WHY TOPIC IS IMPORTANT FOR PEDIATRIC HEALTH CARE PROFESSIONALS?
• Childhood is where bullying starts • Little bullies grow up to be big bullies • If bullying is not addressed early on, it continues/worsens…
WORKPLACE BULLYING: RESPONDING TO THE EPIDEMIC
JOHN S. MURRAY, PHD, RN, CPNP, CS, FAAN
2
OFF THE PLAYGROUND AND INTO THE OBJECTIVES WORKPLACE…
• Comprehend the growing concern of bullying in the health care workplace
• Understand how to recognize workplace bullying
• Recognize the short & long-term impact of bullying on patients, staff and health care organizations
• Describe what measures should be taken to remedy workplace bullying
3 4
GROWING CONCERN GROWING CONCERN
• Workplace bullying IS an epidemic ! • Workplace bullying in nursing: • MUST accept this reality
Fifty-four million (37%)U.S. workers have been bullied at work 18% (Johnson & Rea, 2009) – 31% (Simons, 2008)
Statistic excludes co-workers & family members who also suffer • Must consider study limitations: design, sample size, bias of self-reports, etc. • Workplace bullying IS a public health hazard!
45% of bullied employees suffer from significant stress
33% suffer for >12 months
(American Nurses Association, 2012; Johnson & Rea, 2009; Simmons, 2008) (American Nurses Association, 2012; 2007 U.S. Workplace Bullying Survey) 5 6 GROWING CONCERN GROWING CONCERN
• Rapidly escalating problem in health care – • 2007 U.S. Workplace Bullying Survey especially nursing Largest scientific survey of bullying in U.S. • Joint Commission (2008) – “To assure quality and to "Bullying is 4 times more prevalent than illegal, discriminatory promote a culture of safety, health care harassment" (e.g., race, gender, ethnicity, religion, disability, organizations must address the problem of age) behaviors that threaten the performance of the health care team.” Health care organizations know workplace bullying is not illegal (yet)
“It’s not against the law if your supervisor is mean, unpleasant, offensive, repugnant…”
(2007 U.S. Workplace Bullying Survey) http://www.jointcommission.org/assets/1/18/SEA_40.PDF 7 8
WORKPLACE BULLYING DEFINED WORKPLACE BULLYING DEFINED – REALITY
• Varied definitions • Turning a deaf ear…
• What is agreed upon:
Deliberate mistreatment
Verbal abuse; threatening conduct that is intimidating, or • Blind eye… humiliating; or sabotage that interferes with work
Condescending behavior that continually gets worse …
Repeated & consistent – not a one time event
Harmful to health & well-being – physical, mental, social, financial
(American Nurses Association, 2012; Murray, 2008a; 2009; 2011) 9 10
KEY POINT: WORKPLACE BULLYING DEFINED WORKPLACE BULLYING & ETHICS
• Workplace bullying has nothing whatsoever to do with:
“Tough management” “Workplace bullying violates the ethical principle that “Employee motivation” is paramount to nursing – respect the worth, dignity & “Productivity improvement” human rights of all individuals including colleagues .” “Organizational change” Other nonsense
• Workplace bullying “represents an incompetent, (American Nurses Association Code of Ethics for Nurses , 2001, p. 9) dysfunctional leader who believes they must resort to crude threats or intimidation to encourage staff, or who rationalize their (bullying) behavior in these ways."
