Impact of Violence and Bullying in Nursing Shortage

Nurse bullying is not limited to victimizing the new nurses. Bullying behavior is a mechanism learned and a decision. Some new nurses may notice the bully behavior and accept it in hopes of fitting in or feeling included. Cliques may shape on nursing floors which may be a catalyst for nurture bullying. Cliques offer assistance a bully stow away from their activities and pick back up. This is usually one of the reasons why working environment bullying may be a developing measurement.

The reason for workplace bullying is an issue amongst nurses because nurses spend most of their twelve-hour shift being pulled in various directions. After days and days of this happening, Incivility and Bullying lead to staff burnout and poor job performance (Van Der Wege and Keil, 2019).

The constant stress of negative behavior and lack of support from fellow employees can cause nurses to reevaluate the meaning of their profession. There are some nurses who are able to stick through the bullying behavior, while others feel overwhelmed, feel emotionally distress and end up quitting their job. Nurses already have a stressful job but once you involve bullying into the milieu, it becomes unbearable for others. Bullying can produce and maintain a toxic environment. Nurses who participate in bullying behavior can wear down job satisfaction of their co-workers which can resort in loss of productivity and increase the absences in the workplace. Victims of bullying often have a feeling of regret and dread thinking about their upcoming workdays. Victims don’t complain about bullying because the fear of not being believed or things getting worst due to retribution (Hartley, Sanderson, Pankhurst, and Ambrose, 2019). These beliefs are often associated with the feeling of being ashamed, embarrassed, weak, at fault and target; other reasons may be that nurses are unsure of what procedures are in place, they consider what is happening to them is trivial, because they do not know they can speak or feel that even if they do speak up nothing will be done about it (Hartley, Sanderson, Pankhurst, and Ambrose, 2019).

As a result of nurses or staff not complaining, management may believe there are no concerns or issues due to the lack of evidence. Therefore, leadership needs to be proactive and consistent with checking up on staff and maintain daily shift huddles to allow staff at all levels to feel empowerment to speak up and be reassured that their concerns will be acted on. Speaking up should not be viewed as a complaint or a grievance, but more of a safety concern. If there is a potential risk within an area of bullying then this should be viewed as a systemic problem for an organization, regardless of the number of people involved.

Violence against nurses in the workforce have continued to grow throughout the years in healthcare. According to AHC Media, “In 2016, The Joint Commission issued a quick safety notice about bullying in healthcare, defining it as abusive conduct that might involve verbal, threatening, intimidating, or humiliating nonverbal behaviors, and work interference.” It seems as female nurses are predominately being sexually harassed in the workforce, along with violence amongst nursing staff in general from patient care. There have been incidents reported from nurses being sexual harassed or groped from current coworkers or patients. Some incidents of physical violence against nursing staff were patients coming into the emergency room to seek medical attention, while being under the influence for alcohol or drugs, acting out in violent behavior causing destruction. Other individuals acting out violently can be individuals who have mental health disorders, experiencing manic episodes or negative reaction from their medication. It is highly imperative to keep nursing staff safe in order to prevent injury and staff shortage. The effects of violence in nursing can be detrimental to the proper function within a workforce, ultimately resulting in damage to the nursing profession and patientcare. AHC Media expressed how, “Creating a culture of caring can help stop bullying and prevent the long-term workplace effects of poor staff morale and high turnover rates.”

In efforts to prevent the continuation of bullying in healthcare amongst nursing staff is implementing polices, workplace violence training, disciplinary action for patterns of misconduct, and prevention programs. According to Flynn, “There are three types of workplace violence controls: engineering, administrative and behavioral”. Engineering controls protect the worker from potential harms and hazards, which may include physical and environment safety and security measures, controlled access to the building and patient-care units, monitor surveillance systems, and programming emergency phone numbers into phones (Flynn, 2019). Administrative controls require the employees to change the way they work by implementing policies and guidelines, which may include: proactive safety and security audits and security rounding, reporting violent incidents and repines process, identifying, tracking and managing patients/visitors who are high risk to commit violence, education training for employees, and implementing policies and procedures for employees at high risk exposure to violence, such as employees who work alone or in an unsecure areas.. Some training programs that are common in the hospitals are CPI (crisis prevention intervention), fire safety, intruder/combative safety training, HIPPA (health insurance portability and accountability act) guidelines and training, and proper restraint training on patients.

Behavioral controls augment nursing staff knowledge, skills, and conduct, to help prevent or lessen the severity of workplace violence incidents. Nursing staff should know the following: incidents on their units and in the organization, any unit violence policies, properly respond to violent situations involving patients, deescalating potential violent situations, report violent incidents and threats, implement organization’s emergency response plans and personal safety measures, practice and promote respectful behaviors among their coworkers, and be a neutral employee who can mediate conflict between coworkers (Flynn,2019). A very common workplace violence program that is offered at hospitals is the Union. Union helps protect staff, aid in work incidents, and negotiate pay contracts for their workers; however, money is deducted from staff members account to pay for Union services.

After in-depth research, it is imperative for nursing staff to report any incident of bullying and violence in the workforce. Nursing staff safety is important to keep the workflow steady and morale from becoming hostile. An individual has the right to speak up against bullying, advocating for protection against their oppressors, and having their organization filing a claim that involves disciplinary action for the crime being committed. Most people who are not personally experiencing workplace violence may never see it go on but does not mean it is happening. It is imperative for nursing staff to report violent situations amongst staff and patient, deescalate and mediate situations before it resorts to violence, and stop the cycle of bullying in the workplace. Hospitals need to continue to update memorandums and policies to help protect nursing staff and patients. Having hospital policies prevent the continuation of behaviors from occurring, setting the foundation for immediate action to be taken for any violations. Nursing staff should be able to work in a positive and supportive milieu, making everyday a great day to be a part of a caring healthcare time to aid with treating, teaching, and trusting their fellow coworkers and patients. 

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