BULLYING IN THE PERIOPERATIVE AREA MA. JANETTH BETITA SERRANO, MD, DPBA, FPSA, FPSECP, RMT

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1 BULLYING IN THE PERIOPERATIVE AREA MA. JANETTH BETITA SERRANO, MD, DPBA, FPSA, FPSECP, RMT

2 Definition: BULLYING Bullying is an offensive, intimidating, malicious or insulting behavior or abuse of power conducted by an individual or group against others. Makes the recipient feel upset, threatened, humiliated, or vulnerable. Undermines self confidence. Bullying is behavior that is generally persistent, systematic, and ongoing.

3 Definition: BULLYING A disruptive form of communication a person perceives to be harsh condemnatory attack upon herself or himself professionally or personally. It includes demeaning comments, intimidating or condescending language or intonation, and issuing threats. Social ostracism and silence are subtler forms of bullying than the abusive, disruptive behavior have power to wound and prevent the development of a well functioning team.

4 Definition BULLYING IN THE O.R. intimidating and disruptive behaviors include overt actions such as verbal outbursts and physical threats as well as passive activities such as refusing to perform assigned tasks or quietly exhibiting uncooperative attitudes during routine activities. Sentinel Event Alert, The Joint Commission

6 How Prevalent is OR Bullying? Association of perioperative Registered Nurses (AORN), % of perioperative nurses and surgical technicians reported witnessing coworker bullying on a weekly basis 34 % reported witnessing at least two bullying acts per week. Robert Wood Johnson Foundation,2016 Young working on the day shift or working in an understaffed unit

7 Why does bullying occur in the OR? OR is a high stress environment the hierarchical environment in the OR three sources in the OR and other perioperative units: patterns of condescension secondary bullies who have learned how to survive in the organization institutional bullies managers, charge nurses, supervisors, service line directors, and C suite and administrator level leaders throwing instruments in the OR, verbal abuse, unfair scheduling practices, intimidation,

8 Solving the Problem AWARENESS is a good first step toward minimizing and eventually eliminating bulling in the OR. Solutions to OR bullying: peer pressure from others in the OR to stop bullying behavior HR regulations, policies and procedures that create a zero tolerance environment for intimidating, disruptive and uncivil behavior.

9 Bullying includes silence and social ostracism.

10 3 Faces of Bullying Common in Hospital Settings Bullying by a patient Bullying by a physician Bullying by colleagues

11 Bullying by a patient demanding and treats the nurses like they are his personal servants How were they addressed? Nurses are educated to develop plans of care to deal with manipulative patients who test the limits. The bullying of this patient kept him in control until the nurses took back their power and developed a unified approach to deal with his behavior.

Bullying by a physician After surgery, the male surgeon grabs the front of the nurse s scrub top with his bloody glove and berates her for her performance. How were they addressed?

12 Bullying by a physician After surgery, the male surgeon grabs the front of the nurse s scrub top with his bloody glove and berates her for her performance. How were they addressed? The Joint Commission standards require facilities to have policies on how to deal with disruptive behavior. Some facilities have a zero tolerance policy, which means they will tolerate no incidents of disruptive, bullying behavior

Bullying by a colleagues A nurse is hired as a nursing administrator. When she sits down to eat lunch with the nursing supervisors, she is greeted by silence.

13 Bullying by a colleagues A nurse is hired as a nursing administrator. When she sits down to eat lunch with the nursing supervisors, she is greeted by silence. She tries to start conversations, which sink like a stone without responses How were they addressed? She teamed up with another nursing administrator who was friendly to her.

14 What you can do: Understand what s happening Focus on the evidence, not myths Take action at all levels: personal interpersonal Contextual Uphold all nursing obligations Canadian Nurses Association, 2017

15 THE PERVASIVENESS OF NURSE BULLYING: 7 KEY THOUGHTS 1. Bullying isn't always obvious. 2. It affects nurses personally and professionally. 3. Nearly all OR nurses experience it. 4. It impacts patient safety. 5. Managers need to be responsive. 6. Bullies may not know what they're doing. 7. It's not a lost cause. Association of perioperative Registered Nurses (AORN) Heather Punke, September 01, 2016

Civility and Nursing Practice: Let s Talk About Bullying

Civility and Nursing Practice: Let s Talk About Bullying Professional Practice Nursing Maxine Power-Murrin March 2015 A rose by any other name... Lateral violence Horizontal violence Bullying Intimidation