Equal Opportunity in the Workplace
The healthcare system is a major industry. Just like any other corporate world, it has a rich source of human power. How do they fair as an employer?
This section will feature the state of our work environments. Are we treated the way we should be? Are we better off than those who work outside this industry?
HUMAN RIGHTS SERVICES
Creating a Culture of Civility and Regard
I have been wanting to address and talk about this huge issue of civility in the workplace, as I have seen it a lot of times, and even a victim for a long time, until I finally was impressed by a nurse blogger I met on the net. She has indeed touched and empowered me, to pursue and talk about it and make baby steps to put an end to this ugly side of the nursing experience.
I want to introduce you to:
Dr. Renee Thompson has more than 23 years healthcare experience including clinical practice, nursing education, quality management and executive leadership. This diverse experience has afforded Renee the unique ability to view the delivery of healthcare from a 360° perspective. Renee is the Chief Connections Officer at RTConnections, LLC, an organization that educates, connects and inspires current and future nurses.
Renee is a published author of the book, “Do No Harm” Applies to Nurses Too! Strategies to protect and bully-proof yourself at work. She speaks nationwide to healthcare organizations and academic institutions motivating her audience at keynote addresses, professional conferences, workshops, and seminars. Her presentations and seminars focus on improving clinical and professional competence, eliminating nurse-to-nurse bullying, effective communication and leadership, building a positive and healthy workplace, and nurturing a culture of respect.
Renee also continues to care for patients on a neuro-trauma step-down unit.
Let's read what Dr. Thomspson's perspective is on this issue:
NURSE BULLYING: A VIOLATION OF OUR CODE OF ETHICS
Nurse bullying is alive and well in our current health care environment. But is it a new problem? “Nurses eating their young” has plagued our nursing profession for decades. Maybe that’s why the American Nurses Association decided to address this problem when they created the Code of Ethics.
The ANA Code of Ethics was developed as a roadmap – a guideline for carrying out nursing responsibilities according to high quality standards and ethical behavior. The Code includes nine provisions with sub-provisions.
And guess what?
Nurses who bully other nurses are in direct violation of the ANA’s Code of Ethics first provision.
According to Provision 1, “the nurse, in all professional relationships, practices with compassion and respect for the inherent uniqueness of every individual, unrestricted by considerations of social or economic status, person attributes or other nature of health problems.”
The sub-provision that I believe addresses nurse bullying is sub-provision 1.5, relationship with colleagues and others.
Basically, it states that nurses need to…
· Treat EVERYONE whom they interact with, with respect
· Maintain compassionate and caring relationships with colleagues
· Commit to the fair treatment of others
· Resolve conflict
· Value the distinct contribution of individuals or groups
· Collaborate to meet the shared goals of providing quality health services
Whoa! Can you recognize how behaviors such as…undermining, unfair assignments, sabotage, public criticism, backstabbing and being unapproachable are in direct violation with our Code of Ethics? Me too.
What should we do?
The first step is to know that as a nursing profession, we have guidelines for behavior and practice. Go to the ANA website and read the code!
The second step is to start behaving in ways that honor the code. Are you treating others with respect independent of their individual attributes? Remember, the key to changing others is to start with you.
The third step is to commit to honoring the code by addressing the bad behavior and bad practice of others. According to a survey done by Vital Smarts and the AANC, only 10% of nurses spoke up when they witnessed bad behavior or bad practice. Remember, according to the code, nurses have an ethical responsibility to the public to speak up!
Ending nurse bullying is possible. Heck, we have a roadmap that shows us how to behave. Read it…Know it…Own it…Share it with others.
Thanks so much for reading. Would love to read your thoughts about nurse bullying as it relates to the ANA Code of Ethics.
Take care and stay connected!
SAMPLE BLOGS http://blog.rtconnections.com/2014/12/why-bullies-dont-get-ulcers.html
Why Bullies Don’t Get Ulcers and You DO!
Individuals who find themselves victims of bullying suffer physical consequences. They get headaches, eating disorders, sleep disturbances, are more at risk for cardiovascular disease, AND... GET ULCERS!
But what about the bullies? Do they get ulcers too?
I’m reading a book right now called, “Why Zebras Don’t Get Ulcers” by Robert Sapolsky, about the stress response. According to Robert, when humans are under stress (it happens with primates too), we enter into an “outlet-for-frustration” reaction.
Susan is well known as the “queen bully” on the unit. Everyone tries to avoid her – especially when she’s having a bad day. Today, the highly anticipated Christmas Holiday schedule came out and Susan didn’t get the day off she wanted. LOOK OUT!!! Susan is on a rampage and everyone’s goal is just to stay out of her way.
This stress-induced displacement of aggression is a primitive response and leads some humans to pick on others. If you're the one getting picked on, you end up with the ulcer while the bully avoids one.
