NURS 300 Professional Transitions In Nursing

Why is conducting a formally written literature review important for BSN prepared nurses?
Nurses’ are required to possess excellent problem-solving skills to provide quality-nursing care. In addition, nurses must be able to use both logical and critical reasoning skills to coordinate and manage their patient’s nursing care. This required knowledge goes well beyond the day-to-day tasks.
Because nurses need to practice evidence-based care, they naturally are consumers of research. Nurses need to be able to compare and contrast, critically analyze and finally, synthesise study findings as presented in the literature.
BSN prepared nurses can go on to post-graduate education, and must be prepared adequately to do so, regardless if they wish to obtain a post-graduate degree or not.

Based on these facts, the major assignment in this unit is to conduct a literature review on a topic that is relevant to the transitioning nurse.

Narrative Literature Review Topic
While nursing is a profession dedicated to helping others, the highly charged nature of many of the environments in which nurses work can lead to situations where emotions boil over.
Incivility, bullying, and violence in the workplace are serious issues in nursing, with incivility and bullying widespread in all settings. 

Introduction

People in the modern world have generally become more aware of their surroundings, and they know how they should be treated by other workmates and even clients. Almost everyone across the globe is aware of his/her self-esteem and value in the society than in the past (Hodgins, MacCurtain & Mannix-McNamara, 2014). The reason which is making people more aware of how they should be treated is due to rise of things like human rights which emphasizes equality of all people in the society. People know their rights in the working environment, and they are even aware of what sort of environment they should work in (Misawa & Rowland, 2015). From this perspective, most people think that working condition refers to the physical environment in which they work into and it should free from hazards. However proper working environment can also refer to a healthy environment in which employees are shown some respect by their fellow employees and employers and they are not mistreated, and they are given a chance to participate in the decision making of the organization which makes them feel valued. In the past, people were exposed to hazardous and dangerous working environment which were harmful to their health. In contrast, in the modern world, we are living today people are more aware of the problems which were encountered in the past, and they cannot hesitate to expose any hazards in the workplace.

Background 

Despite having awareness aimed at protecting human rights in the workplace, some individuals still do not realize that they are facing workplace problems (Condon, 2015). The working environment does not necessarily need to be hazardous, but they can be considered inappropriate in case employees are exposed to bullying and incivility in the course of their operation as employees are exposed to stress. Bullying is a type of hazard which employees are mistreated by their supervisor and even their fellow employees. Statistics which have been conducted indicated that 2 million people who are working are bullied, and at least one person in a group of four people is bullied at least once for the past five years. Bullying is said to occur to a person at work when they are subjected to aggressive behavior from their friends and supervisors (Laschinger, 2014). Bullying is the process in which an individual feel intimidated by someone who uses their strength and power to mistreat and hurt them. The presence of this person makes them feel uncomfortable and vulnerable to the extent that they feel stressed which demotivates them and they are not able to operate effectively. Research conducted indicated that it is very significant to expose bullying because it causes anxiety which leads to physical and mental distress. Six million working days are lost annually due to stress caused by bullying, job insecurity and long hours. People who are exposed to bullying are said to have a poor health condition, and they are not motivated to perform their work effectively. They are also believed to have low productivity and increased rate of absenteeism as compared to those who are not bullied. Bullying is long-term harassment which is aimed at a target person (Read & Laschinger, 2013). Incivility, on the other hand, is defined as rude and discourteous actions like gossiping, spreading rumors and in actions such as refusing to help other when requested to do so. Incivility can occur in healthcare sector because healthcare professional operates an environment that involves life and death situations.

Methodology and search strategy

The paper uses the following database to search for relevant information which can give clear understanding of the topic. The search for this literature uses articles which were published between 2013 to 2018. Databases such as Cochrane library and MEDLINE were used to retrieve significant information. Terms such as “bullying and incivility in healthcare sector”, “types of bullying and incivility”, “how new nurse graduate are affected by bullying and incivility in their workplace” and “strategies which new nurse graduates can use to overcome bullying” were used in the literature review.  Significant journals and articles which can help in future development of the nursing career were also picked. The search for this literature review was only limited to search strategy and keywords which are published for the last five years.

