One of biggest challenges facing the health care industry today is workplace violence and bullying. This trend leads to ineffective patient care, job dissatisfaction, and psychological distress. The Joint Commission is tracking these trends and has instituted new requirements in 2022. In a nutshell, direct, curt communication has replaced respectful, interactive dialogues. This is occurring in so many sociopolitical arenas of our life; it must not be allowed to become the norm.
In a recent risk assessment survey of health care staff in Arizona, the results showed an increase in staff harm. Other findings included the following:
* 68% of staff reported that they are concerned for their safety.
* 57% of staff reported experiencing emotional distress related to incidents over the previous 12 months.
* 74% of staff with patient/visitor contact experienced misconduct by a patient, family member, or visitor in the previous 12 months; 41% of those staff experienced six or more incidents.
* 17% of staff reported contemplating leaving their positions related to incidents in the previous 12 months.
U.S. and European stats are also grim (Fink-Samnick, 2021):
* 79.3 million workers are affected by workplace bullying.
* People in nonleadership roles experience workplace bullying that is double the rate of those in managerial positions.
* Although a majority of organizations continue to dismiss, deny, or discount bullying behaviors, in the United States, more than 60% do not have policies in place to manage workplace violence.
It is clear there is a lack of workplace bullying policies and procedures, which must be remedied at the organization level. But what can you do on a personal level? (Fink-Samnick, 2021):
1. Address incivility early: Everyone has rough days, but there's a big difference between "one-and-done" event versus a more enduring pattern. Address the behaviors early, and directly, with the person involved. Grab a witness to the conversation whenever possible.
2. Use human resources: Most people resist involving human resources, but it's important to do so. Should you seek legal recourse, it is vital to demonstrate how all employer channels were accessed, even if you question their usefulness.
3. Stay engaged: Bullies strive to isolate their victims. Keep connected with your colleagues and peers for support.
4. Document everything: An old mantra exists in health care: "If it's not written down, it never happened." Maintain documentation of all bullying interactions and conversations that address the events, including dates and the names of those present.
5. Show your resilience: Bullies strive for reaction from their victims. Instead of immediately reacting, take 10 s to stop, breathe, process, and restore your resilience. Only then can you effectively assess and best manage the situation.
6. Remember: Bullying victims are rock stars: Bullies go after those persons who threaten them, usually their most ethical and competent employees. Let the bully know you're on to them and then thank them for acknowledging your "rock star" status. It will totally unnerve them.
7. Behavioral health support is a must: Bullying wears at your resilience, fueling anxiety, depression, insomnia, and stress. Obtain a mental health consultation for objective support and intervention.
8. Be part of greater change: Bullying is a hot topic across professional associations and accrediting entities. Most have crafted language for their standards of practice and codes of ethics, making bullying and incivility subject to reprimand. Join public-policy and advocacy initiatives to stop bullying on a macro scale. Workplace bullying legislation is advancing in the United States, via the Healthy Workplace Bill, now introduced across 31 states.
9. When the culture can't change, move on: There are times when the bullying culture either can't or won't change. When you've done all you can to stop the incivility cycle, it's time for a career shift. Can you afford to wait?
10. Repeat the mantras given in Figure 1.
Quality, patient-centered care is best provided by a team of individuals who can effectively work together. In addition to some of the aforementioned actionable items, one of the tenets of a well-functioning patient care team just may be a concept known as "intellectual humility." Research is showing that, when it comes to our beliefs and opinions, most of us are much more confident than we should be. In one survey about what percentage of how "right" people are during disagreements, 82% reported they were usually the one who was right. It seems that humans routinely are certain that their answers to questions of fact are correct, and their confidence consistently exceeds the actual accuracy of their answers (Leary, 2021).
People who have low intellectual humility often have stronger reactions when people disagree with them and disregard or disparage people who hold different views. The first step in dealing with overconfidence (or "low" intellectual humility) is for people to realize that much of what they believe to be could, in fact, be incorrect ("high" intellectual humility). Low intellectual humility undermines people's willingness to negotiate or compromise. Disagreements become intractable when people are unwilling to consider the possibility that their personal views might be, at least, partially incorrect.
Many reasons can exist for lashing out at colleagues, whether in the form of bullying or violence. However, believing one is absolutely correct is one big reason and an important starting point. A tough but necessary step is to check your correct-O-meter at the door. Respectfully ask questions, allow others to state their ideas, and recognize different or alternative opinions. Stop and reconsider any new evidence if presented. The next time you feel certain about something, you might just st op and ask yourself: Could I be wrong?
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