Nurses/midwives: we are our own enemies, time for paradigm shift, time is now

WRITTEN BY ANTHONY OWUSU-BOBIE
PRINCIPAL NURSING OFFICER.
FTARMH – ASANKRANGWA.


AIM OF THIS ARTICLE
1. The aim of this article is to point out some of our behaviors we show towards our own
colleagues in the noble profession and find ways to avert the occurrence of such situation.
2. Address the bullying culture among nurses which has become very pervasive in the
profession.


MY PERSONAL EXPERIENCE
I have been a practice nurse in the clinical setting for the past fourteen years and per my
observations, I am only a nurse in the hospital I work now. When I travel from my clinical area
and move to other facilities for medical health, I seize to be a Nurse and do not enjoy any other
benefits from associating myself with the group when I travel to a different facility. (GRNMA)
I have been a victim myself when my ward was referred to two of our premier teaching hospitals
in the country where your own may even have no time to even listen to your plead or to extend
help to you.
The Akans have an adage which goes like this, “ho menisoma me nti na atwie miennu nam”.
Meaning it’s all about friendship and help an association is formed.


WHAT OTHER PROFESSIONALS GROUPS DO.
Doctors would not expose a member when an error is committed, but nurses would do.
A policeman would not usually inspect a colleague on the road.
A military man gives the needed respect to a colleague when he/she introduces him or herself.


SOME OF THE NEGATIVE COMMENTS FROM OUR MEMBERS
Wo ye nurse enti dean ?.
Meaning you are a nurse and so what ?.
Aha nye wo hospital.
Meaning you don’t work in this hospital.
When I was in …………… eg Efia Nkwanta Government Hospital phenomena
Meaning was working in Efia Nkwanta Government Hospital where were you?
Wo ye student.
Meaning you are only a student.
They are Enrolled nurses.


HOW CAN WE STRENGTHEN THE UNITY AMONG MEMBERS
Our motto for the GRMNA is: Unity is strength.
All the benefits we get from the association is good, but we need to show love, respect,
tolerance, sympathy to all our friends in the noble profession.

 NURSE BULLYING
INTRODUCTION
Nurse bullying is a systemic, pervasive problem that begins well before nursing school and
continues throughout a nurse’s career. A significant percentage of nurses leave their first job due
to the negative behaviors of their coworkers, and bullying is likely to exacerbate the growing
nurse shortage. A bullying culture contributes to a poor nurse work environment, increased risk
to patients, lower Hospital Consumer Assessment of Healthcare Providers and Systems
(HCAHPS) patient satisfaction scores, and greater nurse turnover, which costs the average
hospital $4 million to $7 million a year. Addressing nurse bullying begins with acknowledging
the problem, raising awareness, mitigating contributing factors, and creating and enforcing a
strong anti-bullying policy. Nurses and stakeholders also must actively work to change the
culture, and understand that bullying has no place in the nursing profession or anywhere else in
health care.


 DEFINITION
Workplace bullying refers to a process in which the victim is subjected to a series of systematic
stigmatizing attacks from a fellow worker or workers which encroach on his or her civil rights.
In the school-based literature, bullying is defined as a subset of aggressive behaviours involving
three criteria: it is intentional harm-doing or aggressive behaviour; it involves an imbalance of
power between the victim and the bully; and it is carried out repeatedly and over time (Olweus,
1999).


FORMS OF BULLYING
Three main types of bullying are identified: direct physical, verbal and indirect.


NEGATIVE EFFECTS OF BULLYING
1. Threat to professional status (e.g. belittling opinion, public professional humiliation, and
accusation of lack of effort)
2. Threat to personal standing (e.g. gossiping about you, name-calling, insults, teasing); isolation
(e.g. preventing access to opportunities such as leave or training, physical or social isolation,
withholding of information);
3. Overwork (e.g. undue pressure to produce work, impossible deadlines, unnecessary
disruptions); and destabilization (e.g. failure to give credit when due, meaningless tasks, removal
of responsibility, shifting of goal posts, repeated reminders of error, setting up to fail).
4. Bullying sacrifices an organization’s ability to achieve consistent, high quality outcomes
associated with high reliability science.


