Presentation on theme: "Nurse to Nurse Bullying: A Sepsis in Healthcare"— Presentation transcript:
1 Nurse to Nurse Bullying: A Sepsis in Healthcare Susan Strauss, RN, Ed.D.Harassment & Bullying Consultant
2 Objectives To define bullying and harassment To discuss the misconduct within nursing practice incorporating The Joint Commission’s Disruptive Behavior Standard, Nursing Social Policy Statement, Nursing Code of Ethics, and the Scope and Standards of Nursing PracticeTo identify theories, causes and contributing factors of bullying in nursingTo discuss nursing leadership’s role in the prevention and intervention of bullyingTo practice communication techniques in confronting bullying behaviorTo develop a prevention and intervention action plan to implement for North Dakota Nurses Association
3 The art of nursing is based on caring and respect for human dignity. ANA, (2010). Scope and Standards of Practice
4 Standards of Professional Performance (ANA) CollaborationCollegialityEthicsResearchResource utilizationProfessional practice evaluationEducationQuality of PracticeLeadershipEnvironmental Health
5 Code of Ethics for Nurses (ANA) Provision 1:Relationship with colleagues and others….precludes…any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others.
6 Code of Ethics for Nurses (ANA) Provision 5:Preservation of integrity including…verbal abuse from…coworkers.
7 Code of Ethics for Nurses (ANA) Provision 6:Responsibility for the healthcare environment; Responsible for contributing to a moral environment that encourages respectful interactions with colleagues, support of peers, and identification.
13 Definition of Bullying Bullying is persistent, repeated, malicious, offensive, and intimidating behavior which humiliates, degrades and displays a lack of dignity and respect for the target resulting in them feeling vulnerable and threatened.
14 “Bullying may be more appropriately considered a form of organizational defiance rather than simply a form of interpersonal conflict.”Hutchinson, M., Wilkes, L., Jackson, D. Vickers, M.H. (2010). Integrating individual, work group and organizational factors: Testing a multidimensional model of bullying in the nursing workplace. Journal of Nursing Management 18,
21 Etiology & Antecedents of Workplace Bullying Power imbalanceProcesses and structuresChangeInformal alliancesCompetitionReward SystemsRole conflict or ambiguityTolerance & reward for misconductLow satisfaction with managementPsychological theories
26 Patriarchy “finds its way into everyone who grows up breathing and swimming in it, and once inside us, it remains however unaware of it we may be….we are involved, if only by our silence.”Allan Johnson: The Gender Knot: Unraveling Our Patriarchal Legacy
27 Oppression Displaced _____ Dislike of _______ Hopelessness PowerlessnessBelieve in own _______Internalize oppressor’s thoughts & _______Oppressors’ actions perceived _________
28 Horizontal Violence 60% new RNs leave 1st job 1 in 3 RNs quit Adaptive responseSymptomatic
29 “Rather than challenging the masculine hegemony of management, some women – particularly those who employ bullying tactics – may be conforming to the masculine ethic that underpins many management practices.”Simpson, R., Cohen, C. (2004). Dangerous work: The gendered nature of bullying in the context of higher education. Gender, Work and Organizations, 11(2), 182.
30 Large number of women in power positions = less female to female bullying
36 Women Hostile to other Women Lowered self-esteemHostility toward menLowered self-efficacyIncreased emotional dependence on menLess intimacyLess life satisfactionAcceptance of interpersonal violenceCowan, G., Neighbors, C., DeLaMoreau, K., Behnke, C. (1998). Women’s hostility toward women. Psychology of Women Quarterly, 22,
37 Common Law Tort Claims Against Managers & Organizations Aiding & AbettingAssault & BatteryFalse ImprisonmentIntentional infliction of emotional distressNegligent hiring or supervisionPersonal InjuryIntentional interference with business relationshipBreach of contractSomething red lightning bolt or something
38 Harassment As a Legal Issue Title VII of the 1964 Civil Rights ActPicture to show anything related to race, gender, disability, religion. (look under Mayo – diversity).Page38
46 Retaliation Refusal to meet or delays in meeting Refusal or delay in sharing informationThreats_____________Poor performance reviewDestruction of property________________________________________Sabotaging one’s workSpreading rumorsMaking a false complaintVerbal and/or physical abuse
47 What To Do If It Happens To You Document, document, documentStopReportFollow Policy
48 When You Are Bullied: Ignore (most common) Use humor Dismiss UnderstandRespectfully confrontReportDocument
49 Communication Feedback Open & honest Feelings “I” statements Respectful
50 Confronting the Offender •Describe the situation or behavior•State behavior must stop•Use “I” statements•“Broken Record”
51 Why Targets Don’t Confront Offender Picture of people victim – put hand up to say stop.Page
56 Title IX No person in the United States shall, on the basis of sex, be excluded from participationin, be denied the benefits of, or besubjected to discrimination under anyeducation program or activity receivingfederal financial assistance.
57 14th Amendment: Section 1983 Violated student’s constitutional rights Failed to receive, investigate, act upon complaintsFailed to train employees.District’s policy, practice, or custom must cause the alleged constitutional injury.
58 Sexual Harassment Incidents in Schools Younger and Younger AgesMore sexually violentOften mis-labled as bullyingOften not responded to by:School OfficialsLaw EnforcementSource: Stein, Nan (2005). A Rising Pandemic of Sexual Violence in Elementary and Secondary Schools: Locating a Secret Problem. pp , Duke Journal of Gender Law and Policy.
59 Grade Level When First Experienced 11th10th9th8thBoys7thGirls6th5th4th3rdK-2nd0%5%10%15%AAUW Study20%Page
60 Gender-based Harassment Threatening and harassing behaviors based on enforcement of gender-role expectations.
61 Bullying Definition? De-genders problem of sexual harassment/violence Defers attention away from sexual harassment/violenceMislabel interferes with prevention and interventionObscures legal liabilityErodes students’ rights
63 School OfficialsIndifferentUnresponsive“go sit down”“Ignore him”
64 Key Actions Commitment from administration Policy and Procedure TrainingConsequences – x2Teachable momentTitle IX Coordinator
65 The nursing profession is particularly focused on establishing effective working relationships and collaborative efforts essential to accomplish its health-oriented mission.ANA, (2010). Nursing’s Social Policy Statement:The Essence of the Profession, 2010