Types of bullying, incivility, and violence in the workplace

There are different workplace bullying, incivility, and violence which young nurse graduates are exposed to in the health sector of Australia. Some of this activities involve blaming young nurse graduates unreasonably by senior healthcare professionals for their own mistakes. This happens mostly to young employees to an organization because no one believes them even if they make complains and the bullies are seniors. Been treated differently is another form of bullying (Lachman, 2014). This happens mostly to individuals who are isolated by their supervisors and seniors from the first time they join the organization because they are more skilled and competent in their fields and seniors are jealousy of them, and they are afraid they may end up taking their positions. This happens to the seniors who have already built lobbies and they are okay in their comfort zone and they don’t bother doing anything to enhance their skills and thus they resist to take new people in their groups because they’re not secure about their positions. Lobbying is the base of rumors and grapevine in the organization.  When there are lobbies and groups, people defend and support their group and in the process they criticize each other for no good reason (Griffin & Clark, 2014). The criticism can have negative impacts on the organization in case they keep on happening in daily basis resulting into serious issues. Sometimes it can be a group of people against one person just because the person may be having more skills and knowledge than them. This can lead to violence to the extent that the person by end up been beaten by the group.

Humiliation in front of a guest is another form of bullying and incivility which young nurse graduates from Australia suffer from. This is because their seniors are aware that if they attack and humiliate young employees in front of a guest their confidence will go down to the extent that they can end up making some more errors. Seniors also do this in front of guest so that they can attract their attention and make the new nurse graduate feel like an amateur who does not know anything about what they are doing (Griffin & Clark, 2014). Excessive monitoring is another form of bullying which makes young employees uncomfortable and they are not been able to offer their best. This is mostly done by supervisors, but sometimes they overdo it especially for new employees who sometimes make them think they do not know anything and thus leading to low and reduced productivity in the organization. Some people do not like been monitored especially throughout. Though, monitoring the progress of employees is fine, excessive monitoring kills a working environment as employees are not in a position to give much work as they pay a lot of attention to what they are doing so that they can impress the supervisor.

Discussion 

Bullying and incivility are unacceptable behaviors and actions which are experienced mostly in the healthcare sector of Australia. There are large bodies of evidence which are related to this problem as many young nurse graduates from Australia are affected by it (Stubbs & Soundy, 2013). A large number of young graduates in the healthcare sector go through bullying, harassment and incivility during their clinical placement in Australia. Half or 50.1% of students experience bullying and incivility during clinical placement especially in their first 12 months working in a healthcare institution. Young nurse students are more likely to be bullied and harassed as compared to older students. Studies conducted indicated perpetrators of bullying and incivility as registered nurses, patients, enrolled nurses, clinical facilitators and nurse managers. Majority of young nurse student graduates who go through bullying and incivility are reported to be anxious and depressed. A third of young nurse graduates who experiences this behavior are said to be affected negatively and thus they do not pay attention when providing health care services to the patient and they may end up making a lot of mistakes which can be very harmful to a patient’s health (Leo, Reid, Geldenhuys & Gobind, 2014).  Bullying and incivility are unacceptable in all setting especially in a workforce environment. These behaviors are termed as public issues and if they are not appropriately addressed, they may lead to victims experiencing severe psychological and physical morbidities. In Australia, there is increased reports of bullying and incivility of young nurse graduates in the health sector.

