Marie Hutchinson

Integrating individual, work group and organizational factors: testing a multidimensional model of bullying in the nursing workplace

AIM The aim of the present study was to test a multidimensional model of bullying in the nursing workplace. BACKGROUND This paper is part of a larger study of bullying in the Australian nursing workforce. While a number of studies have documented the frequency and consequences of bullying among nurses, there have been few attempts to develop integrated theoretical models that identify individual, work group and organizational factors. METHOD In the third stage of this sequential mixed methods study, data were collected from a randomized survey of Australian nurses. Structural equation modelling and confirmatory factor analysis on 370 completed surveys was used to test a multidimensional model of bullying. RESULTS Organizational characteristics were confirmed to be critical antecedents of bullying, influencing both the occurrence of bullying and the resultant consequences. CONCLUSIONS The findings have important implications for the management and prevention of bullying, suggesting that, if they are to be effective, strategies to address the problem need to focus upon work group and organizational factors. IMPLICATIONS FOR NURSING MANAGEMENT The findings draw in question the usefulness of current approaches to managing bullying and will be of use to nurse managers, particularly those tasked with providing safer and more productive workplaces.

A new model of bullying in the nursing workplace: Organizational characteristics as critical antecedents

Providing a safe work environment where nurses can practice without fear or threat of aggression is acknowledged as a critical global issue for healthcare organizations. Although there has been growing recognition that workplace bullying is one of the most concerning forms of aggression experienced by nurses, to date, there has been little progress in developing explanatory models. In this article, we outline our recently validated model of bullying, which specifies organizational characteristics as critical antecedents. The model has important implications for the management of bullying, identifying that to be effective, interventions need to address features of workplace climate.

‘They stand you in a corner; you are not to speak’: Nurses tell of abusive indoctrination in work teams dominated by bullies

Abstract This paper reports some of the findings from the first qualitative stage of a large national study of bullying in the nursing workplace currently being undertaken in Australia. The findings reported here reveal how relationships between bullies were embedded within informal organizational alliances, enabling bullies to control work teams and use emotional abuse and psychological violence as a means of enforcing bully-defined ‘rules of work’. Within nursing teams, bullies controlled work roles, tasks, and status in the nursing hierarchy through enforcing their ‘rules’. Bullies enforced these rules through a process of ritual indoctrination, destroying the self-confidence and self-image of those targeted, and forcing them to eventually resign their position or acquiesce to survive. The merciless, calculated and deliberate nature of the bullying resulted in profound harm for many of those targeted. The findings of this research have implications for the understanding and management of workplace bullying.

A typology of bullying behaviours: The experiences of Australian nurses

AIM AND OBJECTIVE This study sought to explore the nature of bullying in the Australian nursing workplace. BACKGROUND While there is widespread concern about the extent and consequences of bullying among nurses, to date, there have been no published reports cataloguing the types of behaviours that constitute bullying. DESIGN Reported here are findings from the first stage of a three-stage sequential mixed methods study. METHODS The first, qualitative stage of this study employed in-depth, semi structured interviews with 26 nurses who had experienced bullying from two Australian area health services. Content analysis of the verbatim interview transcripts was performed using the nvivo 7 software program. RESULTS The analysis identified six major categories and constituent sub-categories. The typology of bullying behaviours reported here is one of these major categories. CONCLUSION The typology of behaviours developed from the study provides detailed insights into the complexity of bullying experienced by nurses. The behaviours were labelled: personal attack, erosion of professional competence and reputation, and attack through work roles and tasks. These themes provide insight into the construct of bullying by providing a detailed catalogue of bullying behaviours that show that bullying is frequently masked in work tasks or work processes and focused on damaging the reputation and status of targets. RELEVANCE TO CLINICAL PRACTICE The detailed catalogue of bullying behaviours draws attention to the breadth of the bullying experience. It is anticipated the typology will be of use to nurses, managers and other professionals who are interested in responding to the problem of bullying in nursing.

Transformational leadership in nursing: towards a more critical interpretation

Effective nurse leadership is positioned as an essential factor in achieving optimal patient outcomes and workplace enhancement. Over the last two decades, writing and research on nursing leadership has been dominated by one conceptual theory, that of transformational leadership. This theoretical framework has provided insight into various leader characteristics, with research findings presented as persuasive evidence. While elsewhere there has been robust debate on the merits of the transformational model of leadership, in the nursing literature, there has been little critical review of the model and the commonly used assessment instruments. In this article, we critically review more than a decade of nursing scholarship on the transformational model of leadership and its empirical evidence. Applying a critical lens to the literature, the conceptual and methodological weaknesses of much nursing research on this topic, we question whether the uncritical adoption of the transformational model has resulted in a limited interpretation of nursing leadership. Given the limitations of the model, we advocate embracing new ways of thinking about nursing leadership.

I'm gonna do what i wanna do. Organizational change as a legitimized vehicle for bullies.

Abstract: In-depth interviews with nurses who have been bullied depict bullies masking their bullying behavior behind the cloak of legitimate organizational processes, resulting in extensive harm to targets.

Like Wolves in a Pack: Predatory Alliances of Bullies in Nursing

The findings from the first, qualitative stage of a larger sequential mixed method study of bullying in the Australian nursing workplace are reported. Interviews with twenty-six nurses, recruited from two health care organizations, were analysed using the constant comparative method. Participants described informal organizational networks as the mechanism through which predatory, cooperative, and planned group bullying acts were promulgated. These predatory alliances enabled the co-option of legitimate organizational systems, the concealment of bullying, and the protection and promotion of perpetrators. By identifying the manner in which workplace bullying can be embedded within informal organizational networks, this research has important implications for further research in this field.

Restorative approaches to workplace bullying: Educating nurses towards shared responsibility

Abstract This paper summarises what is known about bullying in the nursing workplace and approaches currently employed to address the problem. Synthesising the available evidence it is identified that restorative approaches which seek to foster shared responsibility and positively influence group norms are underdeveloped. Based upon the principles of restorative justice this approach seeks to foster active responsibility for addressing bullying by building pro-social workplace relationships. Given the importance of socialisation processes in mediating and sustaining bullying among nurses, restorative approaches are proposed as a strategy that can be employed in nursing education to address bullying.

The importance of clinical leadership in the hospital setting

License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Journal of Healthcare Leadership 2014:6 75–83 Journal of Healthcare Leadership Dovepress

Understanding avoidant leadership in health care: findings from a secondary analysis of two qualitative studies

AIM To illuminate ways that avoidant leadership can be enacted in contemporary clinical settings. BACKGROUND Avoidance is identified in relation to laissez-faire leadership and passive avoidant leadership. However, the nature and characteristics of avoidance and how it can be enacted in a clinical environment are not detailed. METHODS This paper applied secondary analysis to data from two qualitative studies. RESULTS We have identified three forms of avoidant leader response: placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant. CONCLUSIONS Through secondary analysis of two existing sets of data, we have shed new light on avoidant leaderships and how it can be enacted in contemporary clinical settings. Further work needs to be undertaken to better understand this leadership style. IMPLICATIONS FOR NURSING MANAGEMENT We recommend that organizations ensure that all nurse leaders are aware of how best to respond to concerns of wrongdoing and that mechanisms are created to ensure timely feedback is provided about the actions taken.