is an active deterrent to behaviors of bullying. A nursing unit has few interpersonal barriers which can allow the manager to know anything about anyone (Johnson, 2015). A healthcare organization should also initiate an open door policy which allows personnel to check in and share their concerns at any given time. The management should take advantage of this lack of barriers in nursing units and open door policy to ensure that they are always readily available to take action when a report of bullying is made and address it before the situation escalates any further. Besides, this open door policy permits managers to keep an eye on the personnel who have no idea when or if they are being observed (Johnson, 2015). Despite this leadership changes seeming effective in its aim to inhibit workplace bullying, it is also limited by the fact that some individuals will come up with strategies to avoid surveillance and some of the staff members might change their behavior when the manager is in the unit. These limitations may be addressed by managers showing up in the nursing units at random or creating presence in absentia (Johnson, 2015).
Control
Control is a theoretical change that proposes catching bullying behaviors early and enforcing behavioral standards. This theoretical change is founded on the argument that if the bullying behavior is recognized early, it can usually be put to an end (Johnson, 2015). Nurses who engage in bullying behaviors do not normally face real consequences for their actions as managers usually talk to them informally about their behavior rather than pursuing the formal disciplinary process which is perceived as frustrating and time-consuming. However, this is not the case with the theoretical control change as it advocates for strict consequences that aim to curb bullying behavior. With this leadership theory, the responsibility to call out bullies for bad behavior does not solely lie with the management but with all the staff members (Johnson, 2015). It creates the expectation that all the staff working within the organization are responsible for their actions in addition to being responsible for keeping an eye on the language and behaviors of their co-workers.
Literature Review
According to existing studies, the presence of management in the nursing unit has been evident to a decline in cases of bullying. This is because of the increase in the number of bullying cases reported. Concerning a study where participants were asked why behaviors of bullying were not reported, around 45.7% of victims of bullying believed that nothing would change. About 13.9% pointed out that they would not like to be seen as troublemakers, while 11.7% believed that the level of seniority would prevent reporting (Lee, Bernstein, Lee, & Nokes, 2014). All these points on the significance aim at identifying and dealing with bullying behavior. Scholars argue that the presence of management in the nursing unit observing and monitoring the behaviors of staff is a huge intervention in the effort of curbing bullying behavior. Also, further research shows that for the presence of management to be effective in inhibiting bullying behaviors, managers need to take control of the situation by randomly showing up at the nursing unit to identify staff that might change their behaviors when monitored(Lee, Bernstein, Lee, & Nokes, 2014). Stern action should also be taken against individuals with the behavior of bullying others.
In a study conducted to identify measures that could be effective to inhibit bullying in the healthcare setting, scholars found that the if the leadership of the organization set measures to identify behaviors of bullying at early stages, they could effectively control the situation(Etienne, 2014). Further research shows that many victims of bullying in health care organizations tend not to come forward to report either because they feel that no action will be taken following the report or that they will be seen as trouble makers (Carter, et al., 2013). However, studies also show that in cases where stern action has been taken against bullies by making them face the consequences of their actions than the informal talk from managers, the prevalence of bullying behavior has greatly reduced. Scholars suggest that the management of any health care organization should take reports of bullying behavior with extreme seriousness and address them before they escalate any further.
Analysis of Impact
Successfully implementing the theoretical changes discussed in this paper could positively impact patient care, nursing management and the health care environment within any health care organization. Victims of bullying behavior tend to be stressed and less focused on their work which may affect their work turnover as well as professional judgment. The moment a nurse gets distracted from efficiently executing their duties, patient care is greatly affected. With the implementation of these theoretical changes, nurses will be able to execute their professional obligations to the best of their abilities, and this would guarantee quality patient care.
In addition to guaranteeing quality patient care, efficiently implementing these theoretical changes in any health care setting would help in improving the way colleagues interact with each other at th
e workplace. Nurses will be able to interact and communicate with each other in the most professional way possible knowing that their behaviors are being monitored and strict policies have been put in place to address bullying behavior. This will also create a very positive working environment as the actions of the nurses will be conducted in a professional manner that will help them build on the knowledge of each for the sake of providing the best care possible for their patients.