  Most healthcare sector, especially in the developed countries, has policies and procedures which aims at preventing and managing bullying and incivility involving their employees. Employers are charged with the legal responsibility of ensuring that they provide safe work environments to their employees. Education institutions are forced by policies to ensure that healthcare students are protected from bullying and harassment during clinical placement (Budden, Birks, Cant, Bagley & Park, 2017).  Bullying in the healthcare sector of Australia is described as a verbal, physical, emotional and psychological abuse of new employees by their employers and supervisors. Studies which have been conducted indicate that workplace bullying and incivility costs between 6-36 billion dollars annually in the Australian economy. 30% of nurses have experienced bullying and incivility in their profession  Australian nursing students are expected to spend some time in the healthcare sector to be able to gain skills and experience on what is expected of them as healthcare professionals (McDaniel, Ngala & Leonard, 2015). This setting makes them more vulnerable to bullying and incivility from their seniors. The national prevalence rates of bullying and incivility in Australia is 9.7% based on the population of the country. One among ten young nurse graduates reports having been bullied in the workplace environment either by a senior nurse or a patient who thinks they have no knowledge and skills in the nursing field which lowers their confidence.

How new graduate nurses’ may be affected by incivility and bullying

New nurse graduates who are exposed to incivility and bullying have a high level of anxiety and thus leading to high job burn-out. Anxiety can have negative effects on them which makes them not able to deliver quality healthcare services to patients (Beckmann, Cannella & Wantland, 2013). The effects of bullying on new nurse graduates do not end when the victim leaves because bullying causes physical and psychological health problems. Nurse graduates may suffer from stress which may affect their performance, and if not addressed it may lead to health complications such as distress, panic attacks, ulcers, and blood pressure (Schaeffer, 2013). Bullying affects a victim’s job performance. Nurse graduates who are exposed to bullying and incivility are not capable of making competent decisions when they are attending a patient, and this may lead to errors in medication and treatment. Victims may also lose concentration on what they are doing leading to reduced production. Bullying and incivility may lead to isolation in which the nurse graduates feel so much lonely, and thus they are not in position to build strong therapeutic relationship with patients, which makes it hard for them to gain valuable information about their health, and therefore they end up making wrong decision on the kinds of treatment and medications which they give to patients (Babenko-Mould & Laschinger, 2014). Bullied nurse graduates waste a lot of their time which they should be attending patients and gaining experience trying to defend themselves from the bullies. They suffer from fear, and thus they are not able to network with other healthcare professionals to learn new ideas and skills. At extent situations where the nurse or victim is exposed to physical beatings, he/she may suffer injuries which leaves them with scars, and it becomes hard for them to forget about their past experiences.

Strategies that new graduate nurses can use to overcome incivility and bullying in their new nursing role

New graduates nurses can use some plan to stop been bullied in the healthcare sector. They can first report those who are bullying them to the top leaders in the organization early enough so that actions can be taken against them to end the behavior (Laschinger, Wong, Regan, Young-Ritchie & Bushell, 2013). In case leaders are not able to solve the problem, a new nurse graduate can refer the bully to the authorities in the Australian government because there are rules and legislation which protect employees against workplace bullying and incivility in Australia. Most nursing care institutions have a fair complaint system in which new nurse employees exposed to bullying and incivility can use to can raise their issues about the challenges which they are encountering in the cause of their operation (Cummings, Grau & Wong, 2014). The system then implements a standard investigation process which is used to evaluate all the incidences which are reported and thus it establishes a disciplinary action plan which is aimed at punishing those found guilty of bullying and incivility. New nurse’s graduates should also attend the organization training in which they are taught skills on how to recognize, prevent and respond to incidences of bullying and incivility.

Another strategy which these young employees can use is through communicating and sharing with their friends and family members about the difficulties and challenges which they are facing and by so doing they are in a position to get some assistance, and they don’t feel so much stressed by the condition (Etienne, 2014). New nurse employees should understand that bullying and incivility start with them not recognizing what is happening around them. Therefore, they should look at themselves and the current workplace environment which they are working into and understand if they are treated well. If they feel like they are not treated well than before it is their role to bring it to the other person attention and ask them to stop it (Seibel, 2014). New nurse graduates in the healthcare sector in Austria should show respect to their colleagues, supervisor, and leaders to prevent bullying and incivility. This is because to receive honor from others you must give it to them as well. So it is their role to evaluate if they are showing some respect to the person who is bullying them because it can be because of their disrespectful actions towards them which are contributing to this behavior. They should also learn to communicate with the bully (Hakojärvi, Salminen & Suhonen, 2014). If someone does something to them which makes them feel like they are mistreated and disrespected they should try and have a conversation with them. They should not jump into conclusion that someone is bullying them if they have not made any efforts of approaching and telling them that their behaviors and actions are disrespectful. New young graduates should give the person an opportunity to understand their perceptions and provide them with some chance to change before taking any steps against them.

