Strategies for Overcoming Incivility and Bullying in Nursing Profession

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the University
Author note

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Introduction
Incivility, bullying and violence are one of the major issues in nursing profession that affects the performance and
concentration of healthcare professionals working in the facility (Griffin & Clark, 2014). Where bullying and violence are acts that
affect the person’s self-confidence and harm them physically, incivility is termed as the rude, disrespectful and discourteous behavior
that affect the person in the process negatively which lead them to several actions that can harm them as well as others in the
healthcare environment (Lachman, 2014). The American Nursing Association has described the definition of bullying as the repeated
and unwanted harmful humiliation, due to which the recipient feels humiliation and distress and affects their self-confidence and self-
esteemed (Spector, Zhou & Che, 2014). On the other hand, the world health organization determines violence as the verbal or physical
act, which is delivered by the patients or colleagues within healthcare related workplace and these activities are responsible for their
health and wellbeing deterioration (D'ambra & Andrews, 2014). Due to these factors within the healthcare facility blaming,
sabotaging, disclosing personal information or unfair activities happen. The type of violence that occurs in this society that occurs in
the nursing profession are customer and client related violence, criminal activities against nursing professionals, such actions due to
personal relationship and act of bullying due to worker on worker violence or action (Clark, Ahten & Macy, 2013). These acts of
violence, bullying and incivility are as Lachman (2014) mentioned that the root of bullying and violence depends on the unvalued,
isolation, disrespectful and lack of self-esteemed are in the nursing profession due to the availability of female professionals in nursing

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profession and powerful male physicians and doctors in higher positions. Therefore, this power distribution determined the prevalence
of such act of bullying and violence in nursing profession (Ariza-Montes et al., 2013).
Background
While discussing this issue in the context of nursing profession, it should be mentioned that bullying, incivility and violence is
not a recent phenomenon in this profession as in the year 1987, a researcher Cox warned the healthcare fraternity about the damages
they are going to face due to increasing violence and bullying in the profession (Allen, Holland & Reynolds, 2015). Further, in the
Australian nursing context as well there are plenty incidences and events analyzing which can determine the prevalence and
occurrence of these unwanted phenomena in the facility (Carter et al., 2013). In the year 2012, the researchers Kvas and Seljak (2014)
included a survey in their research paper that determined that 52% of the registered nurses and midwifes of healthcare facilities in
Victoria were facing trouble in their profession due to the occurrence of violence, incivility and bullying in the workplace (Hayward et
al., 2016). Further, recently in the year 2013, the Australian federal government passed an amendment in the parliament related to the
Fair Work Act that added several new standards and specific provisions about workplace bullying and violence and the Nursing and
Midwifery Board of Australia reflected the changes in policy by making amendments as per the act (Peters, 2014).
The negative affect the new graduate nurses would face due to such prevalence of violence is easily visible by going through
the statistics that determines that the number of nursing professions dropping out first few years of service is increasing in recent time

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(Carter et al., 2013). Further, these violence and bullying activities are difficult to control because nursing colleagues, patient, family
members and visitors and members of interdisciplinary teams, could have carried out such activities and hence, majority of the cases
are not even being disclosed to the higher authority of the healthcare authority (Hayward et al., 2016). Besides these issues are much
more broader than the activity of bullying as majority of the victim nursing professionals are female and new joiners to the facility and
they do not disclose such events as they think it will affect their professional career. Therefore, the prevalence of these unwanted
activities affect majority of the female and fresh graduate nurses who transform themselves to professionals in such facility (Hurley et
al., 2016).
Research question
The research question for this narrative literature review assignment will be as follows:
What are the primary and secondary strategies that new graduate nurses can utilize to overcome incivility and bullying
in their nursing profession?
Search strategy
Search strategy is an important tool to identify research articles analyzing which the answer of research question are found and
those articles are chosen on the basis of several factors specificity of which determines authenticity of search strategy. For this

