Peer Incivility In Nursing Profession: Effects And Solutions

On completion of this subject, students should be able to:

1. identify and critically appraise theories of management in order to locate management issues as they arise;

2. demonstrate a knowledge and comprehension of theories of personal development towards effective leadership;

3. demonstrate a knowledge and comprehension of personality differences in perception and decision making in the health care
sector;

4. recognise and analyse personal changes in relation to health care settings as well as respond to change within the organisation and changing management goals within the organisation;

5. critically evaluate multi-cultural factors in health care settings;

6. plan the effective use of personnel’s time for individuals and groups within the work environment;

7. identify and critically appraise theories of management in order to locate management issues as they arise;

8. demonstrate a knowledge and comprehension of theories of personal development towards effective leadership;

9. demonstrate a knowledge and comprehension of personality differences in perception and decision making in the health care
sector;

10. recognise and analyse personal changes in relation to health care settings as well as respond to change within the organisation and changing management goals within the organisation;

11. critically evaluate multi-cultural factors in health care settings;

12. plan the effective use of personnel’s time for individuals and groups within the work environment;

Incivility and hazing behaviors in the nursing profession

Journal Incident

The phenomenon of peer incivility in the nursing profession has been there for ages. It is not even confined to nurses alone. The behaviors that are generally prevalent when it comes to hazing at the places of work ranges from over behavioral manifestations for example sabotage and infighting to the intern nurses. Here the management of the hospitals fails to convey the information about what is going on within the precincts of their staffrooms. The interns suffer the wrath of unanswered questions, passive-aggressive behaviors that span to failure to respect privacies and confidences. Hazing behaviors can lead to many problems at the hospitals like increased absenteeism, reduced productivity and long-lasting negative effects. This journal report is from my own experiences and how they affected my productivity due to anger and confusion.

At a past nursing internship, I did receive a lot of hazing from my peers as they were belittling me due to lack of skills. They were demonstrating their feelings about dominance towards me, and this will become my major theme. My reaction towards their unprofessional behavior was anger and anxiety. Some of the peers used to go further and perform annoying actions so that they can get a reaction (Siwula, 2016). Upon getting a reaction, the peer would use it against us. As they were on permanent assignments, they would use the reaction realized in manipulating the balance of power; during the short stints of the internship period. This act becomes an emotional detrimental to trainee nurses.  For the fear that in the next internship period the facility will fail to take us in, it resulted in us harboring the anger and anxiety in conducting our daily chores (Siwula, 2016).

Horizontal hostilities generally occur in groups whom one would think and expect that they are closely knit and have close affinities. They usually happen when the medical professionals feel that their status quo are being challenged. The radical groups in the workplace think that they are extremely passionate about each other and they build coalitions that makes it able to further their alliances. The alliances are able to advance their cause in hazing the interns. Nevertheless, the structure of the coalitions are possibly inherently unstable; this is because their bickers always contemplate on the best ways of achieving their common goals (Siwula, 2016).

The nursing profession has a long-standing history of molestation of younger nurses by the veteran nurses. In some cases, it is fun while on most occasions it becomes hurtful and cruel. Essentially this workplace molestation is generally harmful. It is fun in case a veteran nurse looks at the timidity that a young nurse undergoes due to fear and lack of requisite professional skills. Fear notwithstanding, a new nurse is entitled to perform their duties (Siwula, 2016). Sometimes as an intern there is a feeling of being overwhelmed with responsibility, or the lack of confidence which is necessary for carrying out the daily chores and thus being on duty with a peer that mistreats during on job training is bad. The feelings that we used to get as novice nurses affected the delivery of services to patients. I cannot believe that there is any positivity of hazing; nevertheless, the negatives become severe and affect the care and treatment of patients (Siwula, 2016).

Personal experiences and impact on productivity and patient care

Nurses, sometimes they look like the patients they are treating as they harbor compassionate feelings for them. Moreover, like in any other profession, conflicts are surrounding this noble profession between the Registered Nurses and the Certified Nurse Assistants.  As the hospital puts on reliance on efficiency to save lives on them, the small issues they encounter on a daily basis may cause an operational crisis that can affect service delivery to patients. It is salient to know how they affect the operations in the workplace (Davis, 2014).

Embracing diversity in the workplace is potentially important though it sometimes may cause conflicts in the professional setup. Due to communication breakdowns, pressures may emanate from different quarters in case the information is not properly communicated and processed. In case such rivalry results in the hospital setting the patients are always at the losing end (Condie, 2016). Thus, it is paramount that no matter the magnitude of misunderstanding between coworkers, the health of the patients should be above all the disagreements. The wrong rites of passage impact on self-esteem (Davis, 2014).

