Simmering Discontent?

In a perfect world, all of healthcare would consider both the patient and their employees. I believe we all need to keep our moral and ethical compass to open this up to collaboration so whistleblowing and scapegoating did not occur in any organization, healthcare or industry. As the boundaries between physician and nurse becomes more fuzzy within our education, working together will decrease the friction and increase the trust.

Please click on the link to follow along on one nurse’s thoughts on simmering discontent.

 

Source: Simmering Discontent?

Why All Ohio Nurses and the Public Should Get Involved In the Clean Power Plan

I want to speak with you today on why it is so important for the Ohio, and nurses everywhere to promote clean renewable energy and the Clean Power Plan.

Our children’s ability to breath depends on reducing Ohio’s carbon pollution. As a registered nurse and healthcare professional, I believe in primary prevention to reduce asthma and other respiratory illnesses in Ohio. Moreover, primary prevention means making sure the air we breathe is clean.

Personally, my husband is affected by poor air quality with his chronic obstructive lung disease. He can no longer mow the lawn without frequent breaks. I have seen him wheeze, become short of breath, and have to stop what he is doing to catch his breath. I have also seen children struggle to breath because of asthma attacks.

Asthma already affects 257,000 children and 832,000 adults in Ohio. Carbon and other volatile organic compounds, like benzene and methane, trigger asthma attacks and other respiratory illnesses. If the Clean Power Plan is implemented, 2,800 lives will be saved and 760 cumulative hospitalizations will be prevented from 2020 – 2030. If Ohio does not work to reduce carbon pollution, Cleveland will experience 11 more days in the summer that exceed the EPA’s air quality standards with Columbus seeing a 28 percent drop in the number of clean days per summer.

This is not just an Ohio health hazard. According to Cincinnati Children’s Division of Asthma Research, every day in this country, 78,000 children or adults miss school or work daily due to asthma. Approximately 35,000 children or adults have an asthma attack daily. Emergency room visits occur daily for 4,600 children or adults due to asthma. Asthma hospital admission will occur for 1,200 children or adults daily due to asthma, and 10 children or adults die each day from asthma.(1)

The economic cost is close to 56 billion dollars a year.(1)

The economic impact to families and loss of productivity to industry struggling to meet benefits is overwhelming. Everyone’s health will be impacted if Ohio and Senator Portman do not support the Clean Power Plan. So I would like every nurse who feels led to, call Senator Portman’s office and support the Clean Power Plan and EPA’s standards for reducing methane. Future lives depend on it.

By 2030, the Clean Power Plan will prevent 3600 premature deaths, 1700 non-fatal heart attacks, 90,000 asthma attacks in children, and 300,000 missed workdays.(2) 

References and other resources

(1) http://www.cincinnatichildrens.org/research/divisions/a/asthma/default/

(2) https://www.whitehouse.gov/climate-change

(3) http://www2.epa.gov/cleanpowerplan

(4) http://www.epa.gov/asthma/pdfs/asthma_fact_sheet_en.pdf

Did the Great Recession fuel a continuing climate of fear in the workplace?

David Yamada and I are like minds. This country needs to put human dignity at the center of our employee relations. One of my business HR mentors stated that employees are “our greatest asset.” When treated with dignity, with actions that consistently display dignity, you earn their trust and increase their productivity. And I have never seen how badly trust has taken a beating with nurses. For the nurses surveyed in my dissertation, one question seemed so pivotal to me: When faced with stressful work situations, I trust the management to look out for me at the place where I work. Of the 80 nurses who answered the survey, 42.5% (n = 34). How administrators, doctors, and nurse leaders act towards their staff matters. Ruling with fear is not the way to building a healthy workplace.

Minding the Workplace

Edvard Munch's "The Scream" (1893)Edvard Munch’s “The Scream” (1893)

According to economists, the Great Recession is officially over, having “ended” sometime during 2009-2010. However, its negative shock waves continue to impact world economies, labor markets, and the experience of work. Among the most costly and underreported effects is how the Great Recession has enabled some employers to stoke an ongoing climate of fear in the workplace.

