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
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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
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