Isn’t it odd that in all the public health and community programs being produced to address and stop violence against women, nothing is ever said or done about the violence towards women in the workplace? I’m referring in this instance to the ongoing workplace violence that is the bullying and victimisation of nurses by nurses.
In the spirit of stopping violence we have sexual harrasssment programs provided to all employees as a legislative requirement. We are obliged to view DVD’s, read policy handouts and advised on the right way to seek help and support if sexual harrassment occurs.
Unfortunately, in a profession dominated by women. Sexual harrassment is not something that we experience or hear very much about and DVD’s on sexual harrassment, as important as they may be, aren’t especially useful to a predominantly female workforce. I personally have never worried about or experienced sexual harrassment throughout my 35 year nursing career and I haven’t met anyone who has complained about it.
However, I have been bullied and experienced the violence associated with being bullied, I know many other nurses who have been and are still experiencing bullying and yet I have never received any formal education or support on how to stop it or do something about it.
The workplace violence towards nurses, commonly referred to as workplace aggression, bullying and victimisation, is a well-known, well-researched and ever-pervasive problem in the health system; yet staff orientation programs fail to address this issue in the same thorough way that staff/client sexual harrassment or the management of challenging behaviours, physical or verbal violence from clients is managed. Why is this insidious workplace violence ignored? Is it because overt physical violence is easily recognised, the injury evident for all to see and the victim is therefore believed?
Formal research, informal anecdotes and nurses stories of their experience all tell us that nurses who perpetrate workplace violence most commonly use psychological violence against their victim(s). In these instances the injury is invisible and often devastating to the observer and thus the victim is disbelieved and shamed.
This troubling situation mimics many other victims of violence such as child abuse, rape and domestic violence. Until recently, the victim of these types of violence were often disbelieved, belittled and blamed. The community and law makers ignored the damage and the victim of the violence had to prove the perpetrators’ guilt. The violence within nursing and the health system is another instance of “blame the victim” for the violence and pretending the situation just doesn’t exist.
In the current climate, Health Organisations place enormous emphasis on ensuring that clients of the health system receive up-to-date and evidence-based care. Nurses, doctors and allied health professional are all expected to remain current in practice, credentialled in their discipline and attend ongoing education and training. Astonishingly, the same evidence-based considerations do not seem to apply to the management structures or policy developers in Health Organisations. If they did, they would recognise the enormity of the problem that confronts nurses on a daily basis and endeavour to address the ongoing violence and significant and often long-term psychological injury that is sustained by the victim.
Let’s put this in a framework that people might better understand. If we as nurses and health professionals insisted on providing nursing care to our clients that reflected the beliefs and practices of 50-100 years ago, ignored all current research evidence of best practice, and gave care that shamed and belittled our clients, critised them for being sick and not getting better, discussed them disparagingly and personally in front of other staff, clients and visitors and ensured that we made their illness worse; we would face competency appraisals, disciplinary proceedures from health management, hauled up before the NSW Nurses and Midwives Registration Board and ultimately dismissed and lose our registration!
Now let’s consider this even further – if this nursing care issue was taken very seriously and subsequently academically researched and all the evidence proved that our nursing care and behaviour caused our clients to leave our care psychologically and financially damaged, depressed, anxious, emotionally exhausted, fatigued, shamed, fearful, depleted of life and job satisfaction and if they have been under our care for a long period of time they may even have developed post-traumatic stress disorder there would be a public outcry!
A parliamentary enquiry or a royal commission would be set up, the media would be hounding our every step and demanding answers and a public education program would be developed and rolled out to help people understand and manage these damaging nursing practices.
Yet everyday in our health systems, right across the board, health organisations and management, continue to silently condone workplace violence, in spite of all the research evidence that the workplace violence known as bullying continues unabated and to such an extent that we are losing our best and brightest nurses.
I have been reviewing the literature on “bullying in nursing”. Depending on the key words I use in my search criteria I can access up to 500+ papers examining, describing and reviewing bullying in nursing.
One of the newer terms for nursing bullying behaviour is “mobbing“. Workplace Mobbing described by Leyman (1990) and Yildirim (2007) is defined as
“a type of psychological terror of antagonistic behaviours with unethical communication directed at one individual by one or more other individuals. The mobbing process begins by attacking the honor, honesty, reliability and professional abilities of an employee”.
How familiar is this description to all nurses working within our health system? When one nurse is bullied or mobbed 2 things occur amongst colleagues. They either join with the perpetrator and demonstrate similar behaviours or they ignore the mobbing and leave the victim without help or support for fear of being victimised themselves.
Victims of mobbing or bullying are exposed to frightening, humiliating, isolating attitudes and behaviors which is psychological workplace violence. The effects of this violence on the victim are far-reaching and long-term. The injuries that occur to the victim are psychological and financial damage, depression, anxiety, emotional exhaustion, fatigue, shame, fear, depletion of life and job satisfaction, and when the violence continues post-traumatic stress disorder.
The effects of this workplace psychological violence on the health system and the greater community are also far-reaching, expensive and long-term.
Workplace psychological violence is not an issue we can ignore any longer.
Training and recruitment is not the big issue in nursing. The real issue is the rentention of nurses in the health system. If we don’t do something about the ongoing perpetration of psychological violence against nurses; if we continue to be silent and inactive in finding a solution to the problem, nursing will whither as a profession. We will be disrespected by the community as we continue to disrespect ourselves.
Let’s stop the violence now.