WHO IS DOING THE BULLYING?
While it is true that, some older nurses pick on their younger colleagues, bullying behavior
transcends age, gender, and experience level. Workplace bullying also requires the right
environment to thrive. The quality of leadership, in the unit and in the organization, can
contribute to a bullying culture.
Supervisors and managers who lead by intimidation and fear tend to foster the same in their staff.
Nurses in management roles often adopt a leadership style modeled on bad bosses in the past,
which tends to intensify under pressure.


COMMON NURSE BULLY ARCHE TYPES
1. The super nurse is often more experienced or specialized than most, and communicates a
sense of superiority through an elitist attitude, condescending manner, and “corrective
comments.”
2. The resentful nurse develops and holds grudges, encourages others to “gang up” on the
transgressor, and tends to create drama that can permeate the work environment.
3. The PGR nurse uses put-downs, gossip, and rumors (PGR) to bully other nurses, and is
often quick to take offense to a neutral remark. The backstabbing nurse is “two-faced,”
cultivating friendships that they then betray, using information as a weapon to enhance
their power.
4. The green-with-envy nurse expresses bitterness to those who have what they do not:
looks, status, personality, possessions. Their victims often do not realize they are a target.
5. The cliquish nurse uses exclusion as a means of aggression, showing favoritism to some
while ignoring others.


STRATEGIES FOR ADDRESSING NURSE BULLYING
1. Admit there is a problem. Bullying will thrive so long as no one speaks about it, and even if
you do not think it is going on at your organization, it could crop up at any time. Nurse
bullying is a systemic issue in the profession, and every workplace is at risk.
2. If possible, eliminate any situational factors that may make bullying worse, such as work
overload. Stress and fatigue can bring out the worst in people.
3. Start at the top. Train leaders in clear communication and collaboration skills. Make sure
they are modeling the behaviors they expect their employees to follow.
4. Commit to a zero-tolerance policy for those bullies or bad actors who do not change. Name
the specific behaviors included in your definition of bullying so that all staff members are clear
on the expectations. Ensure there are policies in place detailing how bullying should be
reported and addressed.
5. Foster a respectful environment where nurses feel comfortable reporting acts of bullying to
their leaders, or feel supported to address it directly themselves. Take all reports of bullying
seriously and respond to them quickly. Be clear with people who report bullying that you
believe them, first and foremost.
6. Address bullying behaviors as they happen, in a firm but not accusatory manner. Take a
systems approach, bringing Human Resources into the situation early and often.
7. Encourage nurses to seek behavioral health services if needed. Workplace bullying can
seriously impact a person's mental and physical health.
8. Include coworker incivility in your social and online media policy. Make it clear you will
not tolerate any personal attacks on fellow staff, in person or online.
9. Encourage nurses to hold each other accountable. There are often more bystanders than
bullies, so empowering nurses to call out bullying behaviors can change the culture from the
inside out.
NB.
All stakeholders, from school faculty to hospital administration to nurses themselves, need to
work together to create a safe, positive environment for nurses to reach their full potential. In the
words of workplace bullying expert Dr Renee Thompson, “If we are going to finally eliminate
bullying and incivility, we all need to do our part.”


 REFERENCES
1. Edmonson C, Allard J. Finding meaning in civility: creating a no bullying zone. Clin Sch Rev.
2013;6(2):131- 137.
2. Clarke C,M., et el(2018). Bullying in undergraduate clinical nursing education. J Nurs
Educ.;51(5):269-276.
3. American Nurses Association. Position Statement: Incivility, Bullying, and Workplace
Violence. https:// www.nursingworld.org/practice-policy/nursingexcellence/official-position-
statements/id/incivilitybullying-and-workplace-violence/. Published July 22, 2015. Accessed
March 2, 2019.
4. Bartholomew K. ,(2004 ).Ending Nurse-to-Nurse Hostility. 2nd ed. Middleton, MA; HCPro,
Inc.
5. Dellasega C.,(2011). When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of
Bullying. Indianapolis, IN: Sigma Theta Tau International; 2011. 8. Rege A.
6. Things to Know about Nurse Bullying.
https://www.beckershospitalreview.com/humancapital-and-risk/8-things-to-know-aboutnursebullying.html. Accessed March 2, 2019.
7. Edmonson C.,(2015).Strengthening moral courage among nurse leaders. Online J Issues
Nurs.;20(2):9.

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