Abusive Behaviors in the Healthcare Organizations
Problem Identification
The goal of any healthcare organization is to deliver quality services to its clients and the society as a whole. For this objective to be achieved, patients and their families are treated based on the aspect of respect and compassion (American Nurses Association, 2009). On the other hand, to promote effectiveness in the hospital enterprises, nurses should work under the rule of 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. Bullying in hospitals happens when a beginner nurse without experience is rudely responded to after asking for support and assistance from his or her colleagues. In addition, bullying in the nursing organization occurs in the form of verbal affront, backstabbing, undermining, infighting, withholding information, scapegoating, sabotage, gossiping, humiliation, eye rolling, and exclusion, with the primary victim being novice clinicians. Consequently, bullying makes some nurses resign from their work in less than three months or stop asking assistance from the experienced personnel (Berry, Gillespie, Gates & Schafer, 2012). Equally, nursing mistreatment makes the environment very harsh for the new nurses and unfit for them to provide high quality and safer services.
Plan to Address the Problem
In hospitals, it is the responsibility of the nurse administrator to deal with internal problems. In cases where the need relates to nursing staffs, to address the hospital issues in the healthcare system, I would employ interpersonal relationship theories and novice to expert approach instituted by Patricia Benner. Using interpersonal relationship theories, I would ensure that all nurses irrespective of their experience and number of years they have been in the organization respect each other and do not intimidate new nurses. As a nurse manager, I would use these theories to identify the forms of novice bullying that are happening in healthcare centers and educate the experienced nurses on the effect of bullying others. The theories would also help me come up with policies that should be followed strictly to ensure that novice bullying decreases and ends with immediate effect. 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 bullying cases (Borkowski, 2016). In reflection to the nursing practice theory, I can confirm that interpersonal relationship model is a theoretical framework applied in the nursing practice.
Nursing leaders use the interpersonal relationship theory to solve problems that happen within the internal environment of the healthcare organizations. Fernandes and Nunes de Miranda (2016) argue that the interpersonal relationship theory is essential in the healthcare system, as the model assists nursing leaders to define particular problems, interact with others for solutions, and reach to a consensus where the issues at hand are solved through negotiations. In agreement with this argument, Vessey, DeMarco, and DiFazio (2010) show that nursing managers can employ the interpersonal model to investigate the relationship between the individual experiencing bullying and the personality traits of the person perpetuating bullying conducts. From the understanding of the interpersonal relation concept, I noted that the theory is generative, as it can be used use to solve encounters between nursing administrators and new staffs with little working experience.
In addition, using Patricia Benner’s theory is critical in nursing, as nurse administrators can use the approach to understand and teach nurses the five key levels of nursing experience namely novice, advanced beginner, competent, proficient, and expert. The experienced nurses should be informed that nurses in the initial levels of development rely on abstract principles and theories learned in class, which might not be applicable directly in the addressed scenarios. Therefore, it is the responsibility of the experts and proficient nurses to train nurses in the lower levels to garner the required experience and skills, which would help in the 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 responds to their questions regarding work, hence allowing them to offer the best care to patients visiting the care institutions. This would align with the interpersonal relationship theory in which nurses would interact and support each other.
The theory from novice to expert is utilized by many health care organizations for educational and professional development. Boxer and Goldfarb (2011) posit that the model is instrumental in the development stage of nurses education because it uncovers that clinicians can move from novice to expert through different steps of transforms. Polifko (2010) states that novice-to-expert theory is recognized due to its five levels of nursing abilities acquisition as well as, for its significant of making nurses proficiency from new novice to the expert professional. The five levels of this theory include novice, advancement, competent stage, proficient, and expert level. In each step of this model, a different experience is built and principles that redefine and expand the experience of the nursing beginner who wants to gain clinical expertise. The theory creates an educational environment within the hospital’s context, and it is an efficient model that administrators can use to address issues relating to the novice and experienced nursing workers.
The Impact of the Organizations Culture
Organizational culture is a complex concept created by a range of factors including corporate members’ behavior and societal culture (An & Kang, 2016). The two theories that I have discussed in this paper would transform the organizational culture in the hospitals 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.
In the healthcare institutions, individual efforts play a fundamental role in promoting the cultural modification. As the two theories proposed in the intervention plan are valid and recognized for positive impacts, the culture that will be formed by the models will help the healthcare managers address the issue of bullying behavior with immediate effects. Townsend (2012) proclaims when the bullying culture is changed, the healthcare administration will be in a better position to break the cycle of bullying behavior and abuses as it happens to the novice nurses. The new culture can be viewed as a mentoring culture that supports the nursing peers and holds individual perpetrators accountability for their abusive conduct. Furthermore, relations oriented culture in the hospitals is known for its role in making the workplace bullying less prevalent. This coincides with An and Kang’s (2016) study, which showed that a relation-oriented culture has core values such as connectedness, participation, and mutual trust between the experienced and newly recruited staffs in the healthcare firms. In other words, since nurses will empathize, understand, and respect each other in relation-oriented culture, this culture is likely to harmonize the workforce, which will decrease the prevalence of bullying in the nursing organizations.
