1. Thompson, Renee DNP, RN, CSP

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Area of Expertise: Professional Development, Leadership Development, Healthy Work Environments, Eradicating Bullying and Incivility

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Dr. Renee Thompson is the CEO and Founder of the Healthy Workforce Institute and works with healthcare organizations to cultivate a professional workforce by addressing bullying and incivility. Renee has authored several books including "Do No Harm" Applies to Nurses Too! and Enough! Eradicate Bullying & Incivility in Healthcare: Strategies for Front Line Leaders. She is one of only 26 nurses in the world who have achieved the prestigious certified speaking professional designation and, in 2018, was recognized as one of LinkedIn's Top 10 Voices in Healthcare for her contribution to their global online healthcare community. Renee and her team are on a mission to create a world where bullying and incivility are immediately rejected and kindness, respect, and professionalism become the new norm.


DD: How would you describe your leadership philosophy?


RT: My leadership philosophy has evolved throughout my career. However, one of my core values is to promote kindness and respect in all interactions. This commitment to kindness and respect has shaped who I am as a leader and drove me to tackle the longstanding issue of bullying and incivility in health care. All the other skills I've had to master as a leader are built on this foundation of kindness and respect for others.


DD: What are the significant professional milestones thus far in your career journey?


RT: My career did not start the way I thought it would. I got married at 19 years of age and had my first child at the age of 20 years, and because of complications, I had to quit school. After my second child, I decided to go back to school and became a nurse. Because of financial constraints, I enrolled in an associate degree program. Eight years later, I returned to school for my bachelor's, then my master's, and then, finally, my doctoral degree-a key milestone for me. It was not easy, but I was committed to furthering my education because learning is one of my core values.


From there, I've done almost everything you can do as a nurse. From bedside, home care, managed care, and education to front line leader, executive role, and, now, the CEO and Founder of a company.


In addition to the varied roles I've held, other significant milestones include publishing my first book and being recognized as an international expert in addressing bullying and incivility in health care. I've since published three more books and continue to serve healthcare teams across the globe.


DD: From your perspective, what do you see as significant trends or gaps in nursing practice that nursing professional development (NPD) could address?


RT: There is an epidemic of bullying and incivility in health care that not only affects morale and retention but also affects patient outcomes. The problem is that leaders do not always understand how to deal with the bad behavior of their nurses, especially the employees who are so clinically competent. Therefore, they often do what's comfortable-they do nothing. As a result, we are hemorrhaging really great nurses and harming the very patients whom we're serving.


We can no longer afford to use silence as a strategy.


A significant challenge with NPD practitioners is that they are also exposed to disruptive behaviors, especially when facilitating educational programs. However, a common reaction is also to use silence. It's because typically, the person who is disruptive doesn't report to them and they may not feel that it's their responsibility to address the behavior in the moment.


I've heard numerous times from NPD practitioners about the individual in the classroom who is incredibly rude to a guest speaker or disruptive to the class. However, when asked how they handled the situation, they look confused and often admitted that they didn't say anything in the moment. Many times, they did share that they planned to discuss the incident with the nurse after class.


However, the problem was that nobody in that room was a mind reader. They didn't know the NPD practitioner planned to address it later. By ignoring disruptive behavior, they condoned it.


DD: What can NPD practitioners do when faced with disruptive behaviors from nurses who don't report to them?


RT:First, be willing to speak up and confront disruptive behaviors-not just talk about or study it.


The reality is that we live in a world in which good people remain passive in the face of bullying and injustice. Numerous studies show the negative impact disruptive behaviors have on employees and patient outcomes. Many professionals would stay silent if they witnessed bad practice or bad behavior, even in life and death situations. Why is that? Sometimes it's because we think it's someone else's responsibility, like their manager. We're worried about how that person will respond, or we're caught off guard and don't know what to say or do. Knowing this can help. From now on, make the decision upfront to confront any acts of bullying behavior immediately when you see them happening. It's about stepping up by sending a message that bad behavior won't be tolerated anymore. Not here-not now-not ever!


When witnessing disruptive behavior, it's important to confront. The easiest way to do this is to just name the behavior.


You overhear someone say to a new nurse: "You won't last a week here." Immediately intervene and name that behavior, "Excuse me. I just heard you say, 'You won't last a week here' to Brenda (always say someone's name). That was incredibly unprofessional and disrespectful."


Someone is interrupting your speaker or challenging them in your classroom. Stand up and in front of everyone say, "You are interrupting/criticizing our guest speaker, which is rude and unprofessional. You need to stop."


The point is, speak up even if the employee does not report to you.


Document and report.


One of the most powerful tools we have against bullying and incivility is good, clear documentation. Document any acts of disruptive behaviors you witness and be sure to include the date, time, person, and facts. To strengthen your documentation, align the behavior to a patient safety, patient quality, or patient satisfaction concern. Think about how this person's behavior impacts patients and employees.


Once you document it, report the incident to the person's manager and document that you did so. Even if the manager doesn't do anything about it, it is your responsibility to report it.


Don't assume the manager knows what's happening. Tell them.


Lastly, be a role model for professional conduct.


Especially if you've been a nurse for a long time, think about the legacy you want to leave when you're no longer practicing. Be that NPD practitioner now. Show up every day ready for practice and ready to do everything in your power to emulate professionalism, collaborative communication, and what respect and kindness really looks like.


As they say, "Be the type of NPD practitioner you want to work with." Don't wait-start now.