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Problem: A Culture of Bullying and Snitching

The Emergency Department at a hospital in California was struggling, like many in the healthcare industry, with workplace bullying among nurses. Nursing is so rampant in the nursing field, in fact, that in the 80’s the term “nurses eat their young,” was coined and is still widely used today.

In addition to the culture of bullying, a culture of gossiping with others, and snitching on each other, had come to the surface. Anytime there was an interpersonal issue, nurses felt helpless to resolve it, so they reported it to the Head of the Emergency Department. Already stressed for time, the Head didn’t have time to counsel every single incident that was reported to him. He needed his staff to learn to stand up for themselves and each other, and to be able to resolve issues on their own. This would free up the Head to take care of his other responsibilities, and focus on resolving only the escalated complaints.

In addition, the union had become somewhat of a “bully” itself, in that the union representative often threatened union uproar.

Recognizing that the bullying was disrupting teamwork and could even put patients in danger, the CEO, Vice President of Human Resources, and Head of the Emergency Department collaborated to come up with ideas for resolution.

Solution: Training on Communication Skills That Had Been Lost in the Weeds

Desiring a positive outcome for all, and knowing that bullying can be a complicated tenuous problem, the hospital called on Civility Partners to bring their expertise and help them determine the best course of action. Together, they settled on running a training program that could instill some of the skills the staff had clearly lost as the negative culture had crept in and taken over.

It was decided that two different training programs would be offered – one for managers and one for employees.

The employee training program was two-hours, and covered the following three topics:

  1. What bullying is
  2. How to stand up for themselves and others
  3. Tools for positive communication (e.g., listening skills, giving feedback, conflict management, etc)

The employees were also charged with creating a set of ground rules for behaviors that they could hold each other (and themselves) accountable to. Each employee was also required to define a personal action plan for improvement in their own communication, and to turn that plan in to their manager. The manager and employee could then collaborate to solidify the plan, determine resources needed for that employee, and define key indicators of success.

The department head and his management team received a four-hour training on the following topics:

  1. Setting expectations with employees about behavior
  2. Coaching “bullies” in order to help them change their communication style and behavior
  3. Standing up for their employees and for themselves
  4. Holding employees accountable for this new behavior, and collaborating with the employees to ensure success on their individual action plans.

In addition to working with each employee on their individual action plans, the managers were charged with developing action items around the new ground rules the employees had developed in their own trainings.

These trainings were offered all throughout the day so that nurses from all shifts could attend