Minimizing Toxicity in the Work Environment

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Minimizing Toxicity in the Work Environment

• Chelsye Bond, Monique Boutilier, Jennifer
  Fougere, Jessica MacLean

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Violence begins long before fists fly or lethal
weapons extinguish lives. Where resentment and
aggression routinely displace cooperation and
communication, violence has occurred.
- Bernice Fields
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Objectives

• Describe toxic work environments
• Identify how workplace toxicity can affect
  patients, staff organizations
• Explain 3 steps taken to combat workplace
  toxicity
• Summarize the nurses responsibilities in helping
  to provide effective solutions to workplace
  toxicity

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Identifying Workplace Toxicity
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Toxic Work Environments

• An environment in which individuals are the
  target of offensive, intimidating, malicious or
  insulting behavior, and/or experience an abuse or
  misuse of power through means intended to
  undermine, humiliate, degrade or injure the
  recipient.

(Randle et al., 2007)
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Negative Workplace Behaviors

• Verbally abusive language
• Intimidation
• Constant criticism
• Threats
• Spread of gossip
• Physical abuse (i.e. hurling charts)

• Undermining others
• Social exclusion
• Sexual comments
• Racial slurs
• Delegation of unskilled tasks
• Manipulation

(Felblinger, 2008 Randle et al., 2007)
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Workplace Toxicity

• Two types
• Horizontal
• Vertical

Video http//www.youtube.com/watch?v4MT8Wnb9ZY8
NR1
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• Randle, J., a nurse at the University of
  Nottingham, led a study focusing on bullying of
  nursing students. Findings suggested that more
  than half of all nursing students were bullied in
  their clinical placements.

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Anti-toxic Culture

• A quality practice environment creates a
  workplace culture that values the wellbeing of
  clients and employees.

• (CNA, 2006)

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Policies that contribute to positive workplace

• Policies that address
• Ethical issues
• Support safety
• Promote employee recognition
• Ensure adequate resources
• (CNA, 2006)

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Effects of Workplace toxicity

• Patient
• Staff
• Organization

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Staff

• Isolation
• Fear
• Stress-related illnesses
• Physical psychological effects
• Increase in absence or sickness
• Intention to leave profession

(Brown, 2009 Randle et al., 2007 Rocker, 2008)
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Patient

• A study by Rosenstein ODaniel (2005), reveals
  that 53 -75 of healthcare providers saw a strong
  link between disruptive behavior and adverse
  clinical outcomes such as
• Patient Safety
• Errors
• Adverse events
• Quality of care
• Patient Satisfaction

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Organization

• Understaffing
• Poor work relations
• Low supervisor support
• Increased workload
• Lack of resources

• (Cooper Swanson, 2002 Salin, 2003)

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Combating Workplace Toxicity

• Assertiveness
• Conflict Assessment
• Conflict Management

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Assertiveness

• Assertive behavior is standing up for your rights
  while recognizing the rights of others.
• It is communicating accurately and honestly with
  others on an equal basis.

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Assertive behavior has 3 components

• The non-judgmental statement
• The emotional consequence
• The effect of the behavior on the victim and
  service provided
• When you called me stupid in front of my
  patient
• I felt angry and embarrassed because it made me
• seem unprofessional and undermines my patients
• confidence in my ability to care for them.

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Conflict Assessment

1. What is the issue?
2. Who is involved?
3. Where is/was the conflict taking place?
4. Which is the best conflict management style to
   activate?

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• It is well known that the empowering behaviors
  of nurse leaders can be paramount importance in
  the way staff nurses react to their work
  environment.

(Pangman Pangman, 2010)
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Conflict Management Strategies

• Avoiding
• Accommodating
• Competing
• Compromising
• Collaboration

What conflict management strategy would you
choose?
(Valentine, 2001 as cited in Pangman Pangman,
2010)
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Solutions

• Quality practice environment
• CNA Model
• CRNNS complaint submission
• CREW

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Quality Practice Environments

• A quality professional practice environment
• Primary value
• Central to ethical nursing
• Decreases moral or ethical distress

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(CNA, 2003)
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CNA Model

1. Control over workload
2. Nursing leadership
3. Control over practice
4. Support and recognition
5. Professional development
6. Innovation Creativity

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• What actions would you take if the CRNNS
  Standards for Nursing Practice were not followed
  in the workplace?

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How to submit a complaint

• Address your letter of complaint to the Executive
  Director of the College of Registered Nurses of
  Nova Scotia.
• State that you are submitting a complaint
• Provide name and employment information about
  nurse involved
• List and number the incidents about which you are
  complaining. Give details
• Letters of complaint should be marked
  CONFIDENTIAL and addressed to Executive
  Director, College of Registered Nurses of Nova
  Scotia, 4005-7071 Bayers Road, Halifax, NS B3L
  2C2
• For more detailed information please refer to
  pamphlet

TO CRNNS

• (CRNNS, 2009).

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CREW

• Civilitity, Respect, Engagement in the workplace
  is a program designed to improve workplace
  relationships within a team
• Civility
• Respect
• Engagement

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Discussion

• Can anyone provide an example of a strategy used
  to promote a positive work environment?

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Questions