WORK-PLACE BULLYING Jennifer Resto NR226 December 9, 2015
Introduction Work-place bullying is a problem in healthcare Bullying is directed at nurses by other staff nurses as well as charge nurses and nurse managers Bullying is committed by physicians and can be directed at nurses and other physicians Berry, Gillespie, Gates, & Schafer, p. 19 American Medical Association, p. 155 Dellasega, p. 52 2
Why is bullying a problem in healthcare? Impact on the patient: Loss of knowledge passed down from experienced nurses Fear of inexperienced nurses to ask clarifying questions Lack of communication between staff members as a form of power Barber, pp. 300, 302 Rosenstein & O'Daniel, p. 102 3
Why is bullying a problem in healthcare? Financial impact for the medical system: Higher turnover and the cost to recruit and train new staff. Missed workdays due to anxiety, depression, and stress-related illness. Halfer, pp. 10-11 4
Why is bullying a problem in healthcare? Impact on the victim Less mentoring for the novice nurse Increased rates of depression Stress-related illness Increase risk of suicide Berry, Gillespie, Gates, & Schafer, p. 80 Barber, pp. 300, 302 5
Collaborative Model TeamSTEPPS Goal is improved patient safety Stresses effective communication Provides tools in order to adopt effective communication techniques Haynes & Strickle, p. 62 6
Inter-professional Team Staff nurse Charge nurse Nurse manager Director of nursing Therapists who work on unit Physicians Medical director King, et al., pp. 2-3 7
Team Objectives 1. Reduce workplace bullying between staff 2. Improve mentoring program for new nurses 3. Improve communication between team members 8
Timeline and Communication Plan 1. Teach strategies to recognize and manage bullying when it occurs (3 months). 2. Introduce TeamSTEPPS training to all staff (1 year). 3. Establish a new nurse mentoring program (1 year). Agency for Healthcare Research and Quality, 2015 Halfer, pp. 10-11 Rocker, p. 2 9
Outcomes 1. Reduce reported incidents of workplace bullying by 75% within 18 months. 2. Reduce new nurse turnover by 50% within 2 years of implementation. 3. Reduce incident of safety-related serious incident reports Rosenstein & O'Daniel, p. 102 10
Practice Change Recommendations First, nurses should lead by example. Teach nurses techniques to manage bullying when it does occur. Nurse managers should be more aggressive at eliminating toxic staff within their department. 11
References Agency for Healthcare Research and Quality. (2015, December 9). TeamSTEPPS 2.0. Retrieved from TeamSTEPPS Implementation At-A-Glance: http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/ education/curriculum-tools/teamstepps/instructor/reference/implglance.pdf American Medical Association. (2014). To bully and be bullied: Harassment and mistreatment in medical education. AMA journal of ethics, 155-160. Barber, C. (2012). Use of bullying as a management tool in healthcare environments. British journal of nursing, 299-302. Berry, P. A., Gillespie, G. L., Gates, D., & Schafer, J. (2012). Novice nurse productivity following workplace bullying. Journal of nursing scholarship, 80-87. Dellasega, C. A. (2009). Bullying among nurses. American journal of nursing, 52-58. Halfer, D. (2007). A magnetic strategy for new graduate nurses. Nursing economic$, 6-11. Haynes, J., & Strickle, J. (2014). TeamSTEPPS makes strides for better. Nursing2014, 62-63. King, H. B., Battles, J., Baker, D. P., Alonso, A., Salas, E., Webster, J.,... Salisbury, M. (2008). TeamSTEPPS: Team Strategies and Tools to Enhance Performance and Patient Safet. In K. Henrickson, J. Battles, & M. Keyes, Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools) (pp. 1-19). Rockville, Maryland: Agency for Healthcare Research and Quality. Retrieved from http:// www.ncbi.nlm.nih.gov/books/nbk43686/?report=reader Rocker, C. (2008). Addressing nurse-to-nurse bullying to promote nurse retention. Online journal of issues in nursing, 13(3). Rosenstein, A. H., & O'Daniel, M. (2006). Impact and implications of disruptive behavior in the perioperative arena. American college of surgeons, 96-102. 12