Stress stimulates your sympathetic nervous system which increases your heart rate, blood pressure AND the release of glucocorticoids (among other things). These chemicals in your body serve a purpose – it’s to prepare you for a fight or a flight (we all know this!!). And this response is a good thing during an acute incident like, avoiding an attack while walking in the park or getting your child out of the back seat of your car immediately following a car accident, even though your leg is broken, etc. Our fight or flight response is protective. But these chemicals can also damage your body if elevated for too long (chronic stress).
One way humans can reduce the surge of these chemicals is to displace their stress onto others. It’s just like playing hot potato. Let’s pretend the potato is stress. When the potato gets passed to the bully, the bully resorts to a primitive response by passing the potato onto someone else. The problem occurs when you’re the one stuck with the potato because there isn’t anyone left to pass it to. Another reason why you’re stuck with the potato is because you resist the temptation to pass it, which requires a higher level of reasoning. But now you’re stuck with the stress and in turn, your body also releases these chemicals. These chemicals over time wreak havoc on YOUR body. When you’re the one holding the potato, you’re the one with the ulcer.
Bottom line: Humans who bully don’t GET ulcers – they GIVE them.
What can you do to minimize YOUR stress response?
Earlier I mentioned that displacing anger onto someone else is considered a primitive response (animal behavior). However, there is another way to displace this anger and it works for the victim AND the bully.
It’s called social support.
Social support is protective and can decrease the sympathetic response in situations that really don’t require the fight or flight response (like Susan yelling at you).
People who are socially isolated have an overly active sympathetic nervous system while people who are socially active (lots of friend) have a more discerning sympathetic nervous system.
What does this mean?
If the bully has attacked you, the worst thing you can do is to isolate yourself by going into the bathroom and crying. Instead, seek social support from your colleagues. Take a break with a colleague whom you like and talk about good things; find others who have also “received the potato” and talk about your experience; and don’t forget, if you’ve been a witness to the bully’s attack on someone else, go out of your way to support that person.
And, continue to strengthen your social networks outside of work. The more you do, the more discerning your sympathetic nervous system will become and the more you’ll be able to handle a bully’s attack without getting an ulcer!
Thanks so much for reading. I'd love to read your comments about this. Remember, nurses should be kind – not cruel!
Take care and stay connected!
Disruptive Behavior in Healthcare Settings
The safety of patients and staff is always the first priority in healthcare settings. It must be the goal of every healthcare to provide a culture of safety for both.
The Joint Commission has issued a Sentinel Alert on Disruptive Behavior in healthcare settings
- Healthcare has more assaults than any other industry sector in the US
- Intimidating and disruptive behaviors can foster medical errors
- Disruptive behavior contributes to poor patient satisfaction
- Disruptive behavior contributes to preventable adverse outcomes.
- Disruptive behavior increases the cost of care
- Safety and quality of patient care is dependent on:
Collaborative work environment
Intimidating and disruptive behaviors include:
- Overt actions such as verbal outbursts and physical threat.
- Passive activities such as refusing to perform assigned tasks or quietly exhibiting uncooperative attitudes during routine activities.
- Reluctance or refusal to answer questions, return phone calls or pages.
- Condescending language or voice intonation; and impatience with questions.
- The presence of intimidating and disruptive behaviors erodes professional behavior and creates an unhealthy or even hostile work environment – one that is readily recognized by patients and their families.
Movement to End Bullying
ENDING NURSE BULLYING: BUSTING THROUGH THE #1 BARRIER
Nurse bullying is a problem. We’ve ALL heard the phrase “nurses eat their young” yet it continues. Why? Consider this - Dealing with human behavior versus clinical performance isn’t simple. It’s much easier to tell someone she needs to work on her IV insertion skills versus that she needs to treat others with respect. It’s not intuitive to be able to address bad behavior. There’s not a specific guideline that will “fix” every behavioral situation.
So, ending nurse bullying is difficult at best. But the complexity of human behavior isn’t the biggest barrier to end nurse bullying. So what is?
FEAR OF RETALIATION
Fear of retaliation is the #1 barrier to ending nurse bullying and in my opinion, the #1 reason this problem has continued for so long.
Although I’d like to say that you and I could fix this, again, it’s not that simple. But I do want to offer a few strategies that will buffer the impact of retaliation.
Tips to decrease the impact of retaliation
I talk a lot about documentation but really; it’s an important step to ending nurse bullying. It’s even more important if you are concerned about retaliation. Start documenting objective behavior of the bully. Perhaps you confront the bully when she openly criticizes you in front of others and then when in charge, she gives you the worst assignment. Document this. Be as objective as possible. Do this ongoing until you have a collection of objective bad behavior. You may need this if her retaliation gets worse.