British psychologist and consultant Sheila M. Keegan, in her thought-provoking new book The Psychology of Fear in Organizations (KoganPage, 2015), suggests that even though the “recession has eased, . . . its psychological effects may well be with us for some years to come.” In fact, she offers the possibility that “just as the Second World War shaped the attitudes of a generation, so too the recent recession will shape the attitudes, behaviours and fears within organizational life for some decades to come.”

This does not bode well…

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Leading A Passionate Life

First off, if you follow my LinkedIn posts, tweets, and Facebook, you know I have three strong passions in my life. First, my passion is to work with individuals and organizations to create and sustain physically and psychologically safe and healthy workplaces. My posts are made to raise awareness, running the gambit of discussing research data, confidential incidents associated with workplace bullying and mobbing, and forwarding other blogs on leadership, culture change, and communication with employees. Relationships live or die through communication that builds trust and authenticity.
My second passion is promoting occupational health nursing. Employers who use lay people to manage workers’ compensation are at a disadvantage if they do not use occupational health nurses in their HR or safety teams. I also believe organizations should use great interdisciplinary teams, including occupational health nurses. Occupational health nurses are instrumental in reducing costs associate with work injury, illness, and coordination of benefits of work and non-work medical issues as well as streamlining the costs associated with OSHA mandated compliance programs Any industry with over 100 employees doing manual labor should have an onsite or contracted occupational health nurse. Any white-collar industry over 300 employees focusing on reducing healthcare costs should have an onsite occupational health nurse for wellness and health promotion. Total Worker Health initiatives need to recognize occupational health nurses as the assets they are to industry.  
My third passion is clean air and water. From the perspective of primary prevention, organizations need healthy people to work and if the community has exposure to poor air and water quality, there are more sick days, cancers, and stillbirths and increased medical costs associated with that poor quality of air and water. As a nurse, primary prevention of illness and injury means a healthy environment, clean air and water. It is this third passion I want to write about today. 

If you are interested in clean air and water, there are several nonprofits you could support or volunteer. They need nurses, the most trusted profession in the US, to push forward clean air and to educate the public. However, they need all persons to push for clean air and water, which will positively affect the climate. Donations also appreciated. 

Several Ohio Nurses Association and American Association of Occupational Health nurses (myself included) attended a free educational program on how to create messages on climate change. The Alliance of Nurses for Health Environments organized and sponsored the program in Columbus. The program took place June 25th and 26th. Katie Huffling at katie@envirn.org was our hostess and it was an excellent program. For nurses who want to volunteer, consider ANHE and their go-to site on evidenced passed articles and positions.  

http://www.enviRN.org 
There are so many nonprofit environmental groups you can become involved. I will be highlighted. Ohio organizations as well. 
Linda Diamond from the American Lung Association in Ohio addressed the group about their focus and the need to recruit more nurses and doctors for Climate Health. Just follow the link below for that information. I did and submitted a statement. 
http://www.lung.org/associations/charters/midland-states/advocacy/doctors-for-climate-health/ 
A representative from the Ohio Environmental Council, Melanie Houston (Director of Water Policy & Environment) came through to discuss issues with the group. They will be working on methane rules and grassroots training for activists and head to DC on September 17th and 18th to train and talk to Congress. Here is their website.  
http://www.ohioenvironmentalcouncil.org/ 
You can also get involved by tweeting or placing FaceBook messages out there for #AsthmaFeelsLike. That campaign started July 15th and continues. See below. 
http://earthjustice.org/advocacy-campaigns/clean-air  
In case you missed it, President Obama released his highly anticipated Clean Power Plan on Monday – the first time the US is regulating carbon emissions from energy production. You can watch the President’s remarks on the day of the release here: https://www.whitehouse.gov/climate-change 
I hope I have given you increased awareness of how important it is to create a healthy environment that promotes healing. Clean air and water is part of that environment. 

Five terrific words from targets of workplace bullying

Wonderful words for those looking for other employment after workplace bullying has seriously undermined confidence.

Minding the Workplace

“I got a new job!”

On occasion, folks who have experienced workplace bullying will drop me a quick line to report the good news. Sometimes they got a new job while still struggling in the old one. Other times they had left or been pushed out of their old job and then found a new gig. More than a few had to look long and hard for a new position.

