Civility and workplace bullying: resonance of Nightingale's persona and current best practices

Exploration of Workplace Bullying among Nurses: A Focus on Clinical Settings

PURPOSE

Healthcare practitioners in Saudi Arabia sometimes experience workplace bullying (WPB). However, more research on this issue must be carried out in the country. This study aimed to investigate the prevalence of WPB and how individual factors among nurses contribute to different experiences of WPB in clinical settings.

METHODS

This cross-sectional quantitative study occurred among registered nurses in Riyadh, Saudi Arabia. A self-administered questionnaire was used, and nurses filled it out via a Google survey that included sociodemographic details such as age, gender, education, and the WBS to gauge the prevalence of workplace bullying in hospital settings.

RESULTS

Of 416 nurses, 58.7% were aged between 31 and 40, and 76.9% were women. The prevalence of WPB was found to be 54.8%. WPB was higher among middle-aged nurses, men, charge/managerial nurses, nurses with higher education, those with 3 to 6 years of experience, and those working in specialty units.

CONCLUSIONS

More than half of the nurses had experienced WPB at some point. Middle-aged nurses, especially men with higher education and more experience in specialty units, were the most common victims of WPB compared to other registered nurses.

Evidence of Horizontal Violence in Healthcare Settings: A Narrative Review

In the professional realm, the healthcare sector stands out as one of the most susceptible to violence. One notable manifestation of this is violence among colleagues, commonly referred to as horizontal violence, which has garnered significant attention in recent times. To delve deeper into this phenomenon across various categories of healthcare professionals, a comprehensive search was conducted on PubMed, Scopus, and CINAHL, resulting in the inclusion of 13 articles. The findings of this narrative review illuminate how horizontal violence can manifest in both physical and psychological forms and how it often becomes normalized among the healthcare professionals who endure it. Particularly vulnerable to such occurrences are recent graduates and those with limited professional experience. Furthermore, it has been observed that horizontal violence has detrimental effects on the well-being of those subjected to it, as well as on the quality of patient care delivered. Considering preventive measures, numerous studies emphasize the pivotal role of effective departmental leadership in fostering a harmonious work environment. Despite the largely underreported nature of this phenomenon, the conclusions drawn in this study advocate for a deeper exploration of the dynamics surrounding horizontal violence, with the goal of devising targeted strategies to mitigate its occurrence.

Examining 'sticky' storytelling and moral claims as the essence of workplace bullying

BACKGROUND

Fisher (1985) argued that "there is no genre…that is not an episode in the story of life" (p. 347). As they incorporate moral claims, stories become 'sticky,' even when they are not accurate of fact, shifting listener beliefs, values, and sense of self.

PURPOSE

This study examined 'sticky' storytelling and moral claims inherent in workplace bullying.

METHOD

Critical hermeneutic method nested within an integrative review served as the research approach, extending findings reported in published research reports and gray literature.

FINDINGS

Through polished use of rhetorical style and resource control strategies within tacitly or explicitly supportive workplace contexts, bullies construct convincing but morally disengaged narratives-sticky stories-that violate ethical principles and yield moral ambiguity for their victims as they impede workplace productivity.

DISCUSSION

Largely ineffective, policies aimed to stem bullying have done little to date to mitigate bullying's impact. Recognizing the moral storytelling characterizing workplace bullying might strengthen policy for constraining workplace bullying.

The Professional Behaviors New Nurses Need: Findings From a National Survey of Hospital Nurse Leaders

AIM

The purpose of this study was to survey hospital nurse leaders throughout the United States to determine which professional behaviors they believe are essential for nursing students to learn in the classroom.

BACKGROUND

This study was part of a multiphase study. The survey was revised from a previous survey administered to nurse leaders in the Midwest.

METHOD

Participants were surveyed using 46 items in the categories of Change, Communication, Conflict, Leadership, and Self-Awareness.

RESULTS

The highest ranked category was Communication, followed by Self-Awareness, Change, Leadership, and Conflict. The highest rated items in each category were communication with patients, accept constructive criticism, manage change, prioritization, and conflict resolution techniques.

CONCLUSION

Nurse educators and leaders can use the findings to continue to refine nursing education.

