Select an issue from the following list: workplace violence, workplace injury, unit restructuring, floating, nurse turnover, nurse staffing ratios, or use of contract employees
Select an issue from the following list: workplace violence, workplace injury, unit restructuring, floating
Benchmark – Applying Leadership and Management Principles
The purpose of this assignment is to analyze the various approaches nursing leaders employ when addressing issues in practice.
Select an issue from the following list: workplace violence, workplace injury, unit restructuring, floating, nurse turnover, nurse staffing ratios, or use of contract employees (i.e., registry and travel nurses).
In a 1,000-1,250-word paper, discuss the following:
- Describe the issue you selected. Provide data to support how this issue impacts the quality of care in the setting in which it occurs.
- Using research evidence for support, present one possible solution that could be implemented to address the issue. In your discussion, be sure to include financial considerations as they relate to implementation of the solution.
- Describe a leadership style that would best address the issue.
- Discuss how this leadership style compares to your personal leadership style.
- Compare two different leadership theories that could be applied to resolution of the issue. Explain how each theory would be effective in addressing the issue.
- Discuss the nurse’s role within an interdisciplinary team in promoting patient quality and safety while fostering professionalism to address this issue.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
RN-BSN
10.3: Develop capacity for leadership.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 1.1, 2.5, 2.9, 3.2, 4.1, 4.2, 5.1, 5.2, 5.3, 7.2, 10.3.
Expert Answer and Explanation
Workplace Bullying
The issue selected to discuss in this essay is bullying. The act of purposely or maliciously frightening or harming another person is known as bullying (Jang et al., 2022). Bullying in the nursing environment refers to the deliberate act of threatening or causing harm to another nurse. Nurses face bullying from executives, patients, and fellow nurses in healthcare environments, much like in other jobs (Jang et al., 2022). Forms of bullying in nursing include name-calling, belittling, yelling at a nurse, shoving or pushing a nurse, blocking their way, and minimizing their efforts.
Bullying impacts patients in many ways. One of the ways is that bullied nurses are less likely to provide care because of their emotional state, and this can negatively impact patients’ outcomes. Bullying also increases nurse turnover in the healthcare sector (Yosep et al., 2022). One of the most common forms of bullying in nursing is physical aggression. Physical aggression as a form of bullying could cause the nurse physical injuries, which hinders them professionally. There is a nursing shortage when nurses cannot attend to their functions physically (Yosep et al., 2022).
Consequently, the available nurses have to cover the injured nurse’s shift, hence increasing their workload. An increased workload could lead to poor healthcare services being offered to patients because of fatigue, hence leading to negative health outcomes for the patients. Patients’ satisfaction can be impacted when they witness a nurse being bullied. According to Yosep et al. (2022), nursing bullying leads to lower patient satisfaction, which negatively affects them because they may feel that their preferred nurse is a bully or is bullied, hence lowering their expectations about the healthcare organization and their healing process.
Solution to Address Bullying Among Nurses
Bullying in nursing can be addressed by educating the nurses and implementing a zero-tolerance policy regarding bullying in the workplace or online among staff within the organization. Nurses who harass and intimidate other people should not be tolerated. Establishing clear guidelines ahead of time on the reporting and handling of bullying establishes expectations for all nurses (Yosep et al., 2022). It conveys the idea that nurses should be treated with respect and safety at work.
A zero-tolerance policy for bullying means that when a nurse reports that another colleague is bullying them, the management should take the report seriously and start investigations. If found guilty, the nurse who bullied others should be suspended without pay, and if the act injured the victim, the case should be forwarded to the police for criminal investigations to be opened (Yosep et al., 2022). Nurses should be educated about the policy and made aware of the consequences of bullying others. Implementing this solution will not harm the hospital’s finances since less financial action is needed to address the problem.
Leadership Style Effective in Addressing Workplace Bullying
The leadership style that can be effective in addressing workplace bullying is transformational leadership. It is known as a leadership style that affects both social institutions and individuals (Niinihuhta et al., 2022). In its perfect state, it transforms followers into leaders by bringing about significant and constructive change in the followers.
Transformational leadership prevents workplace bullying by promoting open communication and engagement between workers and motivating workers to achieve greater heights. Through open communication, nurses who are being bullied can have the courage to face their leaders and report on their experiences in the workplace.
Also, when all nursing staff feel respected, they will be less likely to bully their colleagues. Transformational leadership also fosters collaboration among nurses. Nurse managers who practice transformational leadership often promote teamwork among their nursing staff, increasing positive relationships among the staff, thus reducing workplace bullying (Niinihuhta et al., 2022).
This leadership style is also anchored in a well-functioning feedback process, creating an environment where staff can safely report any forms of bullying, they are experiencing. Lastly, transformational leadership promotes safe idea-sharing (Niinihuhta et al., 2022). Workers who feel safe sharing their ideas are more likely to report any form of bullying they experience in the workplace.
