Workplace Violence and Bullying in the Profession of Nursing

According to what we have been learning in our Ethics class, workplace violence, or bullying, is a violation of the code of ethics and the five moral principles in healthcare. Bullying is identified by the National Centre Against Bullying as, “When an individual or a group of people with more power, repeatedly and intentionally cause hurt or harm to another person or group of people who feel helpless to respond.” They also go on say that, “Bullying may continue over time, is often hidden, and will continue if no action is taken” (National Centre Against Bullying, 2018). Workplace bullying is not a new sensation for nursing staff, and it is a rising problem of increasing concern. In an article written by Mika Kivimäki, Marko Elovainio, & Jussi Vahtera, titled, “Workplace bullying and sickness absence in hospital staff Workplace bullying and sickness absence in hospital staff,” (2000) they report that, “Workplace bullying has been associated with an increase in the sickness absenteeism of the hospital staff. Targets of bullying seem not to belong to any distinct group with certain demographic characteristics or occupational background.” (Kivimäki, Elovainio, & Vahtera, 2000) Workplace Violence and Bullying Background Workplace bullying or “Lateral/horizontal violence” as Rittenmeyer, Huffman, Hopp, L., & Block calls it in their report titled, “A comprehensive systematic review on the experience of lateral/horizontal violence in the profession of nursing” (2013), is widely reported occurrence in nursing writing.

There are endless descriptions of this, but it is described by them as, “Nurse-on-nurse aggression resulting in destructive behavior of nurses against each other.” This form of bullying or violence is the humiliating and reduces the accomplishments of others with cruel words and unpleasant acts and often causes a wide array of harmful consequences to the victims (Rittenmeyer et al., 2013). Objectives of this article are to provide evidence of victim’s experiences who have reported bullying and how it has emerged on the nursing profession along with its impact of nursing staff work satisfaction, retention and views of programs and strategies to help decrease its occurrence in the workplace (Rittenmeyer et al., 2013). The article is focused on licensed nurses and student nurses in any situation. Other things this article looked at were the use of oppression, generational biases as well as other forms such as; nonverbal innuendos, verbal insults, undermining activities, withholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy and broken confidences, personal attacks, and criticizing one’s competency (Rittenmeyer et al., 2013). The Story The presence of workplace violence or “Lateral/horizontal violence” is spread all through the nursing profession. It has been presented more often by student nurses, new nurses, and even in older more practiced nurses. This experience of workplace violence has caused distress in many of these victims. There is an absence of studies about how its impact effects employee satisfaction and retainment and how effective the programs/strategies would prove to decrease its occurrence and undesirable effects. There is a need a more in-depth high-quality study to get a better account of these occurrences and their influence in particular, along with the effectiveness of interventions that affect one’s career satisfaction and preservation (Rittenmeyer et al., 2013). The study furthermore reported that new graduates had a higher incidence of lateral/horizontal violence, with over one half of the contributors described feeling devalued in their position, another third stated of the contributors reported that they had learning occasions hindered and were assigned to too many duties without proper support (Rittenmeyer et al., 2013). The Commission for Case Manager Certification’s (CCMC, 2018) article titled, “Speak up, speak out: It’s time for case managers to take on the bullies” states that: Bullying is all too common and regrettably, it’s too-often ignored. It is time to recognize that ignoring the problem is condoning it and that puts us, our co-workers, our organizations and our clients at risk,” “Bullying is both a clinical and a quality issue of grand proportion. It is a workforce retention issue—one that contributes to traumatized professionals everywhere” The Analysis Workplace bullying or lateral/horizontal violence is not a modern experience, but in the nursing profession, it is becoming challenging to address today. By exposing some key issues of this study, it is a duty for all nurses to open lines of communication for the victims of lateral/horizontal violence and to increase a moral climate of healthcare involving the ethics of non-malfeasance, beneficence, utility, and autonomy. Having non-malfeasance means to do no harm or cause needless injury according to practical principles. A nurse, in all affairs, should practice compassion and respect for dignity, and be worthy of every patient, and every human being.

The nurse should be unrestricted by considerations of care for these individuals due to the social or financial standing, individual characteristics or the environment of the health problem. Beneficence means to promote the welfare of others.