2. Link bullying behavior to patient safety
Anytime you can link the bully’s behavior to a patient safety issue – ding, ding, ding. Now YOU have some ammunition to protect yourself from retaliation. Why? Because you have a better chance of the bully’s behavior being addressed by more than just you. Patient safety is on the radar of administration and is more likely to be addressed. One nurse shared with me that the bully took away her trach patient’s call bell and then wrote her up for “not having the call bell close to her patient.” What the bully didn’t realize was that patient witnessed her (bully) moving his call bell and reported it to the manager. Wow. Huge patient safety issue. If I were the bully’s boss, I’d fire her on the spot!
3. Gather your posse
There is strength in numbers. Chances are, you are not the only nurse who is getting “eaten” by this bully. Find others like you. Start joining forces – protect each other – watch each other’s backs – act as scouts for one another.
4. Share your fears
The word retaliation is hardly ever spoken. It reminds me of the movie, A Lion King, when no one was allowed to say, Mufasa. Tell your manager, educator, HR person, etc. Tell someone that you are experiencing a bullying situation but you’re keeping silent for fear of retaliation. Why does this help? Imagine if 10 nurses on separate occasions approached the manager and shared their concerns about retaliation. It would get someone’s attention! Say the word – RETALIATION. After all, the fear of retaliation is what is preventing us from ending the cycle of nurse bullying. We need to say it.
Reality insight: If you document, link the behavior to patient safety and gather your posse, and she finds out – she may still retaliate. So be prepared. You may decide that it’s not worth it and stay silent – that the fear of retaliation is too great. Remember that the bully is relying on you and her other victims to think this way. That’s how they exert their power over you. Fear of retaliation is their most powerful weapon. They wield fear like a knife. Don’t give into that fear. Tap into your moral courage muscles and speak up. It’s time we stop being passive about “eating our young”, middle aged and older nurses!
Last resort – if you are working in a toxic environment where you can’t even imagine taking any action against a bully – GET OUT! Leave. You deserve to work in a supportive and nurturing environment.
Would love to read your comments about retaliation and any tips you think would benefit others.
Thanks so much for reading. Air hug to you all!
By Assembly Member Englebright
An act to amend the labor law, in relation to establishing healthy workplaces
The New York State Nurses Association, representing the interests of registered nurses (RNs) and the patients they serve, supports enactment of the above referenced bill which would establish a civil cause of action for employees who are subject to an abusive work environment.
Workplace bullying is defined as the repeated, malicious, health-harming mistreatment of one or
more employees by one or more co-workers or a supervisor. Bullying can include verbal abuse,
conduct that is threatening, humiliating or intimidating or workplace sabotage.1 Research from the Workplace Bullying Institute reveals that 35 percent of the U.S. workforce report being bullied at work, 62 percent of employers who received complaints about workplace bullying either ignored the problem or made the situation worse and 73 percent of workplace bullies are supervisors. Workplace bullying has become a silent epidemic. It is often not discussed because workers fear their careers will be placed in jeopardy if they do so.2
Abusive work environments can cause mental, physical, social and economic harm. Bullied workers experience feelings of humiliation and shame, loss of sleep, stress, depression and severe anxiety. Additionally, some have reported symptoms of Post Traumatic Stress Disorder, Chronic Fatigue Syndrome, hypertension and cardiovascular disease.3 The National Safe Workplace Institute reports that there have been instances where abusive supervisors have provoked bullied employees, pushing these individuals to dangerous levels of violence and aggression.4 Often, workplace bullying is minimized as merely a “personality conflict” or a “difference in styles.” However, employers who do not address issues of workplace bullying experience reduced employee productivity, reduced morale, higher rates of staff turnover, higher rates of absenteeism, and higher medical and workers’ compensation costs.
This legislation will provide legal redress for employees who have been harmed, psychologically, physically, or economically. It will also provide legal incentives for employers to prevent and respond to bullying.
For the reasons stated above, the New York State Nurses Association urges passage of this
legislation, which would encourage employees to speak out against abusive work environments, and empower employers to address abusive behavior.
1 Retrieved from http://www.workplacebullying.org/individuals/problem/definition/
2 Retrieved from: http://www.workplacebullying.org/individuals/problem/being bullied/
3 Namie, G. & Namie, R. (2000). The Bully at Work. Naperville, Ill:Sourcebooks, Inc.
4 Kinney, J.A. (1995). Violence at Work. Englewood Cliffs, NJ: Prentice-Hall.
EQUAL WORK, EQUAL PAY
President Obama: "When women succeed, America succeeds."
Kay Morrison is 90 years old. And in 1943, when she worked as a journeyman welder on the assembly line at Kaiser Shipyard #2 in Richmond, California, she earned the same wage as the man working the graveyard shift alongside her.
As Kay said, "it can be the same today." And yet, on average, full-time working women earn just 77 cents for every dollar earned by men.
Earning equal pay starts with a conversation -- and that's why, this week, President Obama signed an executive order prohibiting federal contractors from retaliating against employees who choose to discuss their pay.
The White House, April 11, 2014