How Transformational Leadership Compares with My Leadership Style.
As a transformational leader, I actively solicit feedback and engage in collaborative goal-setting with staff rather than taking a top-down approach (Niinihuhta et al., 2022). Yet, working in a bureaucratic system, I occasionally find myself issuing directives from the administration in a transactional manner instead of working to translate and implement changes collaboratively with my team. As a result, most of my staff fear coming to me and reporting any safety issue they experience.
I strive to be a strong role model by demonstrating competence, integrity, and high ethical standards. But there are moments when the tremendous responsibilities of my role overwhelm my capacity. My vision is to build communication channels and support systems to empower nurses and nurse leaders to reach their highest potential while providing compassionate care. I aim to foster resilience within myself and my team. I believe that through open communication I aim to create, my nursing staff will be willing to share with me their plights.
Two Leadership Theories
Two leadership theories that can be used to address the problem are transformational and transactional. Transformational theory focuses on promoting innovation and change within an organization. However, transactional theory ensures that processes are implemented as quickly as possible. Transformational theory should effectively address workplace bullying by promoting teamwork and open communication.
Workers who learn to work as a team are less likely to bully each other (Niinihuhta et al., 2022). Also, this form of leadership promotes open communication and creates a safe space where workers can share their ideas, and thus, they are more likely to report when they are being bullied.
Transactional also addresses workplace bullying by promoting collaboration and teamwork. In this theory, staff is needed to work together and move quickly to achieve the goals of an organization. This theory also addresses the problem by clearly communicating rewards and consequences. Leaders can use this leadership style to effectively communicate the consequences of bullying each other in the workplace.
The Role of Nurses
Nurses have many roles in preventing workplace bullying to promote safe and quality patient care. One of the roles of nurses is to report any form of workplace bullying to the hospital authorities (Anusiewicz et al., 2020). Nurses are responsible for ensuring the health and well-being of each other. Thus, they must report any form of bullying.
Another role is to advocate for their fellow nurses. They can do this by confronting nurses who are bullying others. They also have a role of behaving professionally and respecting each other’s space in the workplace (Anusiewicz et al., 2020). Nurses are expected to maintain professional conduct by working with integrity and respecting each other.
Conclusion
Workplace bullying is a serious problem. It can lead to high nurse turnover, low patient satisfaction, and fatigue among nurses. It can also negatively impact morale of nurses and lead to physical injuries. It can be addressed by adopting a zero-tolerance to workplace bullying. Practicing transformational leadership can also help in addressing the problem.
References
Anusiewicz, C. V., Ivankova, N. V., Swiger, P. A., Gillespie, G. L., Li, P., & Patrician, P. A. (2020). How does workplace bullying influence nurses’ abilities to provide patient care? A nurse perspective. Journal of Clinical Nursing, 29(21-22), 4148–4160. https://doi.org/10.1111/jocn.15443
Jang, S. J., Son, Y. J., & Lee, H. (2022). Intervention types and their effects on workplace bullying among nurses: a systematic review. Journal of Nursing Management, 30(6), 1788-1800. https://doi.org/10.1111/jonm.13655
Niinihuhta, M., Terkamo‐Moisio, A., Kvist, T., & Häggman‐Laitila, A. (2022). Nurse leaders’ work‐related well‐being—Relationships to a superior’s transformational leadership style and structural empowerment. Journal of Nursing Management, 30(7), 2791-2800. https://onlinelibrary.wiley.com/doi/abs/10.1111/jonm.13806
Yosep, I., Hikmat, R., & Mardhiyah, A. (2022, August). Types of nursing intervention to reduce impact of bullying and aggression on nurses in the workplace. In Healthcare (Vol. 10, No. 8, p. 1463). MDPI. https://www.mdpi.com/2227-9032/10/8/1463
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FAQs:
What are the causes of workplace violence against nurses?
Workplace violence against nurses is a significant issue that can arise from various factors. Here are some common causes:
- Patient-Related Factors:
- Mental Health Issues: Patients with psychiatric disorders, dementia, or under the influence of drugs/alcohol may exhibit violent behavior.
- Pain and Discomfort: Patients experiencing severe pain or discomfort may act out aggressively.
- Fear and Anxiety: Patients who are scared or anxious about their condition or treatment may become violent.
- Work Environment:
- Understaffing: Overworked and stressed nurses in understaffed environments may face higher risks of violence due to longer wait times and reduced patient care quality.
- Long Wait Times: Prolonged waiting periods in emergency departments or clinics can lead to patient frustration and aggression.
- Inadequate Security: Lack of proper security measures, such as surveillance cameras, security personnel, and panic buttons, can increase the risk of violence.
- Organizational Factors:
- Lack of Training: Insufficient training for nurses on how to handle violent situations or de-escalate conflicts can contribute to the problem.
