WHY TOPIC IS IMPORTANT FOR PEDIATRIC HEALTH CARE PROFESSIONALS? Childhood is where bullying starts Little bullies grow up to be big bullies If bullying is not addressed early on, it continues/worsens WORKPLACE BULLYING: RESPONDING TO THE EPIDEMIC JOHN S. MURRAY, PHD, RN, CPNP, CS, FAAN 2 OFF THE PLAYGROUND AND INTO THE WORKPLACE OBJECTIVES Comprehend the growing concern of bullying in the health care workplace Understand how to recognize workplace bullying Recognize the short & long-term impact of bullying on patients, staff and health care organizations Describe what measures should be taken to remedy workplace bullying 3 GROWING CONCERN 4 GROWING CONCERN Workplace bullying IS an epidemic! Workplace bullying in nursing: MUST accept this reality Fifty-four million (37%)U.S. workers have been bullied at work 18% (Johnson & Rea, 2009) 31% (Simons, 2008) Statistic excludes co-workers & family members who also suffer Must consider study limitations: design, sample size, bias of self-reports, etc. Workplace bullying IS a public health hazard! 45% of bullied employees suffer from significant stress 33% suffer for >12 months (American Nurses Association, 2012; Johnson & Rea, 2009; Simmons, 2008) (American Nurses Association, 2012; 2007 U.S. Workplace Bullying Survey) 5 6
GROWING CONCERN GROWING CONCERN Rapidly escalating problem in health care especially nursing 2007 U.S. Workplace Bullying Survey Largest scientific survey of bullying in U.S. Joint Commission (2008) To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team. "Bullying is 4 times more prevalent than illegal, discriminatory harassment" (e.g., race, gender, ethnicity, religion, disability, age) Health care organizations know workplace bullying is not illegal (yet) It s not against the law if your supervisor is mean, unpleasant, offensive, repugnant (2007 U.S. Workplace Bullying Survey) http://www.jointcommission.org/assets/1/18/sea_40.pdf 7 WORKPLACE BULLYING DEFINED 8 WORKPLACE BULLYING DEFINED REALITY Varied definitions Turning a deaf ear What is agreed upon: Deliberate mistreatment Blind eye Verbal abuse; threatening conduct that is intimidating, or humiliating; or sabotage that interferes with work Condescending behavior that continually gets worse Repeated & consistent not a one time event Harmful to health & well-being physical, mental, social, financial (American Nurses Association, 2012; Murray, 2008a; 2009; 2011) 9 10 KEY POINT: WORKPLACE BULLYING & ETHICS WORKPLACE BULLYING DEFINED Workplace bullying has nothing whatsoever to do with: Workplace bullying violates the ethical principle that is paramount to nursing respect the worth, dignity & human rights of all individuals including colleagues. Tough management Employee motivation Productivity improvement Organizational change Other nonsense Workplace bullying represents an incompetent, dysfunctional leader who believes they must resort to crude threats or intimidation to encourage staff, or who rationalize their (bullying) behavior in these ways." (American Nurses Association Code of Ethics for Nurses, 2001, p. 9) - Dr. Mark Hayes 11 12
RECOGNIZING WHAT WORKPLACE BULLYING LOOKS LIKE RECOGNIZING WHAT WORKPLACE BULLYING LOOKS LIKE Behaviors with cascade of harmful effects: The target Belittling, condescending, demeaning Sabotaged reputation Undermined contributions & credibility Highly skilled Go to person Excellent social skills Appreciated by others Ethical Honest (Workplace Bullying Institute, 2012) Blame without factual justification Stolen work Two-faced Manipulative Social isolation Selfish Controlling, excessive monitoring Dismissive Continually changing expectations (Workplace Bullying Institute, 2012) 13 RECOGNIZING WHAT WORKPLACE BULLYING LOOKS LIKE 14 ILLUSTRATION OF WORKPLACE BULLYING Most workplace bullies are mamagers while a stereotype, it s very real Those who are entrusted to uphold standards worse offenders Managers should be role models Susan Rae Baker, Life and Business Coach, supports the Workplace Bullying Institute, Healthy Workplace Bill, and Freedom From Workplace Bullies Week. In this video, Susan shares her personal story of workplace bullying. Misuse of organizational power protecting friends http://www.youtube.com/watch?v=oflpuwk3qpy&list=pl948a16671105ef89&feature=play er_embedded 15 CONSEQUENCES 16 CONSEQUENCES PATIENT Inefficiencies in care Many people are lost to workplace bullying Physical, psychological, social & financial Common findings: Safety at risk Suboptimal quality of care Blame myself for not listening to my gut! Boss jealous for skills that I have. Manger comment: I have skills as well tip off! Increase in errors I don t want your job Reduced patient & family satisfaction Heat turned up Result intensified, relentless bullying Poor outcomes 17 18
