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August 16, 2012

Essay Paper on Bullying and Novice Nursing Experience


Bullying and Novice Nursing Experience

About a third of novice nurses (NNs) who experience workplace bullying (WPB) intend to leave their current position (Johnson & Rae, 2009; Laschinger, Grau, Finegan, & Wilk, 2010; McKenna, Smith, Poole, & Coverdale,2003; Simons, 2008). With the anticipated shortage of registered nurses (RNs) by 2015 (Health Resources and Services Administration, 2006) and the 581,500 estimated new RN positions projected as a future need (Bureau of Labor Statistics, 2009), increased retention of NNs is essential. Retaining NNs is problematic because the experienced nurses expected to mentor and provide support to NNs are the primary perpetrators of WPB (Dyess &Sherman, 2009; Pellico, Brewer, & Kovner, 2009).
While WPB has been linked to increased intent to leave and poor patient outcomes, few researchers measured the impact of WPB on the productivity of NNs. Given this gap in the literature, the purpose of this study was to determine the effects of WPB on the work productivity of NNs.
The healthcare environment continues to experience WPB. A one-time incident is not WPB, but sustained and repeated negative acts over a period of time perpetrated by one or more employees against a target or targets that is perceived as intentional is WPB (Einarsen, Hoel, Zapf, &Cooper, 2003). The target has difficulty defending against the negative acts of WPB, which creates a power imbalance between the target and bully (Salin, 2003) nurse and a new employee, NNs are in a unique, powerless position. They are unprepared to respond to WPB, increasing an already stressful situation (Dyess & Sherman, 2009; Griffin, 2004).
The prevalence of WPB varies from country to country, from culture to culture, and by the definition and tool used to measure WPB. In the United States, Vessey, Demarco, Gaffney, and Budin (2009) conducted the first descriptive survey on WPB (n = 303) to determine the extent of WPB in the nursing profession. More than 70% of the nurses in the sample had been bullied with half desiring to resign their job. Nearly all the nurses reported moderate to severe stress levels (90%, n = 191) following WPB.
Prevalence has since been measured from 27.3% of RNs in Washington (Johnson & Rae, 2009), to 31% in newly licensed nurses in Massachusetts (Simons, 2008), to 33% in Canadian NNs (Laschinger et al., 2010). WPB is strongly correlated to an increased intent to leave in both experienced and novice nurses (Johnson & Rae, 2009; Laschinger et al., 2010; Simons, 2008).
More than a third of the nurses who reported being bullied intended to leave their position in these studies. In addition, emotional exhaustion and taking a mental health day (not from being physically ill, but in an effort to mentally refresh from psychological stress) were problematic (Laschinger et al., 2010). Strong relationships have been found between WPB and depression, absenteeism, suicidal ideation, and other somatic complaints (Quine, 2001; Vessey et al., 2009; Yildirim, 2009). In a secondary analysis of newly licensed RNs across the United States (n =612), Pellico et al. (2009) reported verbal abuse by experienced nurses as being harsh, cruel, and traumatic.
It is this negative form of social control from senior nurses that exposes NNs to harmful physical, psychological, and emotional outcomes (Dyess & Sherman, 2009). The transition to competent nursing practice can be traumatic as a result of unmet learning needs, reality shock, and poor communication with coworkers (Benner, Sutphen, Leonard, & Day, 2010; Dyess &Sherman, 2009). Acts of WPB create an interference (MacIntosh, Wuest, Gray, & Aldous, 2010) and a stressor (Bond, Tuckey, & Dollard, 2010), impeding nurses’ ability to concentrate on the complexity of tasks related to patient care. Building self-confidence and competence in nursing care is important to NNs’ success and retention.
In the healthcare environment, WPB continues to merit investigation. There is little known about this phenomenon and why WPB continues in the healthcare environment. There are gaps in prevalence, measuring, and how WPB affects NNs’ productivity. Thus, the purpose of this study was to determine the effects of WPB on the work productivity of NNs.

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