Sample Nursing Paper on Nursing Workplace Incivility “Nurses Eating Their Young”

A known and ongoing issue of concern in nursing practice is workplace incivility. Nursing students begin their career with the pressure of experiencing bullying from their experienced colleagues at their workplaces. “Nurses Eat Their Young” is an internationally known idiom, that has surprisingly been in existence in the nursing profession for more than 30 years. In nursing, the idiom is basically used to refer to the bullying that newly licensed nurses experience during their practice (Edmonson. Bolick & Lee, 2017). This paper will therefore focus on exploring this particular ethical issue of concern, which affects a majority of graduate nurses. In addition, it will examine the nursing ethical principles associated with workplace incivility and the importance of this issue in healthcare as well its future implications to nursing practice. Finally, the paper will offer some of the ways in which this issue can be resolved.

“Nurses Eating Their Young”: A Culture of Incivility

Workplace incivility is a phenomenon that has been in existence in the healthcare industry for decades, and in a country like the United States it is estimated to cost approximately $24 billion dollars annually (Kaiser, 2017). Other terms that have been used to describe this phenomenon include; nurses eating their young, violence (both lateral and horizontal), bullying, non-physical aggression, interpersonal conflicts, harassment and verbal abuse. It entails actions that involve finding fault in others, devaluing comments made by others, belittlement, criticism and violence. Therefore, work incivility can be simply defined as low intensity, aberrant behavior with equivocal intention of harming the target, while violating the workplace norms of mutual respect. According to Gillespie, Grubb, Brown, Boesch & Ulrich (2017), the incidence of bullying against nurses is at 30%, with newly licensed nurses being more affected (72.2%). The main problem associated with this culture of incivility is the fact that future generations of nurses will ultimately get infected and hence adopt bullying behaviors, making it a contagion difficult to address. It’s unfortunate that this behavior gets justifications such as it being a rite of passage for the newly licensed nurses, a normal thing that all new employees should experience and an outcome of organizational factors, e.g. high job demand. Work incivility in the nursing profession has been associated with negative consequences such as reduction in work productivity, lack of job commitment and inefficient communication and ultimately, poor patient outcomes (Kaiser, 2017). It is without doubt that work incivility in the nursing profession can tremendously affect patient safety, hence the need to address it.

Significance to Health Care

Nurses play a number of roles in healthcare settings. Their major role however is patient care and quality patient care is a major goal for healthcare providers. As mentioned above, work incivility results to poor work performance, which is directly associated with quality of patient care. Bourdon (2015) explains that disruptive and unmanaged behaviors such as verbal abuse and harassments affects delivery of healthcare services and hence results to poor quality of patient care. This is blanketed by the fact that bullied nurses find it difficult to communicate not only with their colleagues, but also with their patients. This difficulty in communication affects how they deliver important patient information and as a consequence, bullied nurses withhold relevant patient information and delay communication which ultimately result to patient injuries and sometimes death (Edmonson. Bolick & Lee, 2017).

Therefore, work incivility has detrimental effects on healthcare and in nursing it not only affects the nurses who experience bullying, but it also affects how they deliver their services which ultimately affects quality of patient care. One of the most important quality that every nurse should possess is effective communication skills. This phenomenon of “nurses eating their young” literally takes away this skill and it becomes difficult for the nurse to communicate with the patient. Effective communication has its own great significance in nursing practice because it strengthens the bond between the nurse and the patients. This improves patient’s ease and comfort and makes it easier for the nurse to acquire relevant diagnostic information from the patient. This issue therefore matters in healthcare because it affects employee satisfaction, provision of quality care and patient’s safety and outcomes. Moreover, the fact that future generation of nurses are being infected with workplace incivility, indicates that there could be a deterioration of the quality of care that patients receive in future (Gillespie et al., 2017).