- Dr. Mark Hayes 11 12 RECOGNIZING WHAT WORKPLACE RECOGNIZING WHAT WORKPLACE BULLYING LOOKS LIKE BULLYING LOOKS LIKE
• “The target” • Behaviors with cascade of harmful effects: Highly skilled Belittling, condescending, demeaning “Go to” person Sabotaged reputation Excellent social skills Undermined contributions & credibility Blame without factual justification Appreciated by others Stolen work Ethical Two-faced Honest Manipulative Social isolation Selfish Controlling, excessive monitoring Dismissive Continually changing expectations
(Workplace Bullying Institute, 2012) (Workplace Bullying Institute, 2012) 13 14
RECOGNIZING WHAT WORKPLACE ILLUSTRATION OF WORKPLACE BULLYING BULLYING LOOKS LIKE
• Most workplace bullies are mamagers – while a stereotype, it’s very real…
• Those who are entrusted to uphold standards worse offenders
Susan Rae Baker, Life and Business Coach, supports the Workplace Bullying Institute, Healthy Workplace Bill, and Freedom From Workplace Bullies Week. In this video, Susan shares her • Managers should be role models personal story of workplace bullying.
http://www.youtube.com/watch?v=OFlPUwk3QPY&list=PL948A16671105EF89&feature=play • Misuse of organizational power – protecting friends er_embedded
(American Nurses Association, 2012) 15 16
CONSEQUENCES CONSEQUENCES – PATIENT
• Many people are lost to workplace bullying • Inefficiencies in care • Physical, psychological, social & financial • Safety at risk • Common findings: “Blame myself for not listening to my gut!” • Suboptimal quality of care “Boss jealous for skills that I have.” Manger comment: “I have skills as well” – tip off! • Increase in errors “I don’t want your job…” • Heat turned up • Reduced patient & family satisfaction • Result – intensified, relentless bullying • Poor outcomes
(American Nurses Association, 2012)
17 18 CONSEQUENCES – VICTIM CONSEQUENCES – VICTIM
• Physical Headaches Disrupted sleep Changes in appetite Loss of energy Hypertension Substance use/abuse
(American Nurses Association, 2012; Murray, 2008a; 2009)
19 20
CONSEQUENCES – VICTIM CONSEQUENCES – VICTIM
• Psychological • Social Stress Isolation Disrupted relationships – family, friends, colleagues Anxiety Mistrust Social isolation to try to “cope,” “make sense of what has Loss of self-esteem happened” Depression PTSD Suicide
(American Nurses Association, 2012; Murray, 2008a; 2009)
21 22
CONSEQUENCES – FAMILIES, FRIENDS, CONSEQUENCES – COLLEAGUES COLLEAGUES
• Fear
• Impact significantly felt by those who witness • Withdrawal bullying or know someone who is being bullied • Stress
• Lack of support
• Pressure
• Ineffective communication
• Betrayal
23 24 CONSEQUENCES – WORKPLACE CONSEQUENCES – WORKPLACE
Corporate/Institutional bullying • 77% of those bullied, and take action, lose their job!
•Behavior becomes ingrained in workplace culture • Told “you don’t fit in – cope or resign.” “If you don’t resign, you will be terminated!” •Over time bullying becomes the accepted norm • Significantly damages morale & hampers productivity
(American Nurses Association, 2012) (American Nurses Association, 2012; 2007 U.S. Workplace Bullying Survey)
25 26
EMPLOYERS CAN AND DO IGNORE KEY POINT: BULLYING – HR IS TOTALLY INEFFECTIVE! DISTRESSING FACT
27 28
EMPLOYERS CAN AND DO IGNORE CONSEQUENCES – ORGANIZATION BULLYING – HR IS TOTALLY INEFFECTIVE!
• Emerging major employment liability
• Damaged morale Organizations are NOT doing enough to • Hampered productivity identify & combat workplace bullying! • Employee absenteeism
• Disability costs – short & long-term
• Costs associated with sick leave, severance packages, recruiting/hiring new staff
(Workplace Bullying Institute, 2012) 29 30 KEY POINT: ORGANIZATIONAL FAILURE WORKPLACE BULLYING & ETHICS
• "In 62% of cases, when made aware of bullying, employers worsen the problem or simply do nothing.“
Despite losing 21 – 28 million qualified workers who “Nurses are entitled to work in an environment that is were bullied free from harassment & threatening behaviors.”