- Poor Policies: Inadequate workplace violence prevention policies and procedures can leave nurses vulnerable.
- Reporting Mechanisms: Fear of retaliation or lack of clear reporting mechanisms can prevent nurses from reporting incidents, leading to underreporting and continued risk.
- Social and Cultural Factors:
- Stigma and Discrimination: Societal stigma and discrimination against certain groups can lead to aggressive behavior towards healthcare workers.
- Cultural Misunderstandings: Cultural differences and misunderstandings between patients and healthcare providers can sometimes escalate into violence.
- Economic Factors:
- Financial Stress: Patients under financial stress due to medical bills or loss of income may direct their frustration towards healthcare providers.
- Resource Constraints: Limited resources and funding in healthcare facilities can exacerbate tensions and lead to violent incidents.
- Legal and Regulatory Factors:
- Lax Enforcement: Weak enforcement of laws and regulations protecting healthcare workers can contribute to a culture of impunity for perpetrators of violence.
What is the most common workplace violence in healthcare?
The most common form of workplace violence in healthcare is verbal abuse, which includes threats, shouting, swearing, and other forms of aggressive or demeaning language. This type of violence is often underreported but is pervasive across healthcare settings. Other common forms of workplace violence in healthcare include:
- Physical Assault: This includes hitting, slapping, kicking, or other physical attacks. It is often perpetrated by patients, particularly those with cognitive impairments, mental health issues, or under the influence of drugs or alcohol.
- Bullying and Harassment: This can come from colleagues, supervisors, or even patients and their families. It includes persistent criticism, intimidation, or exclusion.
- Sexual Harassment: Unwanted sexual advances, comments, or behavior, which can come from patients, visitors, or coworkers.
- Threats and Intimidation: Verbal or written threats of harm, which can create a climate of fear and anxiety.
- Aggressive Behavior: This includes actions like throwing objects, destroying property, or other forms of non-physical aggression.
What is vertical and horizontal violence in nursing?
In nursing, vertical violence and horizontal violence refer to different types of workplace aggression and bullying, but they differ in terms of the direction and power dynamics involved. Both forms of violence are detrimental to the nursing profession, affecting job satisfaction, mental health, and patient care.
1. Vertical Violence
Vertical violence occurs between individuals at different levels of the organizational hierarchy. It typically involves abuse of power, where someone in a higher position (e.g., a manager or supervisor) exerts control or mistreats someone in a lower position (e.g., a staff nurse or new graduate).
Examples of Vertical Violence:
- Bullying or Intimidation: A nurse manager publicly humiliates or belittles a staff nurse.
- Unfair Treatment: Assigning excessive workloads or undesirable shifts to specific nurses.
- Withholding Support: Refusing to provide guidance, resources, or mentorship to newer nurses.
- Micromanagement: Excessive control or criticism of a nurse’s work without justification.
Impact:
- Creates a toxic work environment.
- Leads to high turnover rates and burnout.
- Discourages professional growth and confidence in newer nurses.
2. Horizontal Violence
Horizontal violence, also known as lateral violence or workplace bullying, occurs between individuals at the same level of the organizational hierarchy. This type of violence is often seen among peers, such as nurse-to-nurse aggression.
Examples of Horizontal Violence:
- Gossip and Rumors: Spreading false or damaging information about a colleague.
- Exclusion: Deliberately excluding a nurse from team activities or communication.
- Undermining: Criticizing or sabotaging a colleague’s work or reputation.
- Verbal Abuse: Making demeaning or insulting comments to a peer.
Impact:
- Erodes teamwork and collaboration.
- Increases stress and emotional distress among nurses.
- Negatively affects patient care due to poor communication and morale.
Key Differences:
| Aspect | Vertical Violence | Horizontal Violence |
|---|---|---|
| Direction | Top-down (superior to subordinate) | Peer-to-peer (same hierarchical level) |
| Power Dynamics | Involves abuse of authority | Involves equal-power aggression |
| Common Perpetrators | Managers, supervisors, or senior staff | Colleagues or peers |
Why Does It Happen?
Both vertical and horizontal violence often stem from:
- Stress and Burnout: High-pressure environments can lead to frustration and aggression.
- Power Imbalances: Hierarchical structures in healthcare can enable abuse of power.
- Cultural Norms: In some cases, a culture of “eating their young” persists in nursing, where experienced nurses mistreat newer ones.
- Lack of Accountability: Weak policies or failure to address abusive behavior can perpetuate violence.
How to Address It:
- Education and Training: Provide training on conflict resolution, communication, and recognizing abusive behavior.
- Strong Policies: Implement and enforce zero-tolerance policies for workplace violence.
- Support Systems: Encourage reporting and provide support for victims of violence.
- Promote a Positive Culture: Foster teamwork, respect, and collaboration among staff.
- Leadership Accountability: Ensure leaders model appropriate behavior and address issues promptly.