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assignment several databases, which will be used to search research articles, are: PubMed, Cochrane, CINAHL, Google Scholar and
predefined key terms related to the research questions will be searched in these databases. The key terms that were used to search for
the articles are: strategies of nurses to overcome incivility and bullying, nursing strategies to overcome bullying and incivility in
workplace, nursing profession and bullying and violence, strategies to overcome bullying and violence in workplace and
nursing profession and associated bullying and violence. Further searching these key terms in CINAHL, Cochrane, PubMed
and Google scholar provides results 120, 247, 1418, 90070 respectively. After this, all these articles were sieved through several
inclusion and exclusion criteria so that required and appropriate research articles could be used for the literature review.
Inclusion and exclusion criteria
As the articles obtained from research included several relevant and irrelevant search results, the necessary research articles
were separated from the group of obtained results using different inclusion and exclusion criteria. The inclusion criteria included
required timeline, which was from 2013 to 2018. This was important as it determined the relevancy and authenticity of the research.
Further, English language, was preferred as the inclusion criteria to increase its relativity. Finally, articles, where strategies related to
coping from bullying and incivility and violence were used for prevention of such unwanted actions in healthcare facility were
included in the assignment.

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On the other hand, research articles beyond the decided timeline for the narrative literature review, language other than English
and having partial aspect of the research question were expelled from the assignment, as it would affect the primary aim of the
research. Finally, articles, which were non-specific with strategies about workplace bullying, harassment violence, books and
informative research articles, were excluded.
Literature Review
Self-Reflection:
Two out of ten research papers reviewed by us critically talked about the experience of nursing professionals with regard to
workplace bullying (Bowllan &Nancy,2015; Meires, 2018) .workplace bullying and violence have been reported to be the most
common concerns among healthcare professionals. Statistical evidences have reported the prevalence of approximately 70% newly
employed nursing professionals being bullied and humiliated at workplace (Meires,2018). It has also been suggested that in most of
the cases there is nil availability of social support to deal with workplace bullying. 1 out of 6 nursing professionals have confirmed
being exposed to workplace violence in Australia. Numerous determinant factors such as unavailability of peer support, being yelled
upon and negative team coordination have been reported to be determinants of workplace violence.

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According to the study conducted by Bowlan and Nancy (2015), workplace violence has been on the increase in comparison to
the recent scientific trends. The research paper critically evaluates the national and international prevalence rates of workplace
bullying. In this context, the authors of the paper have effectively suggested strategies such as incorporating effective training and
framing strict policies to reduce the rate of bullying and ensure cooperation to fresh nursing professionals.
Coping Strategies:
According to Green (2018), workplace incivility has been counted as the most common form of element that disturbs the
professional environment. The paper highlights the presence of uncivilized behavior across reputed health care organizations. The
paper further suggests interventions such as mindfulness strategies to effectively cope with the problem and avoid the worsening of
the scenario at the professional front. Inclusion of meditation has been reported as an effective intervention to channelize negative
thoughts into positive outlook and create a positive work environment. Further training and intimidation by seniors can further help in
effectively dealing with the occurrence of inappropriate behavior.
Education:

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A total of 3 out of the ten research articles reviewed have focused on education and awareness to reduce the prevalence of
workplace violence (Jenkins et al., 2013, Darla et al., 2013 & Hogan et al., 2018). A research study conducted by Jenkins, Kerber and
Woith (2013) has revealed the responses of healthcare professionals to effectively change with awareness strategy aimed at
highlighting the negative implication of workplace bullying. Incorporation of a blended learning procedure to spread awareness
related to the aggressive behavior and spreading awareness about workplace harassment has effectively helped in reducing the rate of
bullying events across healthcare organizations. It has been stated in this regard that an effective visual presentation about workplace
bullying and the associated negative impact that it can create can help in spreading awareness on large scale (Hogan et al., 2018).
Educating nursing professionals about the appropriate ethical code of conduct and nursing standard can help in dealing with the
seriousness of the issue (Jenkins, Kerber & Woith ,2013). Proper training to maintain team-coordination and extend support to
individuals has been documented to elicit positive outcomes. It is pivotal to identify and prioritize the need to check workplace
bullying so as to create and maintain a positive and healthy environment that would help enhance the professional experience of fresh
nursing professionals. In addition to this, scientific studies have also reported that on account of negative workplace bullying there
have been numerous cases of employee turnover (Hogan et al., 2018).
Nursing profession has been affected greatly with the problem of employee turnover. The major issue identified with employee
turnover is the amount of workload and non-cooperative behavior by the supervisors. Insufficient support from team leaders and co-
workers has also been reported as major contributors of negative workplace experience. Lateral violence has been reported to be one