Problem Identification
The mission of the healthcare organization is to deliver an environment of respect and excellence where healthcare professionals, patients, and their families are treated with respect and compassion (American Nurses Association, 2009). This is supported by the values of integrity, respect, caring, compassion, excellence, and accountability. However, this is not possible when novice nurses are bullied by their supervisors or experienced nurses. This happens when a novice nurse who is barely three weeks old in the organization is laughed at or rudely responded to after asking a question. Most of the novices complain of verbal affront, backstabbing, undermining, infighting, withholding information, scapegoating, sabotage, gossiping, humiliation, eye-rolling, and exclusion. This makes some nurses quit in less than three months or stop asking questions (Berry, Gillespie, Gates & Schafer, 2012). This makes the environment very harsh for the new nurses and unfit for provision of high quality and safe care by novices who cannot rely on their supervisors and experienced nurses.
Plan to Address the Problem
The responsibility of addressing the problem rests on the nurse administrator. As a result, this should be done through interpersonal relationship theories and from novice to expert theory by Patricia Benner. Using interpersonal relationship theories, the nurse administrator would ensure that all nurses irrespective of their experience and number of years they have been in the organization respects each other. The nurse manager should therefore identify the forms of novice bullying and educate the experienced nurses of their adverse effects. He should also come up with stern measures in form of policies that should be followed strictly. The policies should outline procedures that should be followed by the nurses who feel bullied and ensure that measures are taken to encourage them to report rather than live with problems (Borkowski, 2016).
For nursing theories, the nurse can use from novice to expert theory by Patricia Benner. Using the theory, the nurse administrator understands and teaches other nurses the five key levels of nursing experience namely novice, advanced beginner, competent, proficient, and expert. The experienced nurses should be informed that when nurses in the initial levels, they rely on abstract principles and theories learned in class that might not be applicable directly in the addressed scenarios. It is therefore the responsibility of the experts and proficient nurses to train those in the lower nurse levels to garner the required experience and skills that would help in provision of high quality and safe care (Shortell & Kaluzny, 2012). This way, experts and proficient nurses would understand the importance of helping and guiding novice nurses and responding to their questions to offer the best care to patients and their families. This would align with the interpersonal relationship theory in which nurses would interact and support each other.
With the two theories, the organizational culture would be changed to make the organization a better place for everyone including nurses, patients, and families. The organization should be guided by clear policies that would enhance respect and support in the organization. Nurses would be encouraged to support and help each other in everything they do. The experienced nurses should understand that they offer great help to novice nurses to ensure that they provide safe care. This way, the culture would align with the organization’s mission, vision, and values.
According to Townsend (2012), bullying in nursing practice and especially for novice nurse is one of the major reasons leading to high turnover rates and low performance. It is through bullying that Keller, Budin and Allie (2016) argue that novice nurses experience high levels of burnout and therefore are unable to provide the require care to their patients. Allen, Holland and Reynolds (2015) also argue that bullying for novice nurses leads to feelings of low self-esteem and self-confidence making it hard for nurses to address issues of their patients. Due to fear of punishment, novice nurses are unable to report to nurse administrators leading to issues of low self-esteem and powerlessness. This further increases issues of frustration, conflicts, and lack of co-worker support. Dellasega (2009) notes that addressing bullying in nursing lowers the rate of turnover and increases quality and safety of care.
Plan to Measure Success
The planned change would be measured based on the relationships among nurses, rate of turnover, number of reported complaints from nurses, and patient satisfaction and outcomes. With effective change implementation, it is expected the rates of nurse turnover decreases, the nature of relationships among nurses improve (become friendlier, supportive, and freer), patient outcomes and satisfaction improve, and reported complaints by nurses decrease and eventually fade away. Each of the goals would have a timeline and percentage rates of measurement so that the nurses can celebrate short-term wins for encouragement (Borkowski, 2016).
References
Allen, B. C., Holland, P., & Reynolds, R. (2015). The effect of bullying on burnout in nurses: The moderating role of psychological detachment. Journal of Advanced Nursing, 71, 381-390.
American Nurses Association. (2009). Nursing administration: Scope and standards of practice. Silver Spring, Maryland: American Nurses Association.
Berry, P. A., Gillespie, G. L., Gates, D., & Schafer, J. (2012). Novice nurse productivity following workplace bullying. Journal of Nursing Scholarship, 44, 80-87.
Borkowski, N. (2016). Organizational behavior in Health Care (3rd Ed.). Burlington, MA: Jones & Bartlett Learning.
Dellasega, C. A. (2009). Bullying among nurses. American Journal of Nursing, 109(1), 52-58.
Keller, R., Budin, W. C., & Allie, T. (2016). A task force to address bullying. American Journal of Nursing, 116(2), 52-58.
Shortell, S.M., & Kaluzny, A.D. (2012). Healthcare management: Organization design and behavior (6th Ed). United States: Thomson/Delmar Learning.
Townsend, T. (2012). Break the bullying cycle. Official Journal of ANA, 7(1), 1-6.