Ethical Principles Involved

The nursing profession is guided by certain ethical principles that all nurses are expected to adhere to in their practice. Nurses are also expected to collaborate with other healthcare professionals, to ensure patient safe and quality patient care. There are some nurses’ roles that require instructions by the physician, while there are others that require the nurse to make own judgement. The two key ethical principles that guide the nursing profession are beneficence and non-maleficence. beneficence means doing good for the benefit of others while non-maleficence means doing no harm to others. It is a nurses’ obligation to ensure that they do good, and avoid actions that cause harm to the patients. This means that in their practice, nurses’ actions need to be beneficial to the patient, while avoiding actions that can cause them physical or psychological harm. Nurses who are prone to bullying their co-workers often end up doing it in front of the patient, who end up feeling disrespected. Such disrespectful behavior affects the patient negatively, and they end up feeling unsafe in the hands of either the recipient or the perpetrator of the actions. Moreover, ineffective communication is one of the actions that are considered to cause harm to the patient and for this reason, balancing the principles of non-maleficence and beneficence is a difficult task for nurses. Another ethical principle applying to this issue is accountability. Though who bully other, end up blaming the recipient once a mistake is made.

Resolving the Ethical Question

Failure to provide quality patient care is the most significant consequence associated with workplace incivility among nurses. Effects of poor work performance and lack of job commitment are all oriented towards poor patient outcomes. Workplace incivility affects the ability of nurses to do good to all patients while preventing harm. The outcomes associated with workplace incivility contradicts the role that nurses are expected to play in healthcare setting (Kaiser, 2017). There is therefore a need to eliminate this phenomenon, through actions that will break the cycle. The American Nurses Association and the Joint Commission have been on the limelight in an attempt to eliminate work incivility through issuance of statements against the phenomenon. Though its unclear what causes incivility, the problem can be resolved through enhanced communication skills and conflict resolution skills. Through resolution of this problem, nurses can learn to behave in ways that can benefit the patients, and in ways that will not harm the patient. Moreover, nurses can learn to be accountable for their mistakes all in benefit of the patient (Gillespie et al., 2017).

Relevance to Nursing Profession

            Behaviors that entail workplace incivility ultimately affects patients. However, nurses are equally affected with estimations stating that more than 60% of new nurses quite their jobs due to workplace incivility. Others end up quitting the profession all together which ultimately cripples the profession. The worst thing about incivility in this profession is that those that bully others are tolerated with the justification that they more experienced and hence more resourceful. However, the truth of the matter is that more patients are harmed and nothing gets done about it. The ultimate result of this is failure to perform the obligations associated with nursing practice, which include promotion of patients’ health and quality of life through prevention of diseases (Gillespie et al., 2017).

Conclusion

            The nursing profession has been for ages described as one that “eats its young”. Rather than playing as role models, the experienced professionals behave with hostility towards their novices. This makes it difficult for the newly licensed professionals to perform their work obligations effectively. This not only affects the performance of the future generation of nurses, but is also makes it seem like a thing that should be tolerated. Workplace incivility should be unacceptable, and eliminating it in the healthcare industry can improve both employee satisfaction and patient outcomes. Nursing is a profession that should uphold integrity and behaviors that entail work incivility not only threatens the profession but it also affects patient safety (Gillespie et al., 2017).

 

References

Bourdon, L. Eliminating lateral violence among perioperative nurses. (2015). AORN Journal,                101(5), P4.

Edmonson, C., Bolick, B., & Lee, J. (2017). A Moral Imperative for Nurse Leaders: Addressing     Incivility and Bullying in Health Care. Nurse Leader, 1540-44. doi:10.101/j.mnl.2016.07.012

Gillespie, G. L., Grubb, P. L., Brown, K., Boesch, M. C., & Ulrich, D. L. (2017). “Nurses eat their young”: A novel bullying educational program for student nurses. Journal of Nursing Education and Practice, 7(7), 11. doi:10.5430/jnep.v7n7p11

Kaiser, J. A. (2017). The relationship between leadership style and nurse-to-nurse incivility: turning the lens inward. Journal Of Nursing Management, 25(2), 110-118. doi:10.1111/jonm.12447