Free Paper Sample on Bullying, Incivility, and Workplace Violence

Introduction

Incivility, bullying, and workplace violence are issues of concern in today’s healthcare settings. Workplace Violence (WPV) refers to any disruptive practice that causes emotional and physical harm (Stene et al., 2015). In this regard, WPV can be intimidation, harassment, an act, or a threat of physical violence at the worksite. Workplace incivility, on the other hand, is defined as low-intensity deviant behaviors characterized by a lack of mutual respect and regard for others (Shi et al., 2018). Research has indicated that social assistance and healthcare industries account for more than 60% of all incivility, bullying, and WPV cases recorded in the United States (Stene et al., 2015). Typically, these behaviors are underreported since the nursing staff has a perception that they are normal (Stene et al., 2015). American Nurses Association should address bullying, workplace violence, and incivility because it leads to decreased staff morale, increased absenteeism, and deterioration in the quality of patient outcomes.

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American Nurses Association (ANA) Official Position

The professional organization recognizes that WPV, incivility, and bullying are part of a complex phenomenon affecting Registered Nurses (RNs) globally (ANA, 2015). Its code of ethics explicitly states that the nursing profession does not condone violence from any source. The official statement stipulates that nurses must foster a civility culture and treat others with dignity (ANA, 2015). Besides, they need to create an ethical environment that values kindness when dealing with employees, colleagues, and coworkers (ANA, 2015). Similarly, any other person interacting with RNs should show high levels of dignity and respect.

The ANA position statement further states that registered nurses and other parties in healthcare settings must cooperate in nurturing a culture of respect that is free from WPV, bullying, and incivility (ANA, 2015). In essence, Evidence-Based Practices (EBPs) can help professionals in practice, academia, and research to mitigate these undesirable behaviors. The professional association further requires RNs and their employers to acknowledge any form of harmful action in their work settings.

International Council of Nurses (ICN) Official Position

International Council of Nurses condemns acts of violence as it threatens the delivery of high-quality healthcare. ICN's official statement is similar to that of the American Nurses Association, although they have a few differences. Both organizations' official position holds that incivility, bullying, and WPV puts nurses and patient safety at risk (ANA, 2015; ICN, 2009). Also, ICN and ANA's statements stipulate that these practices negatively affect the quality of healthcare. Importantly, ICN positions condemn acts of violence perpetrated against the patients, family members, other healthcare professionals, and the general public. The two organizations also support the use of evidence-based policies to prevent incivility and WPV.

Nonetheless, the two official statements differ in two ways. First, ICN focus on eradicating bullying, incivility, and WPV from a broader perspective of human rights through a declaration that any person is entitled to a workplace free from harm (ICN, 2009). Here, ANA's statement differs from that of ICN since it focuses on eliminating destructive behaviors from the perspective of averting adverse outcomes to nurses and patients. Secondly, ANA emphasizes the individual nurse's role in creating an ethical environment free from incivility, violence, and bullying, whereas ICN encourages leadership that models behaviors to avert these issues.

Quality and Safety Education for Nurses (QSEN) Competencies

As mentioned earlier, ANA’s position statement supports the implementation of evidence-based practices to prevent bullying, WPV, and incivility. This aspect reinforces QSEN competency that requires RNs to use evidence-based practices to achieve optimal results (QSEN Institute, 2012). Here, RNs and other stakeholders are better positioned to address the problem by applying policies that have adequate evidence supporting its effectiveness. To achieve this goal, one must develop an attitude of using EBPs to determine the best practice.

ANA’s position also reinforces QSEN competency on safety. Bullying and incivility in healthcare contribute to patient falls and medication errors, which lowers patient outcomes quality (ANA, 2015). The resulting negative experiences and a decrease in quality of care adversely impact patients' overall safety. ANA position statement advocates for workplaces free from these harmful behaviors, and thus fosters the QSEN aspect of patient safety. For RNs to achieve this goal, they must have knowledge of human factors that trigger incivility. They also need to understand communication strategies that create a culture of civility.

Impacts of ANA Position on the Profession

The nursing organization's position on the three issues has significant effects on the nursing profession and the general public. ANA condemns acts of violence and incivility perpetuated in healthcare settings. This position is vital because it protects nurses from deviant behaviors that can lower their morale to deliver on their mandates.