In reference to nursing theories by Patricia Benner, a learning culture is substantial to the healthcare firms that encounter bullying issues. Ratnapalan and Uleryk (2014) suggest that a learning culture influences healthcare companies positively, especially the organization’s performance, its operations, and perception of the experienced staffs toward novice employees. As education at both individuals and organizational levels involves the transformation of the workforce, the culture can make the staffs contextualized with the knowledge of training other employees, especially novice officers. Besides, the learning culture is always productive to the healthcare system, as the culture promotes safety in the workplace, allows staffs to admit and report bullying cases, facilitate organizational learning, and safety of the novice employees. Kabene (2011) argues that when organizations ensure that learning in the working environment is updated, the culture will continue to make the employees supportive to each other, which is one way of modifying environment characterized by the aspect of abuse behaviours. In essence, for the healthcare workplace that calls for promoting culture, it would be significant for the leaders to consider implementing learning culture of safety. The culture will encourage openness and create respectful communication in which novice employees will feel supported to report bullying incidents as they occur.
Plan to Measure Success
Personally, I think that to measure the success of a program is a complex process, but it always works better when the causes and effects of a problem are reviewed.
Causes of Bullying in the Hospitals
Based on the extensive literature, nurses may bully others for some reasons. The first reason for bullying in the hospitals is the aspect of power and controlling in the workplace (Murray, 2009). Apparently, this tells me that novice nurses lack control over new position, which can make the experienced staffs take advantage of the matter and use their power to boss them around. Consequently, this makes beginner workers feel verbalize frustrated and fear to express the situation to nursing leaders because they feel that they might be punished or lose their job. Moreover, bullying in the hospital enterprises continues to be prevalent due to the aspect of unsupportive working groups that focuses on normalizing competition and abuse behaviours (Felblinger, 2008). In many healthcare firms, I can confirm that nurses’ work in groups, which allows them to take responsibilities together and in a healthy relationship. However, some staffs and managers in these groups may have a personality flaw, such as being stubborn and lack of a feel of guilty when they inflict harm on others (Felblinger, 2008). Hence, in such circumstances, novice nurses encounter verbal abuse, as some of the experienced staffs in the groups use their personality to compete with the new recruits instead of supporting their work decisions.
Berry et al. (2012) point out that in healthcare organizations, novice nurses get the feeling of bullying when they are given a responsibility to work on unmanageable tasks or when assigned to responsibilities that inflict job ambiguity. In reflection to this point, I understand that the nursing beginners find the working environment unsuitable for them if assigned to difficult tasks, and it may make them suffer physically or physiologically due workloads that are overwhelming. Thus, as the causes of bullying in the hospital organizations are identified within the working environment, intervention measures should be adopted in an effort to reduce the frequency and harshness of the practice.
Effects of Bullying in Hospitals
According to Townsend (2012), bullying for novice nurse in nursing practice led to high rate of turnover and low performance. Keller, Budin, and Allie (2016) agree with this argument and say that novice nurses experience high levels of burnout, which makes them fail to provide the required care servicer for the patients. Allen, Holland, and Reynolds (2015) also claim that bullying for novice nurses make them lose self-esteem and self-confidence, which make it hard for them to address patient’s needs. Due to fear of punishment, novice nurses are unable to report to nurse administrators bullying cases, which makes them feel powerlessness. This further increases issues of frustration, conflicts, and lack of co-worker support. Dellasega (2009) protrudes that addressing bullying in nursing is necessary as it decreases the turnover rate and increases the quality of care services.
Measuring Success
For one to show the goal of a plan that has been implemented, using a timeline chart that has the percentage rates of measurement is relevant. For that case of nursing bullying, I will use a timeline table with percentages rate so that the nurses can witness the short-term success of the plan for encouragement and motivation (Borkowski, 2016). However, to measure the success of the plan for change, I will consider some factors. As such, to gauge the achievement of the plan that I have proposed for change, the relationships among nurses, the rate of turnover, and a number of reported complaints from nurses, patient satisfaction, and outcomes will be the key determinant. Theoretically, I expect that the change will lead to the decrease of the nurses turnover rate, improvement of the nature of the relationships among nurses (become friendlier, supportive, and freer), patient outcomes and satisfaction improve, and reported complaints by nurses reduces, especially the novice nurses. Townsend (2012) claims that bullying declines the aspect of job satisfaction and morale. In turn, this makes employees skip their duty and offer lower productivity, which can ultimately lead to staffs turnover. Therefore, if the turnover rate is decreased and novice personnel report to work on daily basis, it implies that the plan implemented has eroded bullying successfully, and the beginner nurses and experienced staffs are working in a good relationship.
Besides, I will review the healthcare organization’s financial performance to determine if the plans set to end bullying in the healthcare system is successful. In situations where healthcare organizations lose nursing staffs within the first year due to bullying, the hiring and orientation cost increases, which create a financial burden in the hospital (Townsend, 2012). Thus, if the hospital is not incurring financial burden because of recruiting new staffs aimed to cover for the workers resigning because of bullying, then this will be enough evidence to show that the plan is working well and intimidation in the workplace has decreased. I can also measure transformation plan based on the working environment. As such, if nurses carry out their task as a team, improve communication, and collaboration, this will show that the nurses are working in an environment without any harassment cases for beginner employees. When novice nurses share-bullying incidences with the leaders and team up with experienced nurses, this will be a direct way to predict that the plan has successfully declined bullying and every person in the workplace is satisfied with his or her tasks.
Conclusion
From this discussion, I have noted that workplace bullying is any form of repetitive abuse that makes the victim of the harassment action suffer verbally and feel intimidated by the perpetrator employees. Workplace bullying in the nursing organizations involves abuse and misuse of power within the organization aimed at humiliating other people. As one of the aspect that can influence the performance of the hospital enterprises, bullying and other abusive conducts in nursing institutions must end. Apparently, implementing plans to culminate bullying can drive to the creation of a working environment that is respectful, openness, and an environment where people work as a team. Bullying in hospitals can end if positive organizational cultures are adapted, especially cultures that will promote learning and interpersonal relationship.
References
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