Emotionally Competent Behaviors and Nurse Bullying: Is There a Direct Link? ()
1. The Evidence on Nurse Bullying
An abundance of literature spanning many years depicts the devastating effects of nurse bullying within the profession. Studies show that 60% of new nurses left their first job within six months due to nurse bullying [1] . Additionally, more than 50% of nurses surveyed by the ANA cited experiences of nurse bullying which included threatening or verbally abusive language within the workplace.
The evidence suggests that bullying in general is a deliberate act specifically aimed at another person. Work- place bullying has been described as a gradual, yet intense set of behaviors that may be aimed at an individual and have harmful outcomes [2] . These outcomes include: experiencing physical symptoms and illnesses, decreased workplace productivity, lower self-confidence, lower self-esteem, social isolation, and most extreme thoughts or acts of self-harm.
Conceptualizing nurse bullying appears to be a key ingredient in creating both awareness and preventative strategies. Conceptualizing bullying is difficult due to the vast array of associated definitions. A concrete example describes bullying as “generalized workplace abuse” [3] that is persistent, non-sexual, without physical violence, may involve a power struggle (peer to peer, peer to leader, leader to peer), escalate from minor to severe behaviors, and result in negative outcomes for the nurse being bullied [4] [5] . Based upon research findings, the most common nurse bullying behaviors are illustrated in Table 1.
Based upon the above behaviors, what strategies can be implemented to assist in changing controllable behaviors while utilizing emotionally competent interventions?
Prior to exploring this issue, an overview of emotional competence will be addressed. Emotional competence is a set of behaviors which are unique to each individual. This uniqueness is closely aligned with an individual’s life experiences in combination with innate emotional and personality traits. The majority of researchers agree that emotionally competent behaviors are impacted by both positive and negative interactions and experiences. Additionally, it is hypothesized that emotionally competent behaviors are continually cultivated throughout one’s life based upon interactions and experiences. For knowing and effectively managing one’s behaviors, the following emotionally competent behaviors are deemed most important when addressing ways to combat nurse bullying. These emotionally competent behaviors as identified by Goldman (1995) include emotional self- assessment, accurate self-assurance, self-confidence, emotional self-control, and empathy. According to Goldman, one must be self-aware and in tune with personal emotions in order to effectively interact as well as hold leadership positions. Leadership positions can include but are not limited to roles including, charge nurse, preceptor for new employees, nurse manager or director. Without these emotionally competent attributes, one may not be able to clearly demonstrate therapeutic interactions and role-modeling. Likewise, one must be self-aware of displayed behaviors in order to effectively practice emotional self-control. Emotional self-control is paramount in order to effectively interact with others, build rapport, and manage conflict on any level [12] [13] .
Table 1. Bullying behaviors overt covert.
[4] [6] -[11] .
The effects of nurse bullying can be harmful, career shaping and even career ending for some recipients of bullying. The following case study will illustrate the power of nurse bullying and the benefit of displaying emotionally competent behaviors.
2. Case Study
A brand new RN, Mary recently passed NCLEX and started a job on a busy inner city medical-surgical unit. Mary was 20 years old and overly eager to begin her nursing career. Most of the nurses on the unit were veteran staff and previously worked together at another hospital. The nurses were reunited through a recent hospital merger. Mary was the only new hire on the unit in two years. She entered her job with intense enthusiasm and passion to do well. Mary’s preceptor was selected randomly since none of the nurses had a desire to precept new nurses. In fact, the nurses voiced feelings of viewing the preceptor role as burdensome and extra work without extra pay. As a result, Mary’s preceptor ship was anything but positive. She felt like she was set free from the beginning and was verbally put down when asking about basic nursing procedures. For example, one of her patients needed an NG tube inserted. Mary asked her preceptor to observe her inserting the tube. The preceptor rolled her eyes in disgust and verbalized in front of several other staff members that she should know how to do this basic skill. Throughout the weeks, Mary was singled out when asking for support including the verification of skills which were part of the orientation check list. Singling out behaviors included gossiping and spreading rumors of incompetence, placing notes around the unit depicting “how to do specific skills”, and assigning Mary to go to lunch alone. As a result, Mary started isolating herself from coworkers, questioned her abilities, and quit the job after three months. Mary decided to quit since she felt unsupported, excessively criticized, and isolated. Table 2 illustrates the five emotionally competent behavior in relationship to Mary, preceptor, and staff.
3. Implications for Practice
Creating awareness on the power of nurse bullying and the benefits of assessing and implementing emotionally competent behaviors is essential in creating a culture of change, acceptance and professionalism within today’s nursing environment. Both awareness and reflection can assist in turning the Mary experiences into positive and meaningful professional encounters. Table 3 displays integration of each of the five emotionally competent behaviors into Mary’s case study.
Table 2. Emotionally competent behaviors.
Table 3. Integration of emotionally competent behaviors.
Both bullying behaviors and emotionally competent behaviors may be learned, mimicked, and developed. Emotional self-assessment, accurate self-assurance, self-confidence, emotional self-control and empathy are essential in combatting nurse bullying. Creating awareness of both emotional competence and bullying can be an initial step in cultivating needed tools and support to assist nurses, to professionally role model in the midst of ever changing health care environments.