Most of these rites of passage include alcohol consumption; when such a demand is made to a student who has never indulged in that activity, many of her cognitive processes will be affected. Thus, hazing affects the self-esteem of that intern, and their moral development and identity will be affected. There is a notion that trying to fit in an organization where such rituals are made, results in justifying it (Condie, 2016).

Horizontal hostility has ever been a tradition that the nurses have always accepted for many centuries without question. The proponents of it believe that it is a necessary rite of passage that makes the nurses create and bond in a group. This is not always true, nevertheless, the misconception is still in existence.  The perpetrators of these heinous acts often believe that while they are conducting these acts, they are not likely to get caught. The heinous act is mostly solidified by the “code of silence” that is very prevalent in the groups that haze the interns. In many a time, personalities mostly express their sadistic feelings, and they rationalize it by justifying that “I have the right and duty to do onto you what was done to me.” There are generally many psychological reasons that are brought to the fore in support of the haze (Chrisman, Azubike, Stone, & Davis, 2014).

Conflict resolution techniques to address hazing

In this assignment, the model of reflection is the Gibbs reflective model

The common problems in the nursing profession can be addressed while following appropriate conflict resolution techniques. One is that the existing haze can be solved using improved communication techniques. The registered nurses can set up their plan of embracing the medical interns as their fellow workmates and assist them whenever they call upon them for assistance (Chrisman, Azubike, Stone, & Davis, 2014). For example in a hospital setting, the peers should ensure that the trainees have received the proper instruction they are passing to them to avoid the magnitude of errors that can result. I believe that even making the trainee repeat on what they have been requested to do is important to avoid the hurdles (Spaulding, 2015).

On the other hand, the trainee should take it upon themselves to ensure that they are keen and they are able to take up the information and process it well. The intern can seek for clarification from the peer by asking questions and by at all times avoiding assumptions. I believe that when interns engage in making many assumptions, it becomes the root cause of haze with their peers (Booth, 2017). In achievement of better communication, it will result in increases in efficiency on service delivery. This results in making every person job to become easier and chances of conflict hugely reduced. The vibe and the good feeling at working in such an environment is boosted (Kavanagh, 2014).

As the role of nurses is critical in a hospital setup, the added stress resulting from upset working relationships should not be condoned. Staying away from conflicts in a way it is going to improve the relationships among coworkers while boosting their morale (Spaulding, 2015). When nurses put hazing away the productivity of the interns will be boosted. In case this fails to happen instances of negligence and confusion will suffice. In case both the peers and the interns are happy, the patients are also going to be happy. This is because the nurses are going to be keen on them and they are friendlier. Thus, the patients are going to be happy as they will be receiving better health care (Bertalan, 2017).

 This theory was proponent by Aldo Cimino, in the theory he explains that the veteran’s members of the Nursing usually ensure that the initiates do not enter into the organization with a free pass. This makes them start on hazing rituals that they make it look like that they have to have a demonstration of worthiness by ensuring follow a series of challenges (Wolf, et al,. 2018).

Various theories and perspectives on hazing

This is a theory that was developed by Stephen sweet, and he indicates that the initiates into the nursing profession must follow a crucial time of molestation before they are initiated into the group. He indicates that the interns should be paddled, made to purchase drinks and they are underpinned on all occasions. There are totems that they are made to follow, and it does not matter the hospital organization they are working (Spaulding, 2015).  The theory further indicates that all the challenges that the young initiates go through carrying a symbolic weight. He indicates that they are given different pledges from these professionals mostly in the sphere of social interaction with each other (Aul, 2015).

Cut-throat Behavior

This is my own theory on hazing, and I believe that these fraternities portray a cult-like behavior towards their younger professionals the nature of restrictions that were given includes forbiddance to take showers or even to speak to anyone (Spaulding, 2015).  The hazers usually do exhibit negligent behaviors which are dangerous in nature, and they make these interns to pledges which are invincible. The most shocking thing is that when those interns graduate into the system, they eagerly await the newcomers they subject them to what they went through themselves. This means that this is a never-ending cycle. This cycle is generally referred to as the cycle of reciprocity. That is what is done to us now; then we will do unto others (McGee, 2014).

Meteorologists generally allude to a perfect storm when specific conditions come together into a deadly and a rare storm. Meaning that there are specific elements that merge in order to create chaos that is a characteristic of a perfect storm (Spaulding, 2015). The psychology behind hazing pertain to several elements; these elements collide within a particular framework in order to cause the “perfect storm” increasing the probability of hazardous hazing events. The following are the conditions of this theory (Sidhu, & Park, 2018):

This is well captured Charles Darwin theory of “survival of the fittest” that creates the need for an individual to seek a group in order to identify with it. This group tends to protect the individual and thus to increase his chances of survival. Therefore, maybe hazing is somehow part of that group process, which is it determines the person that will fit into a certain group. Thus the act of forming alliances with a group is generally common, and humanity shows that all humans are social animals and they seek group activities in order to get an identity (Rust, 2016). Though the way an individual seeks an alliance with a group differs from a person to another and from a group to another.

