Objectives
In the modern healthcare system, workplace bullying frequently affects freshly qualified nurses. The objectives of this study are to profoundly explore causes and outcomes, anti-bullying policies and others. The first step in combating nurse bullying is acknowledging the issue, increasing awareness, and developing a strict anti-bullying policy (Baldwin, 2017). Other objectives of the study consider the active shooter situations in healthcare facility. People are frequently startled into inaction when these situations happen (Atkinson, 2017). Therefore, following the specific actions plan can increase nurses and patients’ chances of survival.
Preparing for an active shooter
In an active shooter scenario, the most important thing to do is to take quick action and run, hide, or fight in that order. Every event is unique, and your course of action will depend on them and other factors like your distance from the shooter. Every effort is preferable to nothing, even if the choice is not optimal. Get away from the gunman wherever you can, and encourage others to do the same. Evaluate the exits and prepare an escape strategy. A stern “Follow me” or “Gunshot! Get away!” might be used to jolt spectators out of their complacency. Urge or assist others in escaping. However, it is essential to avoid being overtaken by anyone who decides not to follow and avoid attempting to move anyone injured (Atkinson, 2017). It is crucial to avoid making the hands visible while traveling and leave any personal belongings behind.
After individuals are in a secure area, it is wise to dial 911. The next course of action is to try to conceal somewhere where individuals will be hidden from the shooter’s vision if they are unable to flee the area. It is best to choose a place to hide, like behind a door or a piece of furniture, where everyone will be safe if gunfire is fired in their direction. It is crucial to enter a secluded room, lock the door, and block it off with large pieces of furniture. Fighting is the last choice if one’s life is in grave danger. Acting aggressively toward the shooter will help individuals disorient or disable them. One can scream at them, throw objects at them, or even attempt to harm them with improvised weapons. Although it seems contradictory, if the shooter can be deterred or neutralized, there is a considerably better likelihood that one will survive if they cannot flee.
When law enforcement officials show up, cooperate with them. Their priority is to apprehend the shooter swiftly. They could come off as hostile because they are armed, might deploy tear gas or pepper spray, shout orders, and push individuals around (Titchen, 2017). Observe the officers’ directions and provide prompt responses to their inquiries. They need to know where the shooter(s) are, how many there are, and what kind of weapons, if any, are being used. Expect them to lead you or care for the injured; it is crucial to refrain from trying to acquire information from them. Lay down any items you might be holding in your hands, including purses and jackets, and then raise and maintain the visibility of your hands.
Responsibility for patients in an active shooter scenario
It is unfathomable to consider having a shooter on the loose in your place of business. For patients, families, and nursing staff, the idea of an active shooter situation at a medical facility is terrifying and distressing. The best procedures for responding to an active shooter, including recognizing the issue, alerting the excellent staff of the problem, and keeping themselves, patients, and visitors safe, must be taught to nurses if an active shooter event occurs at an acute care facility (The Joint Commission, 2014). The focus must be on expanding education to include security officer in-services on patient units, teaching nursing staff how to use emergency preparedness flipbooks customized for their teams, and participating in active shooter drills and simulations to better understand knowledge and confidence levels with an active shooter emergency.
Once it is safe to do so, injured patients can receive care. As a nurse, you might offer immediate bleeding control while you wait for emergency medical personnel to come and so save a life. Remember that after the shooter is down or taken into custody, the area becomes a crime scene, and nothing should be moved or handled besides aiding the injured. After receiving first care, casualties are typically transported to a central location for assembly, when a mass casualty strategy will be implemented (Hospital Employee Health; Atlanta, 2013). One can also assist by following one’s knowledge, expertise, and talents. Every healthcare facility must have an emergency action plan, and most hold training sessions to prepare employees for crises. In the event of a fire or bomb threat, these drills frequently just involve evacuation procedures. Yet, the current circumstance also necessitates training staff members on what to anticipate and how to respond in an active shooter scenario. It is also possible to arrange for staff members to receive functional shooter readiness training from one of the several agencies.
