Incivility, Horizontal Violence, And Bullying In Nursing
Incivility, Horizontal Violence, andBullying in NursingChristina Purpora, RN., Ph.D.23rd Annual Medical-Surgical Nursing ConferenceApril 4, 2013Copyright Christina Purpora 2012 All rights reserved
Objectives1. Define incivility, horizontal violence, and bullying.2. Develop a repertoire of responses to these behaviors.3. Explore resources available at work to address thesebehaviors.
Story
What Came Up For You?
Negative Behavior in the Workplace 1,2,4 Non-verbal examples: ignoring a co-worker, making faces,rolling the eyes, intimidating gestures Verbal examples: name calling, sarcastic remarks,backstabbing, gossiping, yelling, screaming Physical examples: pushing, shoving, throwing orslamming objects
Concepts Defined Incivility Horizontal Violence Bullying
Incivility1A form of psychological harassment and emotionalaggression that violates the ideal workplace norm ofmutual respect.
Horizontal Violence2,3Harmful behavior, via attitudes, actions, words, and otherbehaviors that is directed towards us by anothercolleague. Horizontal violence controls, humiliates,denigrates or injures the dignity of another. Horizontalviolence indicates a lack of mutual respect and value forthe worth of the individual and denies another’sfundamental human rights.
Bullying4A situation where one or several individuals persistently(weekly) over a period of time (6 months) perceivethemselves to be on the receiving end of negative actions(a least two) from one or several persons, in a situationwhere the target of bullying has difficulty in defendinghim or herself against these actions. A one time incidentis not referred to as bullying.
What’s the impact of this behavior? Nurses5-8Nursing7,8Healthcare organizations9,10Patients11
What does the literature offer in terms of ways toaddress this behavior? Individual level12 Unit level13 System level14
Lessons Learned From Being a Target: It’s not about you Benefit of the doubt Respond in the momentor maybe later Use humor when it fits Be a mirror Know your resourcesAsk for helpFind an ally or twoPractice responses withan ally6 Talk with your coworkersabout negative behaviorat work and ways toaddress it in the contextof your environment
More Lessons Learned Look in the mirror Be the change
Responding to a BullyAs him or her, “Why?”15Workplace Bullying Institutewww.workplacebullying.org
Back to the story What would you say to Jean? What would you say to Jean if you were Donna? What would you say to Jean and Donna?
Responding to Jean using Lessons Learned I am taken back right now by your reaction to myrequest for help.
Using Griffin’s Cognitive Rehearsal Techniques,Donna Responds to Jean - “This isn’t the time or the place. Please stop.” (p. 260)
What would you say to Donna and Jean?
Thank You!Contact information: cmpurpora@usfca.edu
References1. Felblinger DM. Incivility and bullying in the workplaceand nurses’ shame responses. J Obstet Gynecol NeonatalNurs. 2008; 37(2): 234-242.2. Freire P. Pedagogy of the oppressed. 30th anniversaryed. New York: The Continuum International PublishingGroup; 2003, original work published 1970.3. Blanton BA, Lybecker C, Spring NM. A horizontalviolence position statement [Internet].1998. [cited 2012Aug 30]. Available from:http://proactivenurse.com/index.php?option com content&Itemid 22&id 83.
References4.Einarsen S, Hoel H, Notelaers G. Measuring exposure tobullying and harassment at work: Validity, factor structureand psychometric properties of the negative actsquestionnaire-revised. Work & Stress. 2009; 23(1), 24-44.5.Sellers KF, Millenbach L, Ward K, Scribani M. The degreeof horizontal violence in RN practicing in New York State.J Nurs Adm. 2012; 42(10): 483-7.6. McKenna BG, Smith NA, Poole SJ, Coverdale JH.Horizontal violence: experiences of registered nurses intheir first year of practice. J Adv Nurs. 2003; 42(1):90-96
References7. Rowe MM, Sherlock HS. Stress and verbal abuse innursing: Do burned out nurses eat their young? J NursManag. 2005; 13: 242-248.8. Rodwell J, Demir D. Psychological consequences ofbullying for hospital and aged care nurses. Int Nurs Rev.2012; 59(4): 539-546.9. Johnson SL, Rea RE. Workplace bullying concerns fornurse leaders. J Nurs Adm. 2009; 39(2): 84-90.10. Simons S. Workplace bullying experienced byMassachusetts registered nurses and the relationship tointention to leave the organization. ANS Adv Nurs Sci.2008; 31(2): E48-E59.
References11. Purpora C, Blegen MA, Stotts NA. Hospital StaffRegistered Nurses’ Perception of Horizontal Violence,Peer Relationships, and the Quality and Safety of PatientCare. Submitted for publication.12. Griffin M. Teaching cognitive rehearsal as a shield forlateral violence: an intervention for newly licensednurses. J Contin Educ in Nurs. 2004; 35(6): 257-263.13. Barrett A, Korber S, Padula C. Lessons learned from alateral violence and team-building intervention. NursAdmin Q. 2009; 33(4): 342-350.
References14. The Joint Commission. Sentinel event alert Issue 40.Behaviors that undermine a culture of safety [Internet].2008 Available from: http://www.jointcommission.org15. Namie, G. Comeback lines, Fuggedaboutem. 2012 WBIPodcast 25. [podcast on the internet]. Workplace BullyingInstitute; 2012 [cited 2013 March 5]. Available from:www.workplacebullying.org/category/podcast
bullying for hospital and aged care nurses. Int Nurs Rev. 2012; 59(4): 539-546. 9. Johnson SL, Rea RE. Workplace bullying concerns for nurse leaders. J Nurs Adm. 2009; 39(2): 84-90. 10. Simons S. Workplace bullying experienced by Massachusetts registered nurses and the relationship
2 AMERICAN NURSES ASSOCI ATION POSITION STATEMENT ON INCIVILITY, BULLYING, AND WORKPLACE VIOLENCE III. BACKGROUND Incivility, bullying, and workplace violence are part of a larger complex phenomenon, which includes a “constellation of harmful actions taken and tho
Written by: Professional Issues Panel on Incivility, Bullying, and Workplace Violence Adopted by: ANA Board of Directors I. Purpose This statement articulates the American Nurses Association (ANA) position with regard to individual and shared roles and responsibilities of registered nurses (RNs) and
bullying, cyber bullying and so on, this paper specifically focuses on violent physical school bullying. Based on the recent definition of bullying above, physical school bullying, like other forms of bullying is associated with a series of harmful behaviors occurring repeatedly over time and characterizes an imbalance of power between
Bullying occurring in schools has been sustained for a long time and is currently a universal phenomenon. Traditional bullying is defined as repeated behaviors with the intention of physical or emotional harm against another person and involves physical bullying, verbal bullying, and relational bullying (Fanti, Demetriou, & Hawa, 2012).
Bullying Behaviors Tiers 2 & 3 risk or who have already been identified as engaging in bullying behavior. Another strategy brief addresses bullying prevention and intervention more generally, and focusing more particu-larly on preventing bullying, and the discussion which follows assumes that bullying prevention strategies are also in place.
respond to victimization with bullying behavior. While both boys and girls engage in and are victims of bullying, research has shown differences in their bullying behaviors. For example, boys engage in bullying more frequently than girls (Nansel et al., 2001; Seals & Young, 2003). Also, boys are more likely to engage in physical or verbal bullying,
high levels of racial/ethnic bullying also report high levels of general bullying. Propositions 5 and 6. The experience of bullying is likely to aVect employees' trust in the dispute resolution and conXict management systems of their organizations. Particularly, victims of bullying by supervisors or higher-level organization members
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