Addressing the Elephant in the Room: Nurse Manager Recognition of and Response to Nurse-to-Nurse Bullying

Why do nurses leave their jobs? Understanding person-related hostility in the healthcare sector of Pakistan

Nursing is considered indigent and oppressed because of uneven organizational hierarchies and unsatisfactory work environments. This study aimed to highlight the critical aspects of organizational culture in the nursing profession and, in general, those propagating hostile behaviours among female nursing staff that result in dissatisfaction and intention to leave the organization. A quantitative research approach was applied and a survey research strategy was used to collect the data. Convenience sampling was applied and data were collected from female nurses who were easily accessible and willing to participate in the research. A total of 707 questionnaires were collected from 14 hospitals and the data was analyzed using SmartPLS 4. Lack of administrative support and gender discrimination positively affected person-related hostility. In contrast, person-related hostility mediated the relationship between gender discrimination and lack of administrative support with the intention to leave. Direct or indirect person-related hostility factors can severely damage organizational reputation and quality and may cause the loss of employees with specific organizational knowledge and exposure. Losing an experienced employee to a newer one cannot replace the costs incurred on hiring, training, and providing knowledge to older employees. HR managers in organizations should devise strategies and policies that allow for the timely resolution of issues of nursing staff based on fair work performance.

Promoting Civility in the Workplace: Addressing Bullying in New Graduate Nurses Using Simulation and Cognitive Rehearsal

This evidence-based practice project implementation aimed to enhance new graduate nurses' abilities to address workplace bullying. A mixed educational methodology was used. Participants indicated applying learned behaviors to improve communication, peer relationships, teamwork, and patient safety and to address bullying. Civility ratings did not significantly increase from before to after the intervention, presumably because of high baseline ratings. Future research should identify sensitive and specific measures to detect bullying behavior changes.

In their own words: Nurses countering workplace incivility

The inexcusable effects of workplace incivility on Registered Nurses (RNs) have been extensively noted in the literature and social media. Terms such as bullying, hostile, incivility, and others have been used to describe negative behaviors that affect all health-care workers. These effects can have devastating consequences on the quality of the personal and professional lives of RNs. A qualitative research study examined how extensive the distress of workplace incivility actually is in the healthcare environment. The study also captured the perceptions of the interviewed RNs noting their own description of the destructive force incivility has upon nurses. RN's were asked their personal insights of what interventions might stop or prevent such behavior. Based on both of these findings, a collection of resources has been compiled with the intent to support RNs in managing uncivil behaviors. Although the study was a specific evaluation of RNs, the findings are applicable to other health care specialties as well.

An Integrative Review of Bullying and Lateral Violence Among Nurses in Magnet® Organizations

Over the past several years, researchers have postulated that Magnet® organizations improve collegiality and potentially could mitigate workplace bullying and lateral violence (BLV). In order to synthesize and evaluate the existing literature on BLV in the Magnet® setting, an integrative review was conducted. The final analysis consisted of 11 articles (8 quantitative and 3 qualitative studies) and revealed that researchers still use a variety of terms to define and measure BLV. Several of the studies used blended samples of both Magnet® and non-Magnet nurses, making it difficult to evaluate for response differences. The existing studies suggest that BLV continues to exist and remain a large issue even in the Magnet® setting (Hickson, 2013; Latham, Ringl, & Hogan, 2013). Future studies should examine the prevalence of BLV in both Magnet® and non-Magnet organizations and also explore the organizational factors that reduce its occurrence.

Responding to disruptive behaviors in nursing: A longitudinal, quasi-experimental investigation of training for nursing students

OBJECTIVES

The objective of this study was to determine the impact of a cognitive rehearsal intervention on nursing students' self-efficacy to respond effectively to disruptive behaviors.

DESIGN

This quantitative study was part of a longitudinal, quasi-experimental program of research.

SETTING

Interventions were conducted on site at facilities provided by participating pre-licensure nursing programs.

PARTICIPANTS

A total of 129 nursing students enrolled in their final academic year in three traditional format, pre-licensure nursing programs in the Midwestern United States were recruited to participate in this study.

METHODS

A cognitive rehearsal intervention was delivered to increase self-efficacy to respond to disruptive behaviors in the nursing workplace. Data were collected in writing immediately prior to and following the intervention. Three months later, data were collected in electronic format through a link sent by text message to their mobile phones. Study data were collected on the Self-efficacy to Respond to Disruptive Behaviors Survey, a 10-point Likert scale measuring self-efficacy and its dimensions: knowledge, previous behavioral engagement, affect, and motivation toward responding effectively to disruptive behaviors.

RESULTS

129 students completed the surveys at pre and post-test; 109 completed the survey three months later. Measures of overall self-efficacy and knowledge (p < 0.000), and both measures of situational self-efficacy (p = 0.002; p = 0.020) remained significantly increased three months after the intervention, compared to pre-test. Past behaviors increased on post-test but returned to baseline at the three-month follow-up. The intervention did not significantly impact affect scores. Changes in motivation toward effective responses were mixed between measurements immediately following the intervention and three months later.

CONCLUSION

Cognitive rehearsal interventions can increase self-efficacy to respond to disruptive behaviors with sustained effects up to three months later. Further research is needed to determine the effects of self-efficacy to respond once participants have entered the nursing workplace.

Association of the nurse work environment with nurse incivility in hospitals

AIM

To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy.

BACKGROUND

Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment.

METHODS

Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational.

RESULTS

Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility.

CONCLUSIONS

Supportive nurse managers reduce coworker incivility.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can shape nurse work environments to prevent nurse incivility.