The Search for Support and Healing

Chapter 6 provides nurses, nurse leaders, and organizations interventions to understand, confront, and eliminate bullying and incivility from the workplace. Emotional intelligence (EI) and cognitive rehearsal are techniques when taught to nurses via in-services provided by organizations, can build awareness of verbal and nonverbal cues used in their communication as well as those of others. By understanding how we communicate and respond to others and vice versa, insight to what are appropriate and inappropriate responses can hold nurses accountable to how they treat one another. The neuroscience of oxytocin release at a biochemical level supports the benefits of organizations investing in the mental and physical health of their employees by empowering them to grow individually and as a collaborative team.

Incivility

Nursing professionals experiencing incivility and bullying within the workplace are affected physically and emotionally. The sole purpose of the healthcare environment is to provide therapeutic intervention to the ill. Nurses should not anticipate going to work within healthcare facilities to be harassed, disrespected, and threatened. Be it a nurse working within a clinical environment or employed as a nurse educator in an academic setting, incivility and bullying can cause harm. Chapter 1 will provide an overview of the terms incivility and bullying. Uncivil conduct will be examined through a case study involving a perpetrator to provide insight into how a bully thinks and reacts with regard to their own behavior.

Beyond the Pain

Healthy workplaces promote inclusionary behaviors. When nurses experience exclusionary behaviors such as bullying and incivility, there may also be hidden issues with acceptance of diversity in the workplace environment. Educating nursing staff on the importance of variations in age, culture, gender, sex, race, ethnicity, and religion in the workplace can help facilitate communication among staff. For example, organizations can use educational forums to discuss how different cultures vary in the addressing of conflict within the workplace; some cultures may prefer to reach consensus rather than be confrontational. Chapter 5 discusses strategies that nurses and organizations can implement, such as Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). TeamSTEPPS is a curriculum that can be used to improve teamwork skills, communication, and build team collaboration.

Suffering in Isolation

Unhealthy workplace environments have unfortunately been associated with the profession of nursing. Staffing shortages and long hours worked with high acuity patient caseloads can cause nursing professionals to feel overwhelmed, stressed, and anxious. Cultures of incivility can be accepted within some workplace environments as being normal. Nurse leaders that knowingly ignore patterns of disruptive behaviors by the nursing staff contribute to unit-based (and departmental) dysfunction. Perpetrators feel comfortable in continuing bullying behaviors because they have no fear of retribution. In these environments, nurse leaders themselves may engage in bullying and incivility behaviors. Chapter 4 provides nurses with instructions on how to report uncivil conduct that is not resolving and seek action against the perpetrator when mediation is not an option.

Workplace Bullying and Violence

Bullying in nursing is not a problem existing only in the United States. Nurses internationally are affected by workplace incivility and bullying. Chapter 2 explores the phenomenon of bullying and incivility in nursing in countries such as Israel, Turkey, and Australia. Uncivil conduct experienced by nursing students, faculty, administrators, clinical nurses, and clinical faculty are discussed through the examination of current issues in various workplace settings that nurses work within. Imbalances of workplace tranquility and disruption influence work-life balance, as nurses attempt to find ways to cope with bullying and incivility. The latter potentially leading to organizational issues with retention and turnover of nursing staff.

Health and Mental Health

As healthcare organizations use approaches such as structural empowerment theory and nurse residency programs to engage new graduate nurses in becoming productive members of the organizational culture, bullying and incivility experienced by these nurses can undermine organizations' efforts. Chapter 3 introduces the Reporting of Uncivil Conduct Chain of Command to provide support and direction to nurses that are experiencing bullying by perpetrators in the workplace. Unresolved and persistent uncivil conduct can result in health and mental health problems for affected nurses. Hence, in order to protect nurses' overall health and safety, it is necessary for organizations to adopt zero tolerance for bullying and incivility. Additionally, nurses may benefit from screening programs that can identify risks for self-harm secondary to stress and depression that could be caused by incivility in the workplace.