N419 Exam 2: Workplace Violence & Incivility Graded A+

How does the national institute for occupation safety and health (NIOSH) define workplace violence? - ANSWER violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty Does workplace violence refer to overt or covert behaviors? - ANSWER Both, ranging from offensive or threatening language to homicide What is considered violence? - ANSWER Overt and covert behaviors Threatening actions Violent assaults What are examples of threatening actions? - ANSWER Waving fists, throwing objects, or threatening body language Verbal or written threats Physical attacks - slapping, hitting, biting, shoving, kicking, pushing, beating What are three types of violent assaults? - ANSWER Rape Homicide Attacks with weapons (knives, firearms, bombs) What is horizontal violence? - ANSWER (lateral aggression): aggressive and destructive behavior of co-workers against each other. What is horizontal violence also called? - ANSWER lateral aggression Bullying Interpersonal conflict What is incivility? - ANSWER Includes behaviors from ignoring to rolling eyes, yelling, abusive language & personal attacks. What behaviors are considered bullying? - ANSWER 1. Verbal abuse or harassment 2. Threatening, intimidating or humiliating behaviors (also nonverbal) 3. Work interference What is work interference? - ANSWER sabotage - which prevents work from getting done Bullying is behavior that is ________________, _____________, and ___________. - ANSWER aggressive intentional frequent Is bullying usually deliberate? - ANSWER Typically What is bullying an attempt to do? - ANSWER To control employees How is bullying perceived by the target? - ANSWER As a hostile act Workplace Bullying Institute survey in 2014 estimates that: §________ million US workers are directly impacted or witnessed - ANSWER 65.5 69% bullies are ________ §57% of targets are __________ - ANSWER men women Women bully women in _____% cases - ANSWER 69 Is bullying or sexual harassment more common? - ANSWER Bullying What is not considered bullying? - ANSWER Illegal harassment and discrimination, setting high work standards, having differences of opinion or providing constructive feedback What are the five recognized categories of workplace bullying? - ANSWER 1. Threat to professional status 2. Threat to personal standing 3. Isolation 4. Overwork 5. Destabilization What is an example of a threat to professional status? - ANSWER public humiliation What are examples of threats to personal standing? - ANSWER name calling, insults, teasing What is an example of isolation? - ANSWER withholding information What is an example of overwork bullying? - ANSWER impossible deadlines What is an example of destabilization? - ANSWER failing to give credit where credit is due What are the consequences of lateral violence and bullying in nursing? - ANSWER Low staff morale Increased absenteeism Attrition of staff Nurses leaving the profession Deterioration of the quality of patient care Unmanaged anger leads to insomnia, hypertension, depression, and GI upset How does bullying cause the staff to feel? - ANSWER Low morale What behaviors may staff exhibit if bulling or violence is occurring? - ANSWER Absenteeism Attrition Leaving the profession How does bullying or violence affect patient care? - ANSWER Deterioration of the quality of patient care What four medical conditions does unmanaged anger lead to? - ANSWER Insomnia, hypertension, depression, and GI upset A study of 130 nurses demonstrated unsafe practices as a result of incivility. These practices included Interpreting an ________ order rather than asking for _________________ Lifting or ambulating ________ patients without asking for _______ Carrying out orders not considered to be in the best interest of the ___________ without _________________ them - ANSWER unclear clarification heavy help patient challenging According to the Joint Commission, organizations that fail to address unprofessional behavior are - ANSWER indirectly promoting such behavior Uncivil behavior undermines the healthcare team's _______________ & can lead to medical _______ and _______ _____________ - ANSWER effectiveness error poor outcomes Do perpetrators of incivility see the effects of their behavior? - ANSWER Most are unaware of the effects of their behavior A study of 26 newly licensed RNs hired into their first jobs - educational sessions on identifying incivility and the appropriate responses/behavior. One year later, _______% of those who experienced instances of incivility _____________ the offender - ANSWER 100 confronted When confronted, responses from the perpetrator included - ANSWER •Shock that the new nurse was offended (75%) •Apologies for the behavior (58%) •Shunning of the accuser for a short period (25%) However 100% of the instances of incivility _____________ after confronting the perpetrators! - ANSWER stopped What safety system and culture should be established to protect against bullying? - ANSWER A safety system and culture that has ZERO tolerance; make this a core value of all leaders in the organization What role do leaders have with bullying? - ANSWER Leaders should confront bullies and support the targets of bullying Who should confront a bully and support the targets? - ANSWER Leaders Who should report bullying? - ANSWER Employee What is the employees role with bullying? - ANSWER Report the behavior What education protects against bullying? - ANSWER Educate on appropriate professional behaviors What accountability should be present to protect against bullying? - ANSWER Hold everyone accountable for modeling desirable behaviors What four things should an organization develop policies to address? - ANSWER 1. Bullying 2. Reducing fear of retaliation 3. Responding to patient and families who witness bullying 4. Beginning disciplinary actions (how and when) Reducing fear of _________________ - ANSWER retaliation Responding to ____________ and ____________ who witness bullying - ANSWER patient and families Beginning _________________ actions - ANSWER disciplinary What about disciplinary actions should be identified? - ANSWER How and when Nearly 75 percent of all workplace assaults between 2011 and 2013 occurred in the - ANSWER healthcare industry Between 2000 and 2011, _______ shootings resulted in an injury on the grounds of U.S. hospitals - ANSWER 154 ____ percent of emergency medical workers experience physical violence during their careers - ANSWER 80 ____ percent of nurses report verbal assaults each year - ANSWER 39 ____ percent of nurses report physical abuse each year. - ANSWER 13 Is workplace violence in healthcare usually reported? - ANSWER Workplace violence in healthcare is largely underreported! In 2009 there were 2,050 assaults and violent acts reported by RNs requiring an average of __ days away from work - ANSWER 4 In 2009, the Emergency Nurses Association reported that more than ____% of emergency center (EC) nurses had experienced violence by patients on the job and _____% of EC nurses had experienced 20 or more violent incidents in the past three years. - ANSWER 50 25 What are the consequences of workplace violence? - ANSWER Physical injuries Psychological trauma Mistrust administration What physical consequences are there? - ANSWER Physical injuries Disability Death Healthcare costs of injured workers What psychological trauma occurs from workplace violence? - ANSWER Psychological trauma Increased stress Impacts the quality of patient care What occurs to work environment as a result of workplace violence? - ANSWER Mistrust of administration Exacerbate a hostile work environment Absenteeism Turnover §280 million spent on preparedness and prevention of __________ violence including emergency preparedness training, community-based prevention programs, and staff training for violence-related trauma - ANSWER community