Bullying in Nursing
The ANA defines bullying as the “repeated and unwanted harmful actions that humiliate or offend a person”. Bullying in nursing is a common with the victims often being considered to be a part of an oppressed group. According to the ANA, bullying in nursing involves harmful actions taken or actions not taken and this might include the use of explicit displays of uncivil or threatening acts and failing to take action when there is bulling or violence in the nursing working environment (ANA, 2015). Bullying can take many forms including verbal abuse, belittling, withholding information, intimidation, ignoring, shouting and yelling, sarcasm, unequal work assignments, nonverbal abuse, failing to respect personal privacy or even threats (Stockwell, 2018). All these actions could lead to a nurse feeling humiliated, unworthy and undervalued. The perpetrators can be managers, colleagues and other nursing staff. There are also cases where managers or senior nursing staffs have failed to take action against bullies or provide support to victims.
I chose the issue of bullying in nursing because it is still common in the nursing environment despite different measures and taken to ensure that nurses work in a healthy, safe and respectful work environment. The highly dynamic and complex nature of the health care environment in which nurses work could lead to situations whereby nurses take it out on each other through bullying, incivility and violence. Bullying is unacceptable in the nursing environment as these actions are unwanted and they could to harmful impacts on the recipient nurse.
One measure that is meant to promote a healthy and safe environment is the Occupational Safety and Health (OSH) Act that requires all employers to provide a workplace that is safe from any recognized harm or hazards and this includes bullying. Some employers have policies that prohibit bullying and those that ensure that actions are taken against bullies. The ANA also has taken a stand against bullying and is dedicated towards protecting nurses against all types of conflict and harassment at work. However, bullying is still being reported and as such, the issue should be talked about.
While bullying has been reported in nursing for decades now, the first literature on the issue was published 1970s and 1980s. According to an article by Kohnke (1981), nurses in low-level positions are prone to verbal abuse and this vice continues because these nurses cannot defend themselves for the fear of having a more difficult working environment or even losing their jobs. The same article suggests that bullying in nursing has been passed down from one generation to another. In 1987, Cox reported of the harmful effects of verbal abuse against nurses (1987).
In 2000, an article by Freshwater suggested that nurses bully each other as a way of responding workplace stress and conflict. In the article, the way nurses respond to stress is compared with animal behavior whereby animals end up harming their young. The most common recipients of bulling in nursing are younger nurses or even nursing students and according to Burkley (2018), every nursing instructor knows that nursing students are often bullied by the older and the more experienced staff. While the issue is common in most areas of nursing, research shows that higher rates of bullying or violence are more reported in emergency, psychiatric and geriatric settings.
In 2018, more than 30 years after Cox (1987) reported of bullying in nursing as an issue of concern, the issue is still very common. Research has shown that currently, bullying in nursing is so rampant that about 65% of nursing professionals in the US have reported to have witnessed some form of bullying or workplace violence among coworkers. This shows that bullying in nursing has been increasing in recent years and is a major issue of concern in the profession. As such, effective measures must be taken at the individual and organizational level to prevent the vice, support victims, report perpetrators and take action against perpetrators.
One view about bullying in nursing is that it should be discouraged and action should be taken against perpetrators because it has negative impacts on the entire healthcare profession. Bullied nurses are demotivated, demoralized, emotionally traumatized and this affects their wellbeing and their ability to deliver care. According to ANA, any bullying actions or behavior are unacceptable as it negatively affects the wellbeing of nurses and their ability to deliver care as required (2015). In an article by Edie (2018), bullying in nursing has a larger impact on the workforce as some victims of bullying or workplace violence end up leaving the workforce. This leads to a shortage of nurses and inadequate staffing level in any healthcare environment increases the likelihood of bullying and violence. Research has also shown that bullying in nursing could also negatively impact nursing education as nursing students are often targets of bullying; these incidents lead to alienation of nursing students and this therefore interferes with their learning ability.
Another view about bullying in nursing is that it is a group thing and that the more experienced nurses engage in these behaviors or actions to assert their position and power. Some of these perpetrators bully their victims to serve self-interests or to pursue power or intensify competition from promotion. Other researchers have considered bullying to be an undesirable outcome of increasing workplace pressures and lack of organizational support (Edie, 2018). Since nurses rarely report bullying incidents, organizational characteristics might play a key role in either encouraging or discouraging bullying.
While various others and different bodies has made their opinions and views about bullying in nursing, all of them agree that bullying is harmful to nurses and as such, it should be condemned in the strongest way possible. According to the ANA position statement on bullying, incivility and workplace violence, “RNs and employers across the health care continuum, including academia, have an ethical, moral, and legal responsibility to create a healthy and safe work environment for RNs and all members of the health care team, health care consumers, families, and communities” (ANA, 2015). ANA considers bullying and incivility as unacceptable in nursing and the health profession because of its impact on nurses and patients.
Based on the impacts of bullying on nurses and the entire health care sector, I hold the position that bullying is wrong and all stakeholders must take an active role in preventing it. One reason for discouraging bullying in nursing is the physiological, psychological and emotional impacts it has on nurses. Research has shown that nurses who are bullied often experience high levels of dissatisfaction and low motivation and this negatively impacts their ability to care for patients (Edie, 2018). Some traumatized nurses will take time off work and this could eventually affect their physical, emotional and social wellbeing. Bullying has been linked to low self-esteem, self-confidence and self-image and this could affect the professional competence of nurses.
Another reason for taking a stand against bullying in nursing is because I believe that nurses should have a workplace that is safe, secure and healthy for them to effectively perform their duties. However, bullying takes away this by allowing a few individuals to frustrate and humiliate other nurses so that they submit to them and lose their power in the workplace setting. By combating bullying, I believe that nurses can enjoy a safe and healthy workplace.
I believe that all stakeholders must work together to ensure that the nursing environment is free from bullying. Bullying is an act that is discouraged by both the ANA Scope of Professional Practice and the AACN Baccalaureate Essentials. In the ANA Scope of Professional Practice (2013), bullying is condemned in the scope of nursing practice in the section of The Where of Nursing Practice. In this section, ANA considers bullying in nursing to be a harmful vice to the individual nurse and the overall work environment. Some of the impacts of bullying include increase time away from work, poor patient outcomes and high turnover rates. In Essential VIII: Professionalism and Professional Values of AACN Baccalaureate Essentials, civility human dignity, social justice and integrity are considered to be fundamental to the discipline of nursing. As such, nurses should refrain from bullying, violence and other uncivil acts.
Health care institutions and other employers of nurses should also adhere to the OSH Act by ensuring that the workplace is safe and healthy for nurses to perform their duties. This includes protecting nurses from bullying by laying down measures and procedures to prevent and manage this vice. A zero-tolerance approach against bullying in nursing could help deal with the issue once and for all.