nurse bullying, workplace violence, incivility, bullying, horizontal violence

Studies show that when organizations have a high rate of bullying, they have worse patient outcomes. We know this.
But why?

Because bullying behavior creates an information bottleneck. When nurses are treated poorly by other nurses, physicians, or leadership, they stop talking.
Information stops flowing- information regarding patient care, process improvements, and quality.
Megan isn’t sure her patient’s chest tube is working properly but doesn’t want to ask her colleagues to double check. The last time she asked a nurse to double check something, that nurse made her feel like an idiot. Megan justifies her silence by thinking that perhaps the chest tube is fine and that she is being paranoid. 2 hours later, the patient suffers a tension pneumothorax, has to be intubated and transferred to the ICU. Megan feels responsible and beats herself up for not having the courage to speak up.
Mark is concerned about his patient and wants to call the physician. But when he looks at the call schedule, he sees that the on-call physician is one notoriously known for screaming and yelling at nurses. Mark makes the decision NOT to call and hopes the patient is okay until the end of his shift.
When surveyed, 68% of nurses saw a link between disruptive behavior and adverse patient care events.
Bottom line – bullying behavior decreases the flow of information and therefore constitutes a HUGE patient safety risk.
How to uncork the bottleneck:
FIRST, recognize that as nurses we have an ethical responsibility to our public to speak up EVEN IF we are met with nastiness.
SECOND, take the “mother test.” If the patient was YOUR mother, would you want her nurse to double check things, call the physician even thought the physician will yell, or alert someone to a quality or process issue that my indirectly affect her? OF COURSE YOU WOULD.
And THIRD, any time you speak up and are met with nastiness, always direct their comments and the conversation back to the patient. “I’m concerned about this patient and need your help” or “Help me to understand why you are screaming at me (or making fun of me) when the issue is about the patient – not me.”
Remember, our patients (and potentially your mother) need us to keep the flow of information moving. Speak up. Even if you’re uncomfortable – speak up anyway. Someone’s life might depend on it.
Get rid of the cork!
Thanks so much for reading. I’d love to read your comments about the information bottlenecks in your organizations due to bullying.
Take care and stay connected

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About the author: Dr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations improve the work environment. To find out how you can bring Renee to YOUR organization or nursing event, click here.