Toxic Nursing, 2nd Ed. Cheryl Dellasega

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СКАЧАТЬ would probably take a step back and say something to the older nurses to prevent a divide, too. Coretta is making suggestions in an effort to help, not to suggest she knows more than the other nurses. Her motives are genuine. All of us in our enthusiasm have probably done this very thing. Everyone goes into a new job with great ideas.

      –Kathy Curci

      Behaviors such as hostility and undermining are considered forms of bullying. To effectively deal with bullying in the workplace, it is important to set aside emotions and place emphasis on the facts. The most important person that can stop this bullying is Coretta. Coretta should keep a record of the times when Helen or other colleagues make an inappropriate comment or exhibit an inappropriate behavior. It is important to document the time, place, person, and actual occurrence, being cognizant of only writing the facts. Eye rolling, fist slamming, or other inappropriate nonverbal behavior should also be documented.

      Some bullies feel threatened or are intimidated themselves, so Coretta should assess her own comfort level before approaching the bully (or bullies). One major mistake some nurses make when confronted by bullies is to try to reason with them and attempt to convince them that they’re wrong. It is important not to be nice but rather remain professional and firm when speaking to bullies. Being nice may confirm to them that they’re in a superior position.

      If Coretta chooses to approach Helen or the other bullies, she should state the facts in a mutually agreed upon place. Sometimes, when bullies are presented with data rather than drama (crying, yelling, etc.), they may actually recognize the inappropriateness of their behavior—especially if there is documentation and quotes. If Coretta feels her dialogue with Helen didn’t go well or if she is uncomfortable speaking directly with Helen, Coretta should report her findings to her nurse manager and even the human resources department. Informing management (in writing) and documenting all occurrences and any previous attempt to resolve the issue at the lowest level is vital.

      The term “hostile work environment” is a legal term in the workplace. When formally documenting, use words such as “bullying,” “hostile work environment,” and “intimidation.” Coretta should continue to seek support from others to release some of her stress as a result of the bullying.

      –Cheri Clancy

      reflections

      When an employee is excited to implement a new project, at what point do you feel a nurse manager should intervene, and how? What guidelines help you differentiate between needed change and the hubris of an inexperienced employee?

      What things do you put in place to create a culture of continual learning? As a nurse manager, do you value evidence-based practice, and, if so, how do you help your employees to realistically use these principles in everyday practice?

2.3 Not So New

      Lisa graduated from college with a degree in biology and went to work in a lab. After a few years, she realized that she didn’t really enjoy what she was doing, so she decided to quit her job and go back to school for a nursing degree. Lisa completed a 12-month BSN program, and, at age 31, started her first nursing job.

      The problems began at the very beginning—during orientation. She was in a group of new-grad orientees, which meant that everyone was almost a decade younger than she was. Other new grads looked at her askance and didn’t seem to want to talk to her.

      The worst part was that Lisa felt like she was treated like a complete know-nothing. While venting to her husband one night, she said, “I mean, I realize I’m new to nursing and that most of my colleagues spent more than 12 months on their nursing degrees, but it feels like my whole prior career just didn’t matter at all!”

      It’s not that Lisa feels like she’s better than her new-grad colleagues. It’s just that she has a whole host of skills as a result of being in the workforce for a decade (interpersonal relations, professionalism, people skills, etc.), and she is really upset that she’s treated like a know-nothing in every respect.

      nurse leader insight

      The other nurses in the orientation group don’t know Lisa and don’t understand what her previous degree is all about. How would they know?

      Truthfully, she needs to take a step back and say: “I may have a degree and work experience elsewhere, but it’s unrealistic to think that others would understand that.” Most of the other nurses being oriented may not have a lot of experience themselves, and their contact with patients might have been as a student nurse. They’re not at a point in terms of professional maturity to appreciate the added skills Lisa may bring.

      They don’t know how that will play out in patient interactions; no one really does.

      –Kathy Curci

      Nursing as a second career is becoming very popular. Second-career nurses are entering the profession with diverse work experience and educational backgrounds, and this diversity strengthens the nursing profession. These nurses are adult learners who bring a variety of talents to the nursing profession with their different life and work perspectives. More seasoned nurses should be cognizant that although they may be senior to these new nurses, they also have an opportunity to learn from these new nurses’ previous skills. Employment skills such as critical thinking, emotional intelligence, customer service, and computer skills easily transfer to the nursing profession.

      It is important that Lisa shares her experiences with her colleagues. New nurse orientation can be very intimidating and filled with mixed emotions by many attendees. Lisa can begin gaining respect from her colleagues and even adopt a mentor role by sharing her prior experiences in the lab and applying this to the clinical setting.

      –Cheri Clancy

      reflections

      As nurses on your unit accomplish goals such as continued education or increased skill level, how do you respond? Is it appropriate for the nurse manager to acknowledge achievements and endorse particular steps employees take to improve their performance?

      Should nurses who take online courses or work toward a higher degree be given different responsibilities because they are trying to advance their careers? Or is the seasoned, “tried and true” employee the one you turn to when rewards are being handed out?

2.4 Popularity

      scenario

      The 23-hour unit has a high turnover with a diverse group of nurses who seem to come and go quickly. Lauren, an RN who has been on the unit since it was created, is the designated preceptor for new employees.

      Beth, Lauren’s latest charge, is right out of school and has a habit of laughing when she’s nervous. Halfway through their second day together, Lauren is extremely frustrated and tells her coworkers that Beth isn’t taking her feedback and suggestions seriously. Her comments get more pointed.

      “Get with it, girl,” Lauren tells Beth, who accidentally enters information in the wrong place. “This is the world of high-tech. You should be better at computers than me!”

      Later that week, Beth allows a patient to choose between two pain medication options the physician ordered. Lauren overhears the conversation and takes Beth aside as soon as she leaves the patient’s room. “Never let a patient choose for himself! They don’t know anything about these medications—you’re the nurse!”

      When СКАЧАТЬ