Wednesday, May 29, 2013

Bullying for New Graduates

Introduction Getting a job, for new graduates, is already a tough task. However, there is even a tougher challenge facing those who get jobs in their new places of work. In most of the organization, office bullying targeted to fresh graduates is a common problem. Even if there has been acknowledgement of the occurrence of reality shock as part of fresh graduate transition for many years, there is sufficient evidence suggesting that the issues with nursing transition have become more serious in the recent past. Bullying has a problem in nursing transition has been evident in the phrases such as “nurses eat their young.” Majority of the nurses will acknowledge having gone through the experience of bullying as they entered the practice (Coletti, et al. 2012). This paper discusses bullying in the nursing organizations and some of the important issues surrounding it. As fresh graduates, individuals are normally excited to experience their new skills in the work environment. However, history has revealed that this is hindered by the older nurses. Although there is no universal definition of bullying in nursing, most of the researchers contend that ongoing efforts to cause another individual emotional or physical harm or injury amounts to bullying. Bullying can reflect on real or supposed imbalance of power. However, bullying can also happen between friends and peers. In the nursing environment, bullying may happen in form of relational aggression. This is a form of bullying which suggests that utilization of social and psychological actions instead of physical harm (Todres, Galvin and Holloway, 2009). According to Cleary, Hunt and Horsfall (2010) it is at times typified as covert or overt bullying, but which could be misleading, such as terming a co-worker as being incompetent to his or her face. This is an overt kind of relational aggression. Some authors have utilized the term horizontal or lateral violence in describing bullying among nurses in the workplace (Becher and Visovsky, 2012). However, the too terms tend to be limiting. This is because they refer to bullying among individuals within the same level in the hierarchy. Becher and Visovsky (2012) posit that bullying in the workplace also happens between individuals at different levels in the hierarchy. This is for example when a senior nurse bullies fresh graduates. Bullying can occur past working hours and the period of employment. Bullying can also happen in person or in cyberspace. Factors contributing to bullying Although bullying is common in all organizations, it is a problem more prevalent within the nursing organizations. As a matter of fact, some of the nursing organizations can be suggested to have a bullying culture. In a study carried out in Australia, it was revealed that over 4,000 critical-care nurses, 18 percent suggested that they had experienced verbal abuse in the hands of other nurses. Approximately 25 percent gave rating of the quality of teamwork amongst registered nurses (RNs) as poor or fair, and 22 percent gave rating for respect for other registered nurses (RNs) as poor or fair. In the environment with such a culture, there is a vicious cycle of bullying. In most organizations, management hierarchies encourage and enable domineering conditions, like insufficient staffing ratios, incapability to take uninterrupted meals or breaks, limited supplies, and low credit for the ability of nurses to think critically. Such conditions have continued to fuel the problem. In such an environment, bullying continues generation after generation. Sociological literature revealed that the group which is oppressed tends to act out against each other due to lack of control (Vessey, Demarco and DiFazio, 2010). Hutchinson et al. (2008a) suggests that bullying faced by fresh graduates in the area of nursing is as a result of a vicious circle in the management hierarchy. In the environment where the leaders within the organization are not satisfied with the way things are being done, the problem feeds down the hierarchy to the people at the lowest level. This is the reason why fresh employed graduates are the easier targets, particularly of their immediate supervisors. Hutchinson et al. (2008a) argues that there is a new aspect of bullying in the nursing organizations which was not around a generation in the past. With the development in technology, and the introduction of new devices into the industry, there is a whole new subdivision of the nursing population which is going through the criticizing and disparagement which was in the past reserved only for the fresh graduates. This kind of bullying is very common and is directed to both the fresh nurses as well as the older ones who are technologically challenged. Hutchinson et al. (2008a) posits that there are some events or situations which predispose some people to being bullied, one to being bullied. For the fresh graduates, their skills and experience can play an important role in their being bullied. The bullies are the normally the nurses who feel threatened by these skills and experience. Some of the situations that can also cause bullying by the older nurses include fresh graduates or new hires; getting a promotion or any other honor which the older nurses perceive as undeserved; getting special attention from the physicians; having problems working effectively with the older nurses; an going through serious understaffing (Coletti, et al. 2012). Impacts of bullying Males and females express negative emotions differently across varying ages as well as developmental stages. This has been found especially relevant to professions which are female-dominated such as nursing. Most of nurses in the hospital are restricted to small areas and are supposed work schedules which do not allow the chance to take time for short break. Tensions are thus common with the profession and are made worse in the environment where there is bullying or harassment. The impact of bullying in nursing organizations is as serious today as they were decades ago. The effects of bullying include job dissatisfaction, compromised performance, staff turnover and increased absenteeism (Laschinger et al. 2010). Bullying of fresh nursing graduates has serious effects on their performance which impacts negatively on many other aspects of their work. Bullying affects the effectiveness of the nurses who are targeted. This is mostly because rather than thinking about how they can use their skills and knowledge in doing their work, their thoughts are diverted to the way they are treated by the other nurses and the leaders. This affects the quality of care as well as the safety of the patients. In the environment