When nurses bully one another, they do not promote the welfare of others. Nurses should attempt to bring about the greatest amount of benefit to as many people involved as is possible and consistent with the observance of other basic moral principles and give the greatest benefit and do the least harm. The principle of utility reports that the actions or behaviors are to promote happiness or pleasure and would be wrong to produce unhappiness or pain. All human beings should be valued and held to truthful and accurate information with no compulsion. The presence of lateral/horizontal violence is widespread throughout the nursing profession. Lateral/horizontal violence was reported more frequently by student nurses, new nurses, and older experienced nurses.

Experiences of lateral/horizontal violence causes intense distress in many of the victims. There is an ongoing need for high quality studies to further gather a better understanding of the phenomena its impact and in particular, effectiveness of interventions to affect job satisfaction and retention (Rittenmeyer et al., 2013). Conclusion The presence of workplace or Lateral/horizontal violence is becoming widespread throughout the nursing profession. It is demeaning and downgrades one’s reputation with cruel words and cruel acts that often result in a lack of confidence and self-esteem in the victims. It is inappropriate behavior, it causes confrontation, or conflicts ranging from verbal abuse to sexual and physical harassment between co-workers. It is meant to damage another’s professional identity and limit career opportunities, and attack through work roles and tasks meant to obstruct work or make work more difficult (Purpora, Cooper, & Sharifi, 2015). As a consequence of observing this behavior the students in this study began to question their long-held belief that caring was an important value in nursing. Students in this study often report feeling exploited, ignored and unwelcomed in nursing practice environment. The data in this study indicated that 95.6 % reported experiencing at least one bullying behavior during classroom or clinical work. Students reported that they frequently endured cursing, swearing and other belittling behaviors (Purpora, Cooper, & Sharifi, 2015). Nurses, particularly new nurses and student nurses are vulnerable and must learn to navigate their way around the complexities and respond to the sometimes-unrealistic expectations imposed upon them. Unequal power and hierarchical structures complicates this navigation.

More experienced staff nurses need to be invited to provide input into finding solutions to problems. New graduates should be assigned trustworthy mentors to assist them in navigating this new environment. The faculty which supervises students must explicate to staff the objectives of the clinical placement and give students permission to talk about any bullying behavior that they experience (Rittenmeyer et al., 2013). References Commission for Case Manager Certification. (CCMC) (2018). Speak up, speak out: It’s time for case managers to take on the bullies [PDF]. Mount Laurel: HEALTH2 RESOURCES. Retrieved September 14, 2018 Cox, H. C. (1987). Verbal abuse in nursing: Report of a study: Research explores whether or not-and to what extent-verbal abuse affects nursing practice and turnover rates. Nursing Management, 18(11), 47–50. Retrieved September 14, 2018 Kivimäki M., Elovainio M., & Vahtera J., (2000, October 01). Workplace bullying and sickness absence in hospital staff.

Retrieved September 14, 2018, from https://oem.bmj.com/content/57/10/656.short Laschinger, H., Wong, C., & Grau, A. (2012). The influence of authentic leadership on newly graduates nurses’ experience of workplace bulling burnout and retention outcomes: A cross sectional study. International Journal of Nursing Studies,49, 1266-1276. Retrieved September 14, 2018. National Centre Against Bullying. (2018). Definition Of Bullying | National Centre Against Bullying. Retrieved September 14, 2018, from https://www.ncab.org.au/bullying-advice/bullying-for-parents/definition-of-bullying/ Rittenmeyer, L., Huffman, D., Hopp, L., & Block, M. (2013). A comprehensive systematic review on the experience of lateral/horizontal violence in the profession of nursing. JBI Database of Systematic Reviews & Implementation Reports, (11), 362-468. doi:10.11124/jbisrir-2013-1017 Purpora, C., Cooper, A., & Sharifi, C. (2015). The prevalence of nurses’ perceived exposure to workplace bullying and its effect on nurse, patient, organization and nursing-related outcomes in clinical settings: A quantitative systematic review protocol. JBI Database of Systematic Reviews and Implementation Report,13(9), 51-62. Retrieved September 14, 2018.

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