(American Nurses Association, 2012, p. 3)
(2007 U.S. Workplace Bullying Survey)
31 32
MEASURES TO REMEDY WORKPLACE MEASURES TO REMEDY WORKPLACE BULLYING BULLYING
• Create awareness
• Develop a policy
The wall of silence… • Inform, educate, train
The fear of speaking up about workplace bullying is very real… • Identify risk factors
• Control risk factors
• Encourage reporting
33 34
WHAT SHOULD BE DONE: WHAT SHOULD BE DONE: “EFFECTIVE” & “ENFORCED” POLICIES “EFFECTIVE” & “ENFORCED” POLICIES
• Examine/develop organizational policies Zero tolerance:
• Create & sustain zero tolerance culture •Comfortable reporting
•Complaints taken seriously
•Issue investigated promptly
(American Nurses Association, 2012) (American Nurses Association, 2012) 35 36 WHAT SHOULD BE DONE: WHAT SHOULD BE DONE: “EFFECTIVE” & “ENFORCED” POLICIES LEGISLATION
Policies should: • Laws against workplace bullying are scant at best... • Increased focus on passing legislation •Define acceptable/unacceptable behavior • Government needs to step up!
•Describe how to report misconduct
•Outline steps to be taken to address breaches in conduct
•Highlight what occurs when resolution cannot be reached
(American Nurses Association, 2012; Joint Commission, 2008) http://www.mahealthyworkplace.com/MAWorkplaceBullyingFactSheet.pdf 37 38
WHAT SHOULD BE DONE: WHAT SHOULD BE DONE: LEGISLATION LEGISLATION
• Whistleblower protections are non existent or weak
(Murray, 2008b)
http://www.mahealthyworkplace.com/MAWorkplaceBullyingFactSheet.pdf 39 40
RESOURCES RESOURCES
www.workplacebullying.org
American Nurses Association (2012). Bullying in the workplace: Reversing a culture . Silver Spring, MD: Nursebooks.org
41 42 RESOURCES FINAL THOUGHTS
• Nurses must address bullying
• Every nurse should be familiar with policies Workplace Bullying Institute Research & Publications Archive • Peer support
http://www.workplacebullying.org/wbiresearch/wbi-archive/# pubs • Silence & annoyance not acceptable
43 44
SELECT REFERENCES SELECT REFERENCES
• American Nurses Association (2012). Bullying in the workplace: Reversing a culture . Silver • Murray, J.S. (2008b). The Paul Revere freedom to warn act : Legislation to protect federal Spring, MD: Nursebooks.org whistleblowers from retaliation. American Journal of Nursing , 108 (3), 38 – 39.
• American Nurses Association (2001). Code of ethics for nurses with interpretive • Peters, K., et al. (2011). The emotional sequelae of whistleblowing: Findings from a statements. Retrieved from http://www.nursingworld.org/codeofethics qualitative study. Journal of Clinical Nursing , 20, 2907–2914.
• Johnson, S.L. & Rea, R.E. (2009). Workplace bullying: Concerns for nurse leaders. Journal • Simons, S. (2008). Workplace bullying experienced by Massachusetts registered nurses of Nursing Administration, 39(2), 84-90. and the relationship to intention to leave the organization. Advances in Nursing Science , 31(2), e48 – e 59. • Murray, J.S. (2011). Blowing the whistle – What every nurse needs to know. OR Nurse 2011, 39 – 42. • Workplace Bullying Institute & Zogby International (2007). U.S. Workplace Bullying Survey http://www.workplacebullying.org/multi/pdf/WBIsurvey2007.pdf • Murray, J.S. (2009). Workplace bullying in nursing: A problem that can’t be ignored. MEDSURG Nursing: The Journal of Adult Health , 18 (5), 273 – 276. • Yamada, D. (2008). Workplace bullying and ethical leadership. Journal of Values Based Leadership, 1(2), 49-62. • Murray, J.S. (2008a). No more nurse abuse. Let’s stop paying the emotional, physical, and financial costs of workplace abuse. American Nurse Today , 3 (7), 17 – 19.
45 46
Questions? Thank you!
47 48