Psychological underpinnings of hazing

Thus, the methodology notwithstanding the result is the same. After the member has undergone all the hazing problems, the member then feels that now he is a member of a larger group does accept him and incorporates him as one of their own (Spaulding, 2015). Thus, it is a symbiotic relationship that will serve the group and the individual and they, therefore, accept him hence, and he gets an identity. The group essentially distinguishes itself from the other groups, and they solidify “us versus them” mentality which will create boundaries, nevertheless false, which creates the urge in feeling safe within the group. Therefore, the act of joining a group is to gain protection from the outsiders, and when one joins, one assumes that the members of this same group are going to protect them from agitation towards one another (Frederick, 2014).

The perfect storm can be defined as a particular set of conditions that occurs in a special sequence which when they are combined they give out an extreme event. Every one of the meteorological conditions can exist alone, or in following some combination, they can produce a storm; nevertheless, it is not a storm of extraordinary circumstances (Engelbrecht, Heyns, & Coetzee, 2017).

Conclusions

Nurses are given, and they are professionally required to be compassionate caregivers. So it raises questions as to the reason they harbor abusive and demoralizing acts against each other due to seniority brings confusion.it is generally known that the hospitals are stressful workplaces as the conditions of the patients worsen every minute. It is therefore important that the supply of the nurses to be increased as the peers are getting older (Owens, 2017). It is, therefore, better than the interns to realize where horizontal hostility starts so that they can start the corrective action.  Hostilities subsisting among nurses stems from their peers; when doctors yell at them they tend to bring it down to the interns in case they have stayed for longer periods without debriefing.  Another cause that results in strife is when values differ, and the communication styles clash. Conflicts arise when hospitals mishandle the integration of the interns, this is a common occurrence due to the nursing shortage (Goff, 2018).

The nurses’ interns can be able to come together and defeat the culture of hostility. This can take three levels that entail personal, unit and organizational. This is the way it should follow: start by speaking up. When hostility develops and graduates into an issue in the work environment. One should make themselves known. This will entail talking to a senior medical practitioner or the supervisor about what one is passing. The second step is to confront the offender (Engelbrecht, Heyns, & Coetzee, 2017). This will include engaging in a passive-aggressive behavior of talking to one's colleagues or the third parties who are not in a position of solving the situation. It is even salient to request the senior peer to step away from the duties or attending to the patients so that the matter can be talked about. The peer should acknowledge this uncouth behavior and assure the trainee that stern action will be taken. There should be an understanding of the differences that exist in terms of skills, and the senior administrator should start working with you in seeking the solution of the matter (Ayasreh, Youssef, & Ayasreh, 2015).

The sharing of skills with the senior administrator is a way of ensuring that everyone is able to gain skills that may be missing. Here it very critical as the trainee should ensure that they are not the one causing the haze. This means that they should check on their behavior to ensure that the initiate is not the instigator. The trainee should arm themselves with information so that in the solution of the case they will be having more information than their molesters (Ayasreh, Youssef, & Ayasreh, 2015). This is achievable by conducting a lot of research and reading. At the near solution of the problem, there is a need for creating shared values. In creating them, one works with colleagues so that you can come up with a unit philosophy. This philosophy states the acceptable, unacceptable and the shared values, and it goes further to articulate the consequences that will enable people to be accountable for their actions (Price, 2015).

 Lastly, it is prudent to seek the indulgence and the support of the management in creating a healthy organizational culture. This means that all that has been created in an organizational culture that comes from the top. It is paramount that in the creation of that cultural document there should be consultation to the document known as the AACN’s healthy work environment initiative so that it can be formal and justifiable. The consultation of that document ensures that excellence in the nursing activities is achieved (Taylor, 2016).

Finally, it is prudent to be persistent and patient, as the cultural change can occur nevertheless it happens so slowly.  Horizontal utility generally has a profound influence on the job satisfaction and wellbeing of the initiates in a hospital set up. This brings in the ill calls and affects the turnover rates of the institution directly. Thus the leaders should be always be updated on the potential for a compromised work setting that is generally related to horizontal hostility. The financial viability of a hospital setup cannot be underestimated, and therefore intimidating behaviors like haze should not be condoned, and the perpetrators should even be persecuted (Taylor, 2016). 

References

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