In our previous post, we discussed that bullying and incivility can occur everywhere, but the healthcare environment has an inherent stressfulness that may be even more intense in the correctional environment, where healthcare is not the primary mission. In this post, we are continuing the discussion to include the consequences of bullying and incivility, both individually and organizationally, and how we can address bullying and incivility if it does occur.
The Consequences of Bullying and Incivility
As expected, workplace bullying and incivility against a nurse incurs serious consequences for both the victim and the organization. For the victim, consequences may include physical and psychological-emotional manifestations. These manifestations can be acute and chronic, and some are never resolved. Bullying causes the victim to experience emotions of fear, confusion, shame, and anger. Feelings of uncertainty, isolation, self-doubt, and depression are frequently experienced by individuals who are the victims of bullying. These feelings impact on the person’s ability to think clearly, make sound judgments, and ask questions or verbalize concerns. In addition, physical manifestations may include fatigue, insomnia, the development of hypertension and even nausea and vomiting.
Others who witness the bullying and continual acts of incivility are also affected simply by being in the environment, and research has shown that they, too, suffer emotional and psychological trauma. Untreated or under-treated psychological trauma may lead to substance abuse, heightened vigilance, retaliatory violence and even self-harm.
The impact on the organization may also be great, as morale and productivity are negatively affected when staff no longer trust management, lose the collaboration that is so important in patient care and treatment, and believe that they are working in a hostile work environment. Staff affected by bullying and incivility may also manifest increasing family problems, increased job stress, absenteeism, and staff turn-over may result. When the caregiver is in crisis, or suffering from burn-out, distrust of co-workers and management, and hyper-vigilance, the quality of the care provided to patients is severely impacted. This may result in an increased risk for patient adverse outcomes when nurses are not practicing to the nursing standard of care. The Joint Commission (2008) has asserted that acts of intimidation and disruptive behavior against colleagues can increase incidences of medical errors and preventable adverse outcomes for patients.
ADDRESSING BULLYING AND INCIVILITY
Bullying and incivility should be addressed at the organizational level and the interpersonal level. Organizational strategies include the development of a “zero tolerance” policy, staff training, and encouraging staff to report incidences of bullying and incivility immediately. Personal strategies include immediately bringing the unacceptable behavior to the attention of the perpetrator; reporting continued acts of unacceptable behavior to the Supervisor; “scripting” interactions with perpetrators of bullying and incivility to prepare for such interactions; and using assertive communication techniques that are confident, respectful, professional and direct. The importance of identifying and addressing bullying and incivility behaviors cannot be over-emphasized, as the consequences of these behaviors continuing include the development of a hostile work environment, the diminishing of staff wellness, and potentially negative patient outcomes.
For more information on Bullying and Incivility, check out The Correctional Nurse Educator class entitled Bullying and Incivility for the Correctional Nurse.
Please share your experience with bullying and incivility in the correctional workplace in the comments section below.