Why bullying is a problem in nursing
The phenomenon of nurse bullying is well-documented in the leadership and clinical literature. It begins early and is present everywhere—in the boardroom, at the hospital, and in the classroom. According to one survey, 78% of nursing school students reported bullying during six months. In a different research, more than half of nursing students said they had witnessed or experienced bullying between nurses in clinical settings (Human Trafficking ELearning, 2018). 60% of nurses quit their first job within the first six months as a result of the actions of their coworkers (Human Trafficking ELearning, 2018).
Almost all care settings and units, from the patient floor to the executive suite, include nurse bullying. According to a 2018 survey, about 26% of nurses reported experiencing severe bullying on the workplace (Human Trafficking ELearning). It is crucial to recognize that some workplace cultures are more conducive to bullying than others, which raises the possibility that systemic improvements could lessen the adverse effects of bullying on nurses. Researchers proposed the following environmental factors as bullying causes among nurses (Evans Gartley, 2016).
Low Level of Leadership
When managers and supervisors instill fear and intimidation in their workers, they encourage similar actions. Under duress, nurses in management may develop a leadership style fashioned after poor bosses. (Evans Gartley, 2016).
Employee Disempowerment
Researchers who looked into bullying among nurses proposed that bullies appear in settings where managers feel helpless, such as when nurse supervisors encounter a lack of authority and a high degree of accountability (National Human Trafficking Resource Center).
Suggestions for a new nurse being bullied
A new Nurse can consider the following steps to deal with bullying. First, identify the negative issue in the company (Karatuna et al., 2020). Second, take a zero-tolerance stance against nurses who instigate or condone bullying which is setting clear expectations for the entire nursing team. Third, keep an eye on online environments and provide sanctions for rudeness in social media (Edmonson & Zelonka, 2019). Fourth, consider reports bullying carefully to the managers. In addition, leaders should be role models for teamwork and provide an excellent example of the cooperative behavior.
Further steps that will be vital to combat with bullying are: encourage communication between human resources and the nursing staff. It will be important to use a systematic approach to combat bullying as it happens and establish lines of communication between nurses, managers, and human resources personnel (Lee et al., 2022). Moreover, minimize workplace stressors that can be avoided, such as work overload, exhaustion, and burnout (Edmonson & Zelonka, 2019). Third, encourage counseling for mental health by urging those who have been bullied into getting therapy if necessary. In addition, speak about the responsibility of bystanders and explore the obligation of all workers to speak out if they perceive unacceptable behavior.
Your responsibility
When nurse managers get complaints of bullying, they must listen to the staff member’s account to thoroughly examine the issue and ascertain whether a bullying problem is present. Frontline managers should visit with the concerned employee after validating any malicious or benign bullying allegations. During the meeting, workers must be informed of their legal entitlement to representation from a union or another group. A bullied person may also get assistance and counsel from a doctor, psychologist, or attorney and access to leave for illness, workers’ compensation, or employment insurance. The managers can ask their immediate supervisors for information and problem-solving techniques.
References
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Edmonson, C., & Zelonka, C. (2019). Our Own Worst Enemies: The Nurse Bullying Epidemic. Nursing Administration Quarterly, 43(3), 274-279. Web.
Evans Gartley, C. (2016). Not just “eating our young”: Workplace bullying strikes experienced nurses, too – American Nurse. American Nurse. Web.
Hospital Employee Health; Atlanta. (2013). Most hospital shootings are not preventable – ProQuest. Www.proquest.com. Web.
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Karatuna, L., Jonsson, S., & Muhonen, T. (2020). Workplace bullying in the nursing profession: A cross-cultural scoping review. International Journal of Nursing Studies, 111, Web.
Lee, H., Ryu, Y. M., Yu, M., Kim, H., & Oh, S. (2022). A qualitative meta-synthesis of studies on workplace bullying among nurses. International Journal of Environmental Research and Public Health, 19(21), Web.
National Human Trafficking Resource Center. (n.d.). Recognizing and responding to human trafficking in a healthcare context
Security InfoWatch. (2013). Responding to active shooters in hospitals.
The Joint Commission. (2014a). Quick Safety Issue 4. Www.jointcommission.org. Web.
The Joint Commission. (2014b). Preparing for active shooter situations. Quick Safety.
Titchen, K. (2017). How to spot human trafficking | Kanani Titchen | TEDxGeorgeSchool [Video]. YouTube. Web.