presentation targeted to charge nurses

1. Bayfront Health Spring Hill Nursing department
Rachel Provau RN MSNA CNML

2. Objectives
 Define Bullying and 3 forms found in Nursing
 List 5 recognized categories of workplace violence/bullying
 Name 3 stress related complications related to bullying and 3 resources that are
available to staff
 Explore how bullying behavior affect Patient safety
 Review personality types and how to recognize them
 Discuss four Charge Nurse leadership styles
 Define Civility and discuss ANA recommendations
 Discuss 3 actions that address prevention of bullying behaviors
 List strategies that can be used in your unit

3. Bullying
 Repeated, health-harming mistreatment of
one or more persons (the targets) by one
or more perpetrators.
 Verbal abuse
 Threatening, intimidating or humiliating
behaviors (including nonverbal)
 Work interference – sabotage – which
prevents work from getting done

4. Males vs Females Conflict
styles
 Men – Direct, aggressive, and/or
intimidating.
Women – Passive, indirect, and/or
Manipulative
Relational Aggression-(female bullying)

5. Relational Aggression
 Gossip
 Manipulation
 Intimidation
 Exclusion
 Gestures
 Ridicule
 Teasing
 Cliques
 Campaigns
 Name calling

6. Examples in Nursing:
1. Ignoring- Passive
aggressive
2. Rolling of the eyes
( body language)
3. Refusal to answer a
question
4. Social media post about
a co worker that are not
nice
5. Texting
6. Condescending tone of
voice
27% of Adults report they have been bullied at work
One in six Nurses report they have been Bullied in the past Six months

7. Statistics
 WBI Instant Polls
 817 respondents
(bullied targets and
witnesses)
 QUESTION:
Of the workplace
perpetrators of bullying
I’ve known, they?
© 2014 Workplace Bullying Institute
 82% acted with the
deliberate personal
intention to harm others
 8.6% harmed others but
were not aware of the
consequences
 7.8% followed instructions
of superiors in ways that
hurt others
 1.5% never meant to harm
others; were
misunderstood

8. Categories of Workplace
Violence
 Threat to
professional status
(public humiliation)
 Threat to personal
standing (name
calling, insults,
teasing)
 Isolation
(withholding
information)
 Overwork
(impossible
deadlines)
 Destabilization
(failing to give credit
where credit is due)

9. How does this affect the work
environment of a nursing unit?
 Lower morale, lower
productivity and
increased
absenteeism
 Rapid and increased
turnover
 Negative impact on
organizational
reputation
 Contribute to poor
patient satisfaction
and to preventable
adverse outcomes
 Increase the cost of
care

11. Bullying and Patient Safety
 Failing to tell
another nurse that
the patients lab
results were called
to you
 Refusing to answer
other’s nurses call
lights because
“those are not my
patients”
 Nurses eating their
young or new
orientees – Staffing
compromised
because no one
hired stays
 Indifference or
ignoring – “That
doesn’t mean I have
to do it” BSR/HR

12. Stress complications related to
bullying
Physiological
 Reduced immunity
to infection
 Headaches and
migraines
 High blood pressure
 Waking up more
tired than when you
went to bed
Psychological
 Behavioral
 Anxiety
 reactive depression
 Forgetfulness
 angry outbursts at
home
 Increased reliance
on drugs/self
medicating

13. Resources for staff
 American Nurses
Association (ANA)
 PACERS
 CDC Workplace
Violence prevention
for Nurses
 www.stopbullyingnur
ses.com
 Human Resources
 TJC
 RN2RN
 CNO, HR, ERS
 EAP
 Compliance hotline

15. What personalities are on your
unit?

16. Divergent Book Series Factions
 Abnegation
 Dauntless
 Erudite
 Candor
 Amity

17. Which Faction are you?
 ERUDITE-Characterized by great
knowledge; learned or scholarly (know it
alls)
 AMITY-cultivating strong relationships
and trying to understand each
other. (softies)

18. Which Faction are you?
 ABNEGATION-active forms of stripping
things from your life.(Stiffs)
 DAUNTLESS-Courageously resolute,
especially in the face of danger or
difficulty; not discouraged. (Toughies)
 CANDOR-freedom from bias; fairness;
impartiality ( truthsayers)

19. Leadership and Bullying?

20. 4 quadrants of leadership
 Obnoxious Aggression-
always challenging directly
but don’t care personally
what the consequences
are
 Ruinous Empathy-
Destructive Sympathy,
Sparing someone's feeling
and then having to
intervene because of not
holding someone
accountable
https://youtube/Y9VW7wGO4vY

21. 4 quadrants of leadership
 Manipulative
Insincerity- Very
Sneaky, Manipulative,
Pot Stirrer
 Radical Candor-
using Civility as a
communication tool
to set expectations
of behavior and
responsibilities

22. Bullying and leadership

23. Radical Candor and Civility
The 5 ‘C’s”
 Clear Expectations
 Clear Capability
 Clear Measurement
 Clear Feedback
 Clear Consequences
Examples
 Time Management
 Right skills
 Outcomes
 Fact based to give and
to take from others
 Repeat, Reward or
Release

25. How Radical Candor is effective
to prevent Bullying
 Being willing as a Leader to: ANA
handout review
 Set Clear expectations-
 Clear capability-
 Clear Measurement –
 Clear feedback-
 Clear Consequences-

26. Actions that address prevention of
bullying behaviors
 Zero tolerance
 AIDET
 S.A.F.E.
 Educate all team
members
 Hold all team
members
accountable for
modeling desirable
behaviors

27. Bullying prevention
Strategies
 Prevention of Bullying-
 Responding tp being bullied – Chain of
command, HR, Hotline
 Responding when being bullied-

28. What strategies can you
suggest?

29. American Nurses Association (ANA) Code of Ethics (ANA,2001)
that states professional nurses have an ethical mandate to
become skilled communicators.

30. References
 Institute of Medicine. Keeping Patients Safe: Transforming
the Work Environment of Nurses. Nov. 3, 2003
 Occupational Safety and Health Administration. Workplace
violence in health care: Understanding the challenge. OSHA
3826, 12/2015
 Workplace Bullying Institute. The Healthy Workplace
Campaign. Healthy Workplace Bill website
 The Joint Commission. Behaviors that undermine a culture
of safety. Sentinel Event Alert, July 8, 2008;40
 American Nurses Association. Incivility, Bullying, and
Workplace Violence. ANA Position statement 7/2015
 Nursing Times. Bullying in Nursing and ways to deal
with it. March 2013

31. References
 Kimmalonescott.com
 J. Mill- On Liberty ISBN 1-59986-973-X 1859
 G. Robins- 25 Rules of Civility + Radical Candor +
Ruinous Empathy LinkedIn Blog 2/10/2016
 P.M. Forni- Choosing Civility: The 25 rules of
Considerate Conduct 11/2003
 D. Huber- Leadership and Nursing Care
Management ISBN 978-1-4557-4071-0 1996
 R. A. Patronis-Jones- Nursing Leadership and
management: Theories, Processes and Practice
ISBN 0803613628 9780803613621 2007