Improving the nurses work environment can increase satisfaction with the professional role in addition to improving outcomes and cost of care Stickler and Scoff, Hostile work environments still exist today for many nurses and continued efforts are necessary to change these environments for proper patient care and retention of nurses.
This is an open access article distributed under the terms of the Creative Commons Attribution License http: This article has been cited by other articles in PMC. Abstract Background Although there is a sizeable body of evidence regarding the nature of hostile behaviours among clinicians in the nursing workplace, what is less clear is the nature of the relationship between these behaviours and patient care.
To inform the development of appropriate intervention strategies we examine the level of evidence detailing the relationships between hostile clinician behaviours and patient care. Methods Published qualitative and quantitative studies that examined hostile clinician behaviours and patient care were included.
Quality assessment, data extraction and analysis were undertaken on all included studies. Results The search strategy yielded 30 appropriate publications. Employing content analysis four themes were refined: Conclusions Our results document evidence of various forms of hostile clinician behaviours which implicate nursing care and patient care.
By identifying the place of nurse-nurse hostility in undermining patient care, we focus attention upon the limitations of policy and intervention strategies that have to date largely focused upon the disruptive behaviour of physicians. We conclude that the paucity of robustly designed studies indicates the problem is a comparatively under researched area warranting further examination.
Workplace bullying, Disruptive behaviour, Quality of care, Teamwork, Nurse-physician relations, Work environment, Systematic review Background Internationally, various studies and reports have raised concern regarding hostile behaviours in the nursing workplace [ 1 - 3 ].
Although aggression and violence from patients and their visitors are cause for concern, nurses report hostility from colleagues, managers and other professionals to be of most concern [ 4 ].
The types of behaviours that constitute hostile behaviours between clinicians have been variously categorised as horizontal or lateral violence, insider perpetrated violence, relational aggression, bullying, incivility, harassment, and aggression [ 5 - 7 ]. The instigators of hostile clinician behaviours in the nursing context can include other nurses, physicians or other health professionals [ 8 ].
It is widely held that the various forms of hostile behaviour exhibited in the workplace threaten patient safety by impacting negatively upon the nature of the work environment, including eroding effective professional communication and professional relationships that underpin delivery of safe care [ 10 - 12 ].
Hostile behaviour within work teams can result in reduced communication and disruption to teamwork [ 8 ]. In the health care context, relatively subtle forms of hostile clinician behaviours, such as withholding information or covert intimidation have the potential to cause serious harm when patient care is impacted [ 13 ].
Furthermore, these behaviours not only have the potential to impact negatively upon the delivery of patient care, the consequences for clinicians targeted by hostility can include anxiety, depression, post-traumatic disorder and withdrawal from work [ 1 ].
Reflecting the degree of concern about hostile workplace behaviours, The Joint Commission responsible for accrediting health care organizations in the US released a Sentinel Event Alert drawing attention to the dangers of intimidation and disruptive behaviours in undermining a culture of safety [ 14 ].
The dissemination by the Joint Commission of a Sentinel Event Alert reflects concern about an identified trend in sentinel events related to unexpected patient death or serious injury. Importantly, both of these terms minimise the hostile, and often aggressive, intimidating and abusive nature of the behaviours involved, which can include physical assault, bullying, sexual harassment and racial slurs [ 17 ].
For this reason in this manuscript we have chosen the less ambiguous term hostile clinician behaviours as an umbrella concept to encapsulate the range of hostile behaviours that may occur between clinicians and contribute to adverse patient care by influencing the culture of safety, quality of care and patient satisfaction [ 14 ].
Despite widespread recognition of the potential impact of hostile clinician behaviours on patient care, no studies have systematically examined the available evidence on the relationships between these factors.
The review Aims For this review we were specifically interested in examining the relationship between the various forms of hostile clinician behaviours and patient care.
The following two questions were developed to guide the systematic review and analysis. Methods Papers published during the period — were included in the review. This timeframe was chosen following an initial scoping review of the literature that identified the emergence of literature on hostile clinician behaviours in the nursing context from the early s, with reported studies appearing after To provide more in-depth understanding into the questions the review sought to address a mixed-studies design, including qualitative, quantitative, and mixed methods studies was chosen [ 18 ].
The initial scoping review identified that there has been very little primary research on this topic, thus the scope of the review was enhanced by examining data from studies not primarily designed to investigate the relationship between hostile clinician behaviours and clinical outcomes.
This type of review is useful where there is limited research on an important issue to inform policy and practice.Workplace Conflict in Nursing Essay Sample. The whole doc is available only for there are significant negative outcomes for nurses that can disrupt one’s emotional, physical, and psychological well-being.
While conflict is inevitable, frequent conflict is detrimental to the quality of nurses’ work environments, clinical outcomes and. Hostile work environments still exist today for many nurses and continued efforts are necessary to change these environments for proper patient care and retention of nurses.
As a new graduate RN I was unaware of these standards as I began my first position in the operating room as a scrub nurse in our local hospital. Transforming the Work Environment of Nurses,” emphasizes the importance of the work environment in which and while bullying can create a hostile work environment, it is not the same as the organization allowing an illegal hostile work environment (for example, causes negative effects on the victim, and is an attempt to control.
The Effect of the External Environment on Work in Australia - The Effect of the External Environment on Work in Australia This essay considers how changes in the external environment of organisations have altered the world of work. Negative Outcomes For Nurses: Hostile Work Environments Essay.
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Empowering work environments for nurses were hypothesized to impact group processes and thereby work effectiveness as reflected in patient outcomes (patient satisfaction, therapeutic self care, falls and nurse-assessed risks).