The Reality Of The Medical Field And The Dichotomy

Leadership is about getting people to understand and believe in your vision and to work with you to achieve your goals while managing is more about administering and making sure the day-to-day things are happening as they should.

In a profession where caring is the epicenter of the job, it is disconcerting to see a high occurrence of bullying in the nursing environment. Lateral bullying and lateral violence are terms used to describe bullying, uncivil behavior, disrespect, social devaluing, peer control and verbal, physical and emotional abuse occurring between nurses and or colleagues (Ceravolo et al., 2012). Abusive behaviors from a superior are considered vertical or hierarchal violence and are commonly seen when the superior attempts to control or bully the nurse using their superiority, often leaving the nurse feeling defenseless due to an imbalance in power and control (Broome & Williams-Evans, 2011). Some examples of bullying include harsh criticism, unfairly blaming others for mistakes, and withholding patient care information (Simons et al., 2011). In a recent study measuring workplace bullying, Simons, Stark and DeMarco (2011) found that the most common behaviors those feeling bullied experienced included being assigned workloads they felt were unmanageable, and being ignored or excluded by their peers.

Workplace bullying is a growing problem in the American workplace and the Nursing Profession no exception. Addressing workplace bullying and its impact on the nursing profession is paramount to upholding patient safety and decreasing nursing attrition rates. Defining the problem is the first step in addressing it. In the past, workplace bullying was referred to as “Nurses eating their young.” There are many names for the various levels of workplace bullying like horizontal and lateral violence, hostility, mobbing, and verbal abuse. Bullying actions can take place overtly or covertly. Nurse-to-Nurse bullying is known to occur during interaction communications and manifests by withholding information, intimidation, threats, verbalizing harsh innuendo and criticism, and undermining personal values and beliefs (Rocker, 2008). Power disparities are also a source of bullying. For example, using charge position for controlling staff assignments, reporting coworkers for perceived lack of productivity, placing others under pressure to achieve impossible deadlines, and withholding knowledge for policies and procedures (Rocker, 2008). Outright actions of yelling at coworkers and refusing to mentor new staff with their practice are also considered bullying behavior.

In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also

Unfortunately, bullying amongst nurses has been a dark undertone in the profession throughout it’s history. An all to common phrase of “nurses eat their young” is often expressed in current and past nursing environments. Nurses care tirelessly for their patients with compassion and grace yet don’t seem to want to take care of their own. Many have come to believe this is simply the way it is, similar to an initiation or right of passage. Bullying, incivility and horizontal violence have no place in the nursing profession. Bullying can be defined as “situations where an employee is persistently picked on or humiliated by leaders or fellow co-workers” (Longo and Hain, 2014). Horizontal or lateral violence occurs when the behavior is between colleagues, or between two nurses with the same power. Bullying can show its ugly

Not all nurses go into the profession with leadership ideas. The nursing profession must produce leaders throughout the health care system. Leaders must function as workers, and administrators with leadership qualities, while still meeting their budgets and running effective units with high functioning and happy staff members. They need to trouble shoot necessary and work with the medical faculty while pleasing their staff and the administers.

There is a difference between leadership and management, although they are similar in some ways. While, they both want to achieve common goals, influence people, and work with people, they are different. Managers aim to create consistency and

We have all heard the phrase that nurses eat their young, yet this is a sad but true reality in nursing. Most who have heard this phrase can relate to it because approximately 50% of all nurses have been victims of bullying by other nurse and an additional 27% have been witnesses to the bullying. In an article by Granstra (2015), the author identifies the prevalence of bullying amongst nurses. The term, horizontal or lateral bullying, refers to a nurse being initiated, harassed, or shown hostile/aggressive behavior from a coworker. This is differentiated from bullying from a superior which is not the focus of this paper. Granstra (2015), goes to say that the effects of the bullying have overall consequences not only to the victim but the organization they work likewise. It is noted that bullying decreases performance, therefore, patient safety is at risk and there is a higher rate of absenteeism and turnover which results in a financial impact on the facility.

Bullying is a term that many associate with children and while this has been recognized as a serious issue in schools across the country, such conduct unfortunately does not stop there. It has been said that nurses eat their young and while this may sound particularly extreme, bullying as well as lateral and vertical violence in the nursing profession has been an ongoing and increasingly prevalent issue in recent years. Nurses are commonly placed in leadership roles, and while one would think this would offer the opportunity to recognize and prevent this type of behavior in the workplace, the potential for abusing this power is high and the opposite repeatedly occurs. The impact of bullying and lateral and vertical violence can be severe and extremely detrimental for not only the individual on the receiving end, but the entire nursing staff as well as the patients in their care.

Bullying in the work place is a never a comfortable thing, especially for the victims. Nurses spend over half of their day at work, which is more than what they spend with their family. Therefore, it is important that the work force is safe from bullying and is accommodating to everyone. Bullying has been a problem in the work place for a number of years and the same goes for the nursing workforce. Bullying is a very disruptive behavior in the workplace and it can lower the morale among staff as a result. This type of disruptive behavior will cause nursing staff to call out on a regular basis, or even quit their jobs. Bullying can also lower the standard of the profession and when patients see such disruptive behavior, it also makes the profession looks bad. Moreover, bullying can be very detrimental to the nurses’ ability to care for their patients. It can have a major psychological effect on nurses, that they can loose

Leadership may mean different things to different people, the consensus opinion of experts in this field is that leadership is using power to direct and influence activities of people to achieve set goals or targets. Nursing leadership is all about every nurse providing, facilitating and promoting the best healthcare services to client and to the public. Leadership is a shared responsibility. (CNO 2012). The nursing profession need leaders that can build the capacity of nurses through mentoring, coaching, supporting, developing the expertise and management skills of nurses to make a difference to the quality of patient care at all levels of the profession ( McIntyre & McDonald, 2014 ). At the core of every leadership either political or managerial is power and how the leader uses it. While it is practically impossible to lead without power, how the nurse leader uses this power not only determine the leadership style but also the results or outcomes of what is achieved through the process.

The most pressing issue that results from this patterned behavior is its effect on patient care. Nurses are called to care for their patients in a professional manner with upmost respect and compassion while advocating and keeping them safe from unnecessary harm. However, when they work in an environment that fosters hostility, intimidation and constant criticism, they are set up for failure. The end results of nurse bullying, regardless if a nurse is a victim or not, are unhealthy and unsafe work environments. Consequently, the patients in these work environments are indirectly affected. The nurse’s priority shifts from patient-centered care, to merely keeping his/her head above water from the constant bullying. He/she becomes preoccupied with thoughts of how the situation could have gone better, how he/she could be the one to blame for something, and how everyone around him/her could not see what was happening and if they did why did no one do anything about it? This preoccupation of self is detrimental especially for those people that are under the nurse’s

Forty-nine percent of all American workers have reported that they have been affected by workplace bullying, whether they were the target or the witness (2). The nursing profession is no exception to this startling statistic. Both the American Nurses Association (ANA) and The Joint Commission (TJC) have addressed the need for a positive work environment that is “free of abusive behavior, such as bullying, hostility, abuse of authority, and reprisal for identifying abuse in the workplace” (8). Bullying in nursing is thought to begin during undergraduate education and extend into the workplace after graduation (3), with new nurses being suffering the most (6). With the prevalence of those who have been bullied in the workplace, it is safe to say that a nurse or nursing student will be the target of this type of violence at some point in their career (3). The purpose of this paper is to explore the issue of workplace bullying specific to nursing, effective and ineffective management strategies to confront this problem, and the potential barriers to addressing the situation.

Not all managers are leaders and not all leaders are managers. The biggest difference between management and leadership is people skills. In determining if a person is a leader or a manager, Bova (2008) lists some differences with which many a person would agree. One difference is that a manager directs people. Managers essentially tell employees to get the job done. Many people work on autopilot until their work shift ends. However, people will follow a leader. Leaders inspire others to want to strive for their best and to go beyond their normal duties.

As a new gradate nurses enters the working field they hear the terms “fresh meat” or “the old eat their young”. Feeling like you don’t have enough clinical experience can cause uncertainty and anxiety. But hearing the stories about workplace bullying and intimidation can cause a feeling of intimidation. “Bullying involves a real or perceived imbalance of power and repetition of the negative behavior” (Gumbus A., Lyons B. 2012) There are different types of behaviors, such as threating or yelling, it can be more insidious and passive, like refusing to cooperate or perform necessary tasks. Bullying is a serious issue, it’s an ongoing problem in the healthcare workplace. Bullying causes demoralization of the victim and decreased job satisfaction, as well as the individual feeling sadness, anxiety, depression and isolation. This disruptive behavior can foster medical errors which can lead to harm of the patients. Nurse bullying is also costly for healthcare employers. It often results in increased turnover when nurses who are bullied choose to quit their jobs rather than remain in a work environment that makes them miserable.