Role of Family Motivation, Workplace Civility and Self-Efficacy in Developing Affective Commitment and Organizational Citizenship Behavior

The mechanism connecting the antecedents to positive attitudes like affective commitment (AC) and positive behaviors like organizational citizenship behavior (OCB) is an under-researched area in the field of positive organizational scholarship. Drawing on Social Exchange Theory (SET), this study empirically validates family motivation and civility as antecedents of affective commitment and organizational citizenship behavior through the mediating mechanism of self-efficacy. The process by Hayes (2013) was used to analyze time-lagged and multi-source data collected from 335 employees of educational and telecom sector. Results indicate that the relationship of affective commitment with family motivation and civility is partially mediated whereas the relationship of organizational citizenship behavior with family motivation and civility is fully mediated by self-efficacy. This study adds to the literature of family-work enrichment accounts by validating family motivation as a novel antecedent for positive behavioral outcomes. The implications of the study are discussed.

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.

Faculty and Student Incivility in Undergraduate Nursing Education: An Integrative Review

BACKGROUND

Incivility is a critical issue in undergraduate nursing education. Uncivil acts in academia are increasing and have the potential to affect future nursing practice and patient safety outcomes.

METHOD

An integrative literature review was completed to describe faculty-to-student and student-to-faculty incivility in undergraduate nursing education.

RESULTS

Seventeen studies were included in the review. Four themes emerged from the data: (a) Detrimental to Health and Well-Being, (b) Disruption to the Teaching-Learning Environment, (c) Stress as a Catalyst, and (d) Incivility Incites Incivility.

CONCLUSION

The results support data that incivility has harmful physical and psychological effects on both faculty and students, and also disturbs the teaching-learning environment. Causes of un-civil acts have been highlighted to provide groundwork for schools of nursing to implement strategies for mitigating incivility. [J Nurs Educ. 2017;56(12):709-716.].

Nursing curriculum and bullying: An integrative literature review

OBJECTIVES

The purpose of this integrative review was to identify and synthesize key concepts that inform curriculum which increase nursing students' competence, skills and strategies when addressing bullying. Specifically, the authors sought to examine the concepts informing educational interventions, skills, and strategies, which addressed the bullying of nursing students.

DESIGN

Integrative literature review.

DATA SOURCES

A search of the electronic databases CINAHL, MEDLINE, ERIC, PsycINFO, Proquest, and PubMed was conducted in January 2016 using search terms such as 'bully' 'nursing student' 'education' and 'curriculum'.

REVIEW METHODS

Articles were screened for relevance and eligibility and extracted onto a table. Critical appraisal was conducted using multiple tools. Papers were analysed using constant comparison and concept mapping.

RESULTS

61 articles were included in the synthesis. Concepts identified included: empowerment, socialization, support, self-awareness, awareness about bullying, collaboration, communication, and self-efficacy. All concepts linked to empowerment. Social Cognitive Theory was used by many studies. Active teaching methods which gave students opportunities to practice skills were the most effective.

CONCLUSIONS

Empowered nursing students have the potential to address bullying more effectively and competently. Empowerment of nursing students is a powerful concept that educators must consider when developing curriculum and educational interventions to address bullying.

A social-ecological framework: A model for addressing ethical practice in nursing

AIMS AND OBJECTIVES

To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice.

BACKGROUND

Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers.

DESIGN

Conceptual framework development.

METHODS

A comprehensive literature review was undertaken using the social-ecological framework as an organising construct.

RESULTS

This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic.

CONCLUSIONS

Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research.

RELEVANCE TO CLINICAL PRACTICE

Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can assist in developing strategies and resolutions.

"I was yelled at, intimidated and treated unfairly": Nursing students' experiences of being bullied in clinical and academic settings

AIMS AND OBJECTIVES

To present findings from a study that explored nursing students' experiences of bullying in clinical and academic settings, the strategies used to negotiate bullying and recommendations for empowering future students.

BACKGROUND

Nursing students are identified as a group who are at particular risk of bullying. Numerous studies have examined students' experiences of bullying in clinical contexts by qualified nurses; however, there has been far less attention to the bullying that occurs in academic settings where the perpetrators are university staff and other students.

DESIGN

The qualitative findings presented in this paper form one component of a mixed-methods, multisite study that examined the nature and extent of bullying in one cohort of nursing students.

METHODS

A convenience sample of 29 first-, second- and third-year undergraduate nursing students from one semimetropolitan Australian university was recruited for semistructured interviews in 2014. Interview data were analysed using NVivo.

