Concept of Bullying In Nursing Education and Its Impact
Whats is Bullying in Nursing Education
Bullying is defined as repeated, unreasonable actions intended to intimidate, degrade, humiliate, or undermine. It generally occurs when there is a power differential and can result in harm to one's physical and mental health (Canadian Center for Occupational Health and Safety, 2005).
Bullying behaviors may be overt, such as yelling or using
profanity, threatening abuse, publicly belittling or humiliating, or spreading
malicious rumors or gossip; the more covert behaviors, such as isolating an
individual; changing expectations, guidelines, and deadlines; or providing
incorrect information to sabotage one's work, are equally destructive but less
obvious to prove
Incidence of Bullying In Nursing Education
The phrase "Nurses cat their young" has been around for generations and refers to the aggressive and non supportive behavior senior nurses exhibit toward newer and younger student nurses. This often quoted phrase suggests that bullying is unique to nursing: however, in contrast, bullying occurs in all occupational sectors (Namie, 2014) and across the age span (Longo, 2013).
It is vital that nursing recognizes the existence of bullying, across all domains clinical practice, administration, education, and research) in order to develop prevention strategies establish reporting protocols, and implement education and awareness programs to promote quality workplaces, free of bullying behaviors.Within the academic domain, bullying has been reported as occurring from educator to student, student to student, student to educator, and educator to educator.
In all instances, the bullying behaviors negatively impact student recruitment, retention, satisfaction, and the overall quality of the educational setting (Beckman, Cannella, & Wantland, 2013) and ultimately the quality of patient care. Within the educational domain, students must be prepared to recognize and manage bullying behaviors and be aware of the dynamics so that they themselves do not develop behaviors consistent with bullying interactions.
Impact of Bullying on Nursing Education
Bullying in nursing education is a double edged sword as health care and education are the occupational sectors reporting the largest proportion of bullying experiences (Namie, 2014) It is suggested that individuals attracted to both nursing and education possess caring and nurturing qualities that make them susceptible targets to bullying It has also been theorized that nursing, as an oppressed group, experiences horizontal violence (bullying staff to staff) as a result of being a predominantly female group that is devalued within a hierarchical health care system (Purpora, legen , &Stott , 2012: Roberts, 1983).
Nurse educators have a responsibility to empower nursing students so that they do not adopt the oppressive group behaviors associated with bullying and lateral violence.Nurse educators also have a responsibility to ensure that they are not perpetuating bullying behavior. As a practice-based 42 Bullying discipline, the education of future nursing practitioners requires that students gain knowledge and competence through clinical experience.
While nursing educators are valued for their nursing expertise, they may not necessarily be equipped with theories of teaching and learning that prepare them to effectively provide feedback while recognizing the students' efforts and building on the students' strengths. Anecdotally, clinical instructors and staff nurses routinely define their feedback to students as constructive criticism; students define it as bullying.
In a recent study of Canadian undergraduate baccalaureate nursing students, 88% reported having experienced at least one act of bullying, with the clinical instructor identified as the greatest source of the bullying behavior, followed by staff nurses (Clarke, Kane, Rajacich , &Lafreniere , 2012). The most frequently reported bullying behavior was the perception from students that their efforts were undervalued, followed by reports of being unjustly criticized.
Nursing students who self labeled as being bullied were significantly more likely to consider leaving nursing and believed that the bullying behavior had a negative impact on their learning experience (Clarke et al., 2012).The academic setting is a perfect opportunity to provide role playing or simulated scenarios for students and educators to act out aggressive interactions and problem solve a non aggressive resolution.
Students may share experiences they perceive as negative and demeaning and identify effective communication strategies to discuss with the instructor. Because bullies often do not identify their behavior as bullying (Thompson, 2012) role-playing provides educators the opportunity to reflect on behaviors and determine if they are contributing, directly or indirectly, to a bullying culture.
Guideline Regarding Bullying In Nursing Education
There is a need to ensure that nursing students are equipped with effective communication and conflict resolution skills, Nursing students will not only benefit by being prepared to address bullying behavior when it occurs, they will also be able to support their colleagues should they experience it. Equally important is the need to ensure that all nurses who interact with nursing students are able to do so in a constructive and empowering manner.
Promoting reflective nursing practice will encourage nurses to reflect on their own behavior and identify if they are guilty of bullying behaviors. Since nursing education does not exist in a vacuum, every member of the health care team must play an active role in eliminating bullying from the health care sector.Research into the phenomenon of bullying needs to begin with the development of a unified definition of bullying and valid and reliable standardized tools for measuring bullying.
Studies that evaluate the implementation of policies and legislation that address the existence and management of workplace violence, including bullying, are needed to create and sustain quality learning environments for nursing students.
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