CONSEQUENCES VICTIM CONSEQUENCES VICTIM Physical Headaches Disrupted sleep Changes in appetite Loss of energy Hypertension Substance use/abuse (American Nurses Association, 2012; Murray, 2008a; 2009) 19 20 CONSEQUENCES VICTIM CONSEQUENCES VICTIM Psychological Social Stress Isolation Anxiety Mistrust Loss of self-esteem Depression PTSD Suicide Disrupted relationships family, friends, colleagues Social isolation to try to cope, make sense of what has happened (American Nurses Association, 2012; Murray, 2008a; 2009) 21 22 CONSEQUENCES FAMILIES, FRIENDS, COLLEAGUES CONSEQUENCES COLLEAGUES Fear Impact significantly felt by those who witness bullying or know someone who is being bullied Withdrawal Stress Lack of support Pressure Ineffective communication Betrayal 23 24
CONSEQUENCES WORKPLACE CONSEQUENCES WORKPLACE Corporate/Institutional bullying 77% of those bullied, and take action, lose their job! Behavior becomes ingrained in workplace culture Told you don t fit in cope or resign. If you don t resign, you will be terminated! Over time bullying becomes the accepted norm Significantly damages morale & hampers productivity (American Nurses Association, 2012; 2007 U.S. Workplace Bullying Survey) 25 26 EMPLOYERS CAN AND DO IGNORE BULLYING HR IS TOTALLY INEFFECTIVE! KEY POINT: DISTRESSING FACT 27 EMPLOYERS CAN AND DO IGNORE BULLYING HR IS TOTALLY INEFFECTIVE! 28 CONSEQUENCES ORGANIZATION Emerging major employment liability Damaged morale Organizations are NOT doing enough to Hampered productivity identify & combat workplace bullying! Employee absenteeism Disability costs short & long-term Costs associated with sick leave, severance packages, recruiting/hiring new staff 29 (Workplace Bullying Institute, 2012) 30
KEY POINT: WORKPLACE BULLYING & ETHICS ORGANIZATIONAL FAILURE "In 62% of cases, when made aware of bullying, employers worsen the problem or simply do nothing. Nurses are entitled to work in an environment that is free from harassment & threatening behaviors. Despite losing 21 28 million qualified workers who were bullied (American Nurses Association, 2012, p. 3) (2007 U.S. Workplace Bullying Survey) 31 32 MEASURES TO REMEDY WORKPLACE BULLYING MEASURES TO REMEDY WORKPLACE BULLYING Create awareness Develop a policy Inform, educate, train The wall of silence The fear of speaking up about workplace bullying is very real Identify risk factors Control risk factors Encourage reporting 33 EFFECTIVE & ENFORCED POLICIES 34 EFFECTIVE & ENFORCED POLICIES Examine/develop organizational policies Zero tolerance: Create & sustain zero tolerance culture Comfortable reporting Complaints taken seriously Issue investigated promptly 35 36
EFFECTIVE & ENFORCED POLICIES LEGISLATION Policies should: Laws against workplace bullying are scant at best... Increased focus on passing legislation Government needs to step up! Define acceptable/unacceptable behavior Describe how to report misconduct Outline steps to be taken to address breaches in conduct Highlight what occurs when resolution cannot be reached (American Nurses Association, 2012; Joint Commission, 2008) http://www.mahealthyworkplace.com/maworkplacebullyingfactsheet.pdf 37 LEGISLATION 38 LEGISLATION Whistleblower protections are non existent or weak (Murray, 2008b) http://www.mahealthyworkplace.com/maworkplacebullyingfactsheet.pdf 39 RESOURCES 40 RESOURCES www.workplacebullying.org American Nurses Association (2012). Bullying in the workplace: Reversing a culture. Silver Spring, MD: Nursebooks.org 41 42
FINAL THOUGHTS RESOURCES Nurses must address bullying Every nurse should be familiar with policies Workplace Bullying Institute Research & Publications Archive Peer support http://www.workplacebullying.org/wbiresearch/wbi-archive/# pubs Silence & annoyance not acceptable 43 44 SELECT REFERENCES SELECT REFERENCES American Nurses Association (2012). Bullying in the workplace: Reversing a culture. Silver Spring, MD: Nursebooks.org Murray, J.S. (2008b). The Paul Revere freedom to warn act: Legislation to protect federal whistleblowers from retaliation. American Journal of Nursing, 108 (3), 38 39. American Nurses Association (2001). Code of ethics for nurses with interpretive statements. Retrieved from http://www.nursingworld.org/codeofethics Peters, K., et al. (2011). The emotional sequelae of whistleblowing: Findings from a qualitative study. Journal of Clinical Nursing, 20, 2907 2914. Johnson, S.L. & Rea, R.E. (2009). Workplace bullying: Concerns for nurse leaders. Journal of Nursing Administration, 39(2), 84-90. Simons, S. (2008). Workplace bullying experienced by Massachusetts registered nurses and the relationship to intention to leave the organization. Advances in Nursing Science, 31(2), e48 e 59. Murray, J.S. (2011). Blowing the whistle What every nurse needs to know. OR Nurse 2011, 39 42. Murray, J.S. (2009). Workplace bullying in nursing: A problem that can t be ignored. MEDSURG Nursing: The Journal of Adult Health, 18 (5), 273 276. Workplace Bullying Institute & Zogby International (2007). U.S. Workplace Bullying Survey http://www.workplacebullying.org/multi/pdf/wbisurvey2007.pdf Yamada, D. (2008). Workplace bullying and ethical leadership. Journal of Values Based Leadership, 1(2), 49-62. Murray, J.S. (2008a). No more nurse abuse. Let s stop paying the emotional, physical, and financial costs of workplace abuse. American Nurse Today, 3 (7), 17 19. 45 Questions? 46 Thank you! JMurray325@aol.com 47 48