where quality of health care is affected, the entire society suffers. There is also a negative effect on the image of the organization (Eagar, et al. 2010). MacKusick and Minick (2010) posit that retention of nurses has remained a major problem for nursing organizations. This problem is made worse by bullying of fresh nurses as the problem poses a huge risk of resignation in the initial year of practice. Some nurses find it extremely work to work in an environment where they are bullied and as a result end up resigning. Fresh nurses are view themselves as being helpless and unable to change their situation within the organization. This causes them serious stress and other psychological problems that make their performance to decrease. Some of these problems are so serious that the nurses are not able to continue working (Hutchinson et al. 2008b). Edwards and O'Connell (2007) suggest that bullying at the workplace has also been revealed as having negative effects on patient outcomes as well the delivery of quality of care to the clients. There is also the issue of the erosion of professional wellbeing and personal health of the fresh graduates. Effectiveness and quality of care to clients is only possible in a setting with open communication as well as respectful professional relations. This is the kind of condition which is missing where the organization condones bullying. Professional communication cannot happen where there is evidence of bullying. Collaboration and team working is also not possible in this kind of environment. Recommendations Research reveals that there is loss of about 18.9 million working days due to bullying. It is unfortunate that most organization do not have in place effective mechanisms to address the problem. It is not a surprise to learn that the greatest turnover in majority of the nursing organizations happen among the fresh graduates in their initial year of working. In Australia, it is noted that the turnover is 25 percent per annum. Gaffney, et al. (2012) suggests that this is a critical issue considering that 10 percent of the present workforce in nursing is fresh graduates. Even if some of this turnover might be unavoidable, most of the losses can be avoided in an environment where the nurse leaders become aware and address of the needs of the fresh graduates, as well as support them better in their transition in the nursing practice. Most of the experts in this area view transforming of a negative work situation as the role of the management or the administrators. Hutchinson et al (2008) suggest decentralization of authority and creation of “more democratic and less hierarchical workplaces” (p. E68). There have been some efforts in different parts of the world, aimed at addressing the issue of bullying in the workplace. Edwards and O'Connell (2007), cites the “Zero Tolerance” directive developed in Britain in the year 1999. The aim of the directive was “preventing violence and bullying incidents against and among National Health Service staff, as a model for adoption by nurse educators” (p, 29). There was also a recommendation for students to receive “formal preparation to deal and cope with bullying” (p. 30). Hutchinson et al. (2010b) argues that nurses being oriented on a novel unit would profit from this kind of training. The nurse leaders would begin by carrying out studies on the nurses in their individual departments regarding the perceptions of the emotional environment. This can be done through the use of questionnaires in an anonymous manner. The surveys are important in identifying whether or not there are cases of bullying or relational aggression amongst the nurses working on the unit or department. In case the results of the survey reveal that there is an issue of bullying, interventions should be designed that will involve all the members of the unit. For instance, a campaign can be developed to create awareness on the issue and the ways of addressing it. Once the nurses are reading from the same script regarding the problem, it can be an important point to begin a discussion from where to brainstorm possible solutions. Gaffney, et al. (2012) suggests a process for dealing with critical conversations: the ones in which the stakes are very high, emotions are strong and there are varying opinions. It is argued that an environment where other feels that there are efforts towards a common objective, there is promotion of effective dialogue. The suggestion for effective dialogue entails the ideas of personal responsibility and assertiveness: ‘owning one’s feelings, stating facts, openness, and requesting for feedback. The World CafĂ© is an approach that encourages conversation which matter with the use of seven directing principles. This approach involves coming together of different groups in an environment that is welcoming, suggesting questions which draw out effective dialogue, encouraging all the members to participate and contribute, paying attention to insights and patterns and giving room for collective knowledge in suggesting solutions (Hutchinson et al. 2010a). With the acquired knowledge, it is possible to come up with guidelines for addressing the particular needs of the department or unit. In an environment where the culture of the organization encourages bullying, guidelines should be developed and followed to change the culture. This can be achieved through establishment of a committee to survey the problem in greater details, creating a code of conduct as well as needing the employees to sigh it regularly, creating an assertive communication procedure which is standard, and developing a conflict resolution approach for the organization or unit. There are various sources of information on conflict resolution methods that can be effectively used. Nurse leaders should be able to define the culture of the unit and clearly create guidelines for behavior that is acceptable within the unit. Under the guidelines, there would be consequence for unacceptable behavior amongst the nurses (Johnson, 2009). Conclusion Bullying of fresh graduates in the workplace is a common problem in most organizations, but is a major problem in nursing organizations. This paper has discussed bullying in the nursing organizations and some of the important issues surrounding it. There are various factors, personal and organizational that cause bullying in the nursing organizations. This is unfortunate due to the serious consequences that result from bullying. It is thus important that the administrators of health care organizations come up with ways of dealing with this problem. Some recommendations from the literature have been given in the essay. 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