Nursing Workforce Retention: Challenging A Bullying Culture

Abstract

Discussions surrounding nursing shortages typically focus on recruitment, but retention is also a problem. Emerging research suggests that intimidation in the nursing workforce is a problem that planners need to deal with as part of an overall strategy aimed at maintaining a balance between supply and demand. This paper explores issues surrounding intimidation in the nursing workforce and looks at how one major teaching hospital in Australia attempted to address the problem. Fo r e c a s t e r s h av e e s t i m at e d that the supply of registered nurses in the United States will no longer meet the demand for nursing services by 2010. 1 Much has been written about changing the image of nursing and innovative recruitment strategies to address this imbalance, but this may not be enough, as nurse retention also continues to be a problem. Indeed, the International Council of Nurses conference in Copenhagen in 2001 identified retention issues as the major factor in the international shortage of nurses. 2 A little-studied but potentially important factor in retention involves intimidation (bullying) of and by nurses and a management culture that dismisses this as a problem. Retention And BullyingLyn Quine's study of the extent of workplace bullying in the United Kingdom found that 38 percent of nurses reported being bullied in the previous year and that 42 percent reported witnessing the bullying of nurses by other staff. She compares this with a study showing that one in eight non-health care staff experience bullying. 3 Another British study of 462 midwives found that 46 percent reported being bullied and that of these, 55 percent were considering leaving within the year. 4 Moreover, the intimidation factor seems to be more than a minor annoyance, and improving the way that management addresses such issues in nursing may be critical for improving retention. Terry Misener's U.S. study found that one of the main components of job satisfaction for nurses was "intra-practice partnership and collegiality." 5 But recent evidence suggests that management may turn a deaf ear to such complaints; Linda Aiken and colleagues' study of 43,000 nurses across five countries showed that fewer than half of nurses are satisfied with the way that "administration listens and responds to nurses' concerns." 6 n Reasons for bullying behavior. A British study suggests that nursing has always condoned intimidating behavior. 7 The profession established itself at a time when public health was a reform movement, requiring its F r o m t h e

Turkish nursing students’ perceptions and experiences of bullying behavior in nursing education

“…Bullying within nursing is primarily intra-professional (i.e. between nurse and nurse) and horizontal violence is common in nursing and the victims are especially the younger students and student nurses [26][27][28] . It is proposed that external pressures are often held responsible, such as health care workers' requirement to find a scapegoat for errors as a reason for the existence of bullying behavior towards nursing students [26] .…”

“…between nurse and nurse) and horizontal violence is common in nursing and the victims are especially the younger students and student nurses [26][27][28] . It is proposed that external pressures are often held responsible, such as health care workers' requirement to find a scapegoat for errors as a reason for the existence of bullying behavior towards nursing students [26] . Recent change in health sector in Turkey which involves adaptation requirements for the issue of accreditation and patient rights and the financing of hospitals on output-based formula which leads to greater levels of alertness in the hospital patient population increased workloads for nurses.…”

Workplace violence experienced by nursing students: A UK survey

“…When bullying is instigated or goes unchecked by nurses, such activities and behaviors become culturally normalised (Steven 2002). Although single acts of aggression or harassment occur in the workplace, bullying is a form of repeated behavior that occurs over time (Einarsen & Mikkelsen, 2003).…”

Nurse-to-Nurse Hostility, Confrontational Anxiety, and Emotional Intelligence: An Integral, Descriptive Pilot Study

“…1 Nurse-tonurse hostility (NNH; also known as horizontal hostility, nurse-on-nurse violence, and lateral violence) is an example of emotional challenge that has a negative impact on nurse performance, satisfaction, retention, health, and patient safety. [2][3][4][5][6] Relationship building (team building) was recognized as a key factor in reducing NNH by researcher Kathleen Bartholomew. 2 NNH is defined as "a consistent pattern of behavior designed to control, diminish, or devalue a peer (or group) that creates a risk to health and/or safety."…”