A study by Stene et al. (2015) demonstrated that incivility, WPV, and bullying negatively impact the overall productivity of RNs. Briefly, these behaviors and actions induce fear, frustrations, irritability, and stress that compromise healthcare delivery. Long-term effects associated with incivility and WPV include flashbacks, chronic pain, and disability (Stene et al., 2015). In essence, ANA’s position has had positive impacts as it has provided a safe environment for patients, nurses, and other employees in healthcare settings.

The implementation of ANA’s official position has made healthcare organizations responsible for providing a safe working environment for the public and their employees. In this regard, the statement has necessitated employers and healthcare organizations to take the necessary precautions to minimize the risk of bullying, WPV, and incivility. Stene et al. (2015) corroborated that healthcare facilities have implemented interdisciplinary approaches to preventing these behaviors. Importantly, employers have introduced zero-tolerance policies in adherence to ANA’s official statement (Stene et al., 2015).

The position has improved the quality of patient outcomes. According to Bambi et al. (2017), a safe working environment free from various forms of abusive behaviors positively correlates with patient outcomes. There is also evidence that bullying and incivility among nurses lower patient care quality besides triggering other adverse events (Bambi et al., 2017). The resulting decrease in the quality of care is detrimental to the public as it deters people from accessing care. Accordingly, ANA’s position helps prevent these issues through provisions that require RNs to comply with the code of ethics for nurses.

The position helps promote responsible behaviors and, at the same time, prevent all manner of abusive practices in workplace settings. It also helps avoid an unsupportive work relationship that leads to unsafe medication. Armstrong (2018) argued that incivility causes emotional upset and distractions that put patients' lives at risk. ANA condemns incivility and, as such, enhance interdisciplinary collaboration that is needed to sustain optimal patient outcomes.

Novice Nurses and the ANA Position

Coaching leaders would promote ANA position with novice nurses by implementing a comprehensive systems approach to WPV, incivility, and bullying. The strategy includes creating awareness of prevention strategies and building an open organizational culture that promotes respect for other people's rights. The plan also involves providing resources needed to allow novice nurses to understand the nurse code of ethics. Besides, leaders need to demonstrate leadership that models behaviors and encourages novice nurses to report destructive behaviors.

Conclusion

Incivility, WPV, and bullying have far-reaching effects on RNs and the delivery of healthcare. These abusive actions lower the quality of patient outcomes as it lowers staff morale. Patient safety is also not guaranteed because these practices distract and upset nurses emotionally. ANA strives to create a work environment free from these behaviors. Its position statement condemns assaults, and it calls for the use of evidence-based practices to minimize its risk and end the problem. International Council of Nurses and ANA positions support QSEN competencies of safety and using evidence-based practices. In the future, cases of bullying, WPV, and incivility will likely drop as healthcare organizations minimize their risk factors.

References

ANA. (2015). American Nurses Association official position statements.
https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403-410.
https://doi.org/10.1177/2165079918771106

Bambi, S., Guazzini, A., Piredda, M., Lucchini, A., De Marinis, M. G., & Rasero, L. (2017). Workplace incivility, lateral violence, and bullying among nurses. A review of their prevalence and related factors. Journal of the Society of Medicine and Natural Sciences, 89(6).
https://doi.org/ 10.23750/abm.v88i5-S.6838

ICN. (2009). Position statement on workplace violence and bullying.
https://www.icn.ch/sites/default/files/inline-files/ICN_PS_Prevention_and_management_of_workplace_violence.pdf

QSEN Institute. (2012). Quality and safety education for nurses' competencies.
https://qsen.org/competencies/pre-licensure-ksas/

Shi, Y., Guo, H., Zhang, S., Xie, F., Wang, J., Sun, Z., Dong, X., Sun, T., & Fan, L. (2018). Impact of workplace incivility against new nurses on job burnout: A cross-sectional study in China. BMJ Open, 8(4), e020461. https://doi.org/10.1136/bmjopen-2017-020461

Stene, J., Larson, E., Levy, M., & Dohlman, M. (2015). Workplace violence in the emergency department: Giving staff the tools and support to report. The Permanente Journal, 19(2), 113-117.
https://doi.org/10.7812/tpp/14-187.