FINDINGS

Participants described multiple examples of bullying occurring in both clinical and academic settings. Perpetrators included clinicians, facilitators, academics and fellow students. Bullying ranged from incivility to physical attacks. The impact of the bullying was profound; it caused many of the participants to feel anxious and distressed, it undermined their confidence and perception of competence, and it often led them to question their career choice. Strategies described by participants to cope with or manage the bullying included avoidance, trying to "just survive" and seeking support from trusted academic staff, family and friends. No episodes of bullying were formally reported.

CONCLUSION

Bullying remains a pervasive phenomenon occurring in both clinical and academic settings. Students are, in many respects, a vulnerable and disempowered population who often fear the consequences of making a formal complaint. Thus, reporting structures and support strategies need to be re-examined, and resilience training is imperative.

RELEVANCE TO CLINICAL PRACTICE

Bullying remains a continuing concern in undergraduate nursing degrees. Efforts must be made in clinical and academic settings to heed the advice of undergraduates using broader strategies to address the issues.

Nursing faculty academic incivility: perceptions of nursing students and faculty

BACKGROUND

Incivility in nursing education can adversely affect the academic environment, the learning outcomes, and safety. Nursing faculty (NF) and nursing students (NS) contribute to the academic incivility. Little is known about the extent of NF academic incivility in the Middle East region. This study aimed at exploring the perceptions and extent of NF academic incivility in an undergraduate nursing program of a public university in Oman.

METHODS

A cross sectional survey was used to collect data from 155 undergraduate NS and 40 NF about faculty academic incivility. Data was collected using the Incivility in Nursing Education Survey.

RESULTS

The majority of NS and NF had similar perceptions about disruptive faculty behaviors. The incidence of faculty incivility was low (Mean = 1.5). The disruptive behaviors with the highest incidence were arriving late for scheduled activities, leaving schedule activities early, cancelling scheduled activities without warning, ineffective teaching styles and methods, and subjective grading. The most common uncivil faculty behaviors reported by participants were general taunts or disrespect to other NF, challenges to other faculty knowledge or credibility, and general taunts or disrespect to NS.

CONCLUSION

The relatively low level of NF academic incivility could still affect the performance of some students, faculty, and program outcomes. Academic institutions need to ensure a policy of zero tolerance to all academic incivility, and regular monitoring and evaluation as part of the prevention strategies.

Can a comprehensive code of conduct discourage incivility in nursing students?

BACKGROUND

This article discusses problems associated with incivility in nursing education and a proposed implementation strategy designed to decrease uncivil acts of student behavior.

PROBLEM DESCRIPTION

Like most colleges across the nation, this nursing program was experiencing an increase in acts of student incivility.

OPERATIONAL DEFINITIONS

Incivility, also called bullying, may include behaviors such as name calling, side conversations, and condescending language.

METHOD

The sample consisted of 94 third-semester nursing students and 6 faculty members. The Incivility in Nursing Education survey was used as a tool to measure student and faculty perceptions.

DATA ANALYSIS

Data from pre- and postimplementation surveys demonstrated scientific evidence of both faculty and student perception and a significant decrease in acts of uncivil behavior in the nursing program.

LIMITATIONS

Because the study was limited to one nursing program and included only third-semester nursing students, the results of the study may not be transferable to all nursing programs.

CONCLUSIONS

The study revealed a reduction in perceived uncivil acts of behavior in the nursing program by faculty and students.

When Push Comes to Shove: A Comparative Concept Analysis of Motivation and Coercion in Nursing Education

BACKGROUND

Understanding the fine line between motivation and coercion in nursing education may offer insight into satisfaction and autonomy in young nursing students, leading to increased retention, effectiveness, and professionalism in the workplace.

PURPOSE

To compare and analyze the concepts of motivation and coercion with application to nursing academia.

METHODS

Using the Walker and Avant method for concept analyses, definitions and defining attributes of motivation and coercion were identified, along with antecedents, consequences, and model cases for each concept. Comparison of the concepts noting comparative terms and notable differences are presented.

CONCLUSIONS

The comparison of the concepts of motivation and coercion reveals the stark contrast in the consequences of motivational and coercive power interactions in creating professional, satisfied, and empowered nurses. Nurse educators should seek to identify the best ways to create autonomy, competence, and relatedness in their graduates while minimizing coercive power plays which foster distance and dependence. Miller.