At times the new job doesn’t pay as well as the previous one, or maybe it isn’t as high up on the organizational chart. It may even mean finding a new line of work or occupation.

Nevertheless, securing new employment after experiencing workplace bullying can be a big step toward personal renewal. Here are a few points to ponder when this opportunity presents itself:

First, it’s absolutely natural to have apprehensions about returning to work after being bullied, mobbed, or abused at a…

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A short discussion on novice nurse workplace bullying

In 2012, we published our preliminary research on workplace bullying (WPB) in the Journal of Nursing Scholarship on the effects of workplace bullying on the productivity of novice nurses. Our article focused on novice nurses. Therefore, the implications emphasized preparation and protection of novice nurses going into an environment where negative behaviors of incivility and WPB continue in spite of The Joint Commission standard to eliminate disruptive behaviors for facilities. The interventions were concerned with novice nurses. Education and discussion of the issues surrounding bullying behavior should be an open discussion in nursing schools, in clinical rotation, and new hire orientation. Equipping the novice nurse to recognize the difference between bullying behaviors and constructive mentoring is paramount. Additionally, how to successfully cope through or stop stressful or WPB behaviors is essential. Novice nurses need to receive education to mindfully consider their own stressors, and then crucially and respectfully confront the perpetrators of these WPB behaviors. This may be hard to do, given a mostly female population already are socialized to avoid conflict but confronting the behaviors will decrease the likelihood that WPB behaviors will continue towards them. Encouraging novice nurses to follow the facility protocol for reporting incidents is also essential to stopping the behaviors (Bartholomew, 2006; Berry, Gillespie, Gates, & Schafer, 2012; Dellasega, 2011; Griffin, 2003).

Every employer, not just healthcare employers and nurse leaders, are responsible for providing a physically and psychologically safe work environment for all of their employees. Many hospitals and nurse leaders are working towards that end, which include educating all nurses on what is adverse intraprofessional communication and behavior. Unfortunately, perpetrators of bullying behavior do not always recognize themselves as the “bully” unless confronted about long standing behaviors and attitudes. Progressive counseling, corrective actions, and discipline must be well document to remove the predatory bully from the environment if he or she continues to act inappropriately.

However, social norms and organizational culture take time to change (Schein, 2004). Behaviors associated with long standing hazing of novice nurses (e.g., assigning larger patient loads, sink-or-swim attitudes, assigning problem patients, micromanaging with fault-finding instead of mentoring) require novice nurses to acknowledge appropriate organizational norms and effectively confront and stop hazing and WPB behaviors instead of rationalizing incivility and WPB behavior as social norms to be used on the next novice nurse. As nurses, we need to consider self-care and work/life balance on equal standing with patient care. If we do not take care of ourselves, patient care will suffer.

References

Bartholomew, K. (2006). Ending nurse-to-nurse hostility: Why nurses eat their young and each other. Marblehead, MA: HCPro, Inc.

Berry, P. A., Gillespie, G. L., Gates, D., & Schafer, J. (2012). Novice nurse productivity following workplace bullying. Journal of Nursing Scholarship, 44(1), 80-88.

Dellasega, C. (2011). When nurses hurt nurses: Recognizing and overcoming the cycle of bullying. Indianapolis, IN: Sigma Theta Tau International.

Griffin, M. (2004). Teaching cognitive rehearsal as a shield for lateral violence: An intervention for newly licensed nurses. The Journal of Continuing Education in Nursing, 35(6), 257-263.

Schein, E. H. (2004). Organizational culture and leadership. San Francisco, CA: Jossey-Bass A Wiley Imprint.

Conflating abuse and incivility in the academic workplace

Teachable moments with the attitude it is business may be excellent use of reframing to maintain ego in that kind of environment.

Minding the Workplace

In an advice piece titled “Coping with Verbal Abuse” in a recent issue of the Chronicle of Higher Education, Robert J. Sternberg offers advice for those who have experienced this form of mistreatment in the academic workplace.

Sternberg, a former university administrator and past president of the American Psychological Association and now a professor of human development at Cornell University, offers his short list of common types of verbal abuse in academe:

That abuse comes in many different forms: book reviews, referee reports on journal submissions, evaluations of grant proposals, questions and comments during presentations, offhand comments by less-than-collegial colleagues, and on and on.