Interdisciplinary team 

Patients, their family members, professional healthcare colleagues, and supervisor are termed as members of the interdisciplinary team because they should all take part in ensuring that they eradicate bullying and incivility in healthcare sector so that healthcare professionals are in a position to offer high-quality healthcare services to the patients (Szutenbach, 2013). Interdisciplinary teamwork is a complex process in which different individuals with various kinds of skills, expertise, and knowledge work together to have positive impacts on patient care (Schaeffer, 2013). Patients should ensure that they don’t use disrespectful language to new nurse graduates when they are administering services to them because it pisses them off making them unable to offer quality services to them as well as lowering their confidence. Patient’s family members should give the young nurse graduate a chance to perform their operations smoothing without bothering them so that they can be able to offer their best. They should learn how to use polite language to healthcare professionals whenever they make minor mistakes while attending their patients and give them a chance to correct it instead of quarreling them and forwarding them to their seniors. This gives the new nurse graduate morale in their work, and they also feel valued. Healthcare professional and supervisors should not intimidate new nurse graduates because they’re young or lack of enough experience, skills, and expertise. However, they should give them enough support and assist them in areas where they face complex situations which they cannot handle on their own.

Findings

There are various setting in which different kinds of people can be exposed to bullying and incivility. The first place is a hospital setting where a patient can be bullied by fellow patients or healthcare professionals (Clark, Ahten & Macy, 2013). Healthcare professionals may be asking them too many personal questions which can make them uncomfortable but because they do have an option they are just forced to share it. Fellow patients maybe isolating him/her making them lonely and thus leading to deterioration of their health condition. Bullying can also happen in a home setting where the older children mistreat the young ones by forcing them to do their house chores like cooking, washing or even sexually assaulting them and threatening them to do something more worse to them in case they attempt reporting them to their parents and guardians. This can affect the child both physically and mentally (Hodgins, MacCurtain & Mannix-McNamara, 2014). School setting is another environment in which children are exposed to bullying. This can be from their teachers and their colleagues. Teachers can do this by exposing the students to unnecessary punishments. Young nurse graduates in the healthcare sector are also exposed to bullying and incivility by their seniors and other healthcare professionals. In the healthcare sector, young nurse graduates are exposed to bullying because of the following factors (Lachman, 2014).  Lack of respect by the graduates is the first factor. When supervisors and other health care professionals feel offended by the behavior of new nurse graduates, they tend to bully and mistreat them. Jealousy is another factor in case the young graduates seems to have more knowledge and skills than their supervisors and leaders.

Conclusion 

Bullying and incivility happen mostly to new nurse graduates in Australia when they first join healthcare institutions. Their supervisors may bully and mistreat them if they jealousy of their skills and knowledge and they are afraid they may end up taking their positions and replacing them. It is advisable that the young nurse graduate should first approach the person who is bullying and mistreating them and discuss it with them before they take further actions. In case the person is not willing to change, and he continues with his/her bad behavior, then the young graduate should forward them to the organization leaders so that they can be corrected about it. New nurse graduates are advised to attend organizational training so that they can gain skills and knowledge on how to deal with bullying and incivility when they encounter them in the course of their work. Organizations should enforce rules and regulations which deals and punishes those who try to mistreats their juniors and new nurse graduates. This will be very helpful as it enables them to be able to perform their work more effectively and deliver high-quality services to patients.

References 

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