I just returned from the Sigma Nursing Healthy Work Environment Conference. During this conference, nurses from around the world shared their research findings related to cultivating a healthy work environment. While only a small percentage of the presentation topics included bullying or incivility, it was clear that the global nursing community recognizes the negative impact bullying and incivility have on a healthy work environment. The research shared was remarkable!!
However, I still got the sense that there’s more effort in STUDYING disruptive behaviors and less in DOING something to stop it.
WHAT THE STUDIES SHOW
Disruptive behaviors, including nurse bullying and incivility, continue to plague healthcare organizations, even after being researched for over 25 years!
- 48% of registered nurses admit to being bullied in the workplace during the previous 6 months.
- 43% of nurses experienced at least 2 negative behaviors on a weekly/daily basis;
- A 2017 blog post by Pittsburgh-based Select International Healthcare indicated roughly 85% of nurses have been abused by a fellow nurse. Approximately one in three nurses have considered quitting the profession due to bullying!
These are just three of a gazillion statistics on bullying and incivility. We talk about how bad it is, warn new nurses about it during residency programs, and study, study, study the topic. But what are we DOING about it?
Please do not misinterpret my opinion. I’m not suggesting that we should stop conducting research on this topic or that studying the effects of disruptive behavior isn’t valuable. What I am suggesting is that we need to exert just as much if not more effort into taking action. We can study, study – talk and talk, but it’s time to take action.
TAKING ACTION AGAINST BULLYING
During the Sigma Conference, I had the great honor of sharing the stage with Dr. Denise Stewart from Baylor Scott & White Medical Center – Temple and watch Ivette Roldan from Nicklaus Children’s Hospital accept the Healthy Work Environment Award.
Both BSW and Nicklaus took action when they realized bullying and incivility were an issue. They reached out to me for help and implemented my healthy workforce intervention, which ultimately decreased turnover, improved nurse and patient satisfaction scores, and improved patient care.
Sharing the stage with Denise and watching Ivette receive the award were some of the proudest moments in my career. This feeling of pride didn’t come from a place of ego (well, maybe a little). It came from a place of humility knowing that although I was their guide, they, the leaders and employees at Baylor Scott & White Medical Center and Nicklaus Children’s Hospital, are the true heroes who stepped up by declaring…” we don’t play that [bullying and incivility] game anymore.”
3 mindset shifts these organizations adopted:
- Although it’s important to determine how disruptive behaviors are showing up in your organization, don’t spend all of your time and energy studying it. Focus more of your time and energy on DOING something about it.
Many times when an organization reaches out to me for help, I discover that they started taking action by forming a committee of people who are charged to tackle the issue of disruptive behaviors. They identify subcommittees, meet regularly, review their data (employee engagement scores, satisfaction scores, etc.) and talk about the bullying and incivility. However, they spend all of their time talking about it but don’t necessarily take action. Why? In most cases, it’s because they don’t know where to begin. Like a hamster on a wheel, they just keep running.
BSW and Nicklaus got off the wheel. They took action.
- Don’t just throw every possible intervention against a wall and then watch to see what sticks. Changing a culture requires a strategic approach. Seek help from an external expert if you don’t have the expertise or bandwidth to tackle this issue on your own.
One of my favorite examples is from an executive leader who said, “Well. Now we know we have a problem [bullying]. I’m not an expert in this topic. Who is? Let’s ask for their help.” Far too often, organizations think they can use existing employees, typically educators, and assign the task of solving the problem to them. Although the intent is good, most often, they don’t succeed because it’s just ‘one more thing’ on their already overfilled plates.
- Transforming a culture takes a top down, bottom up, and everything in between approach. You can’t just put the leaders in a room and decide how you’re going to tackle this problem. You need to involve everyone if you truly want to eradicate disruptive behaviors.
At BSW, we asked their patient experience counsel (shared governance) if they wanted to lead an initiative called, “Sacred Spaces”. I created this initiative to address a common way disruptive behaviors show up in healthcare – yelling, criticizing, gossiping, etc. in patient care areas. When we presented the opportunity, the members of the counsel said, “Oh. We should own this. This initiative should be ours.” And they ran with it!!! It was amazing to see this group of nurses take total ownership of this initiative and then watch it spread across the organization.
Successful interventions exist for resolving bullying and incivility. Healthcare organizations and leaders who take a proactive approach against bullying and incivility may find themselves better positioned to address it, like Baylor Scott & White and Nicklaus Children’s Hospital did.
A few organizations would be ready for an intervention because they “get it” and understand how disruptive behaviors have a significant negative impact on human capital, patient outcomes, the nurse, the profession, and the organization. Some will even take these recommendations and implement on their own. You may be among the few that has the expertise and bandwidth to implement successfully.
Or you may be among the majority of hospitals who are lacking the expertise and bandwidth (time) and understand that it’s often best to have someone come in and implement this process.
If you want to discuss how you can achieve similar success, contact the team at the Healthy Workforce Institute at firstname.lastname@example.org
We’d love to support your efforts to cultivate and sustain a healthy workforce culture.