Rather than simply giving it back and “telling off your abuser” (a potential “career-ender”), Sternberg recommends that one adopt approaches more likely to “pay off in the long run,” such as:

  • “Ignore the abuse and, if possible, the abuser.”
  • “It’s not always personal…

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AMA study: The costs of reduced employee loyalty

You get what you give. If more employers treated employees as assets and treated employees justly, employers would get more loyalty. When there is an uneven exchange, stress in exchange occurs, causing one individual to have power over another (Emerson, 1976). Stated succinctly, the organizational culture influences the behavior of its employees interpersonally and towards the organization based on positively or negatively perceived organizational support, justice, and reciprocity.

Emerson, R. M. (1976). Social exchange theory. Annual Review of Sociology, 2, 335-362.

Minding the Workplace

Reduced employee loyalty is costly to companies, but it appears that too many of them aren’t taking this seriously.

In an article for Workforce, American Management Association vice president Sam Davis reports on a new AMA research study showing that 52 percent of managers “see their employees as less loyal than five years ago.” He further notes that this perceived reduction carries negative costs: “A lack of loyalty can clearly be detrimental and result in loss of trust, higher absenteeism and turnover, shoddy work, gossiping, the formation of cliques and, in extreme cases, incite a mutiny.”

The December 2014 study included survey responses from some 1,200 North American executives, managers, and human resources professionals.

Unfortunately, the AMA study also suggests that a lot of employers aren’t taking the cultivation of employee loyalty very seriously. According to Davis, “One in five respondents said ‘yes,’ loyalty is a major focus at…

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The importance of stopping workplace #bullying in healthcare

Recently, I have been part of an advisory panel with the American Nurses Association on workplace violence, incivility, and bullying in healthcare.  Actually, I have been studying why these behaviors continue in the “caring” community. I like to laugh at myself, and with that, comes the unique sense of humor of a nurse.  I asked the wrong question when I first started. I asked “why do we bully?” I should have asked, “How can we stop it?”

I have learn that all of us can be “the bully” in an environment fueled by stressful events, lack of control over the care to be given, the time to give the “care” to our patients we have been taught is right, and the continued imbalance of power associated with gendered roles outside and inside of work. For those HR people who say coach the bully, coaching also includes progressive discipline. Nurse managers/leaders need to be educated and coached to be able to use progressive discipline not to fire the bully nurse but to rehab him or her back into the group. Parity occurs when the process for disruptive behaviors (bullying) is equally applied to physicians and nurses, which includes Employee Assistance Program intervention.

However, I would like to illuminate the fact that nurse peers and leaders continue the “nurses eat their young” by minimizing or rationalizing the behaviors of others, even their own behaviors. During transition from novice to competent nurse, nurse peers and leaders bully each step of the way creating the next generation of nurses who believe that bullying is normalized behavior. Humans use aggression within  families, some more than others. The violence, incivility, and aggression is global, societal, and the healthcare culture reflects normalization of aggression towards its employees. Nearly 35% of those men and women we work with have been affected by bullying or intimate partner violence prior to their license. We all appear to have a willful blindness or personal bias of wanting to be seen in the best light. God forbid we show any weakness least it become amplified by rumors or personal dislike. Authenticity, trust, and work relations are lost behind the façade that must be maintained.

Our profession is fragmented between the various specialties as human care become more complex. The one value linking all professional nursing specialties is nurses “care for” patients. This “caring” makes professional nursing the most trusted profession in the United States. As we work to dissolve the internal work conflict, incivility, and bullying between each other, each nurse is going to have to push the changes necessary to stop the behaviors from continuing to the next generation of new novice nurses by creating a systematic onboarding process for new nurses nationally, advocate to control our own work, advocate for a physical and psychologically safe work environment, and co-create a better work-life balance between employees and employers.  it is not the individual nurse that must change. The entire system has to change.

Healthcare organization also need to work with professional nurses for this change to happen for safe patient and cost-effective care, not profit. Profit will increase when quality of care is predicated on safe staffing levels and a “just culture” when there are no gender discrepancies in pay. Nurses are capable of creating and sustaining great change. It is time to create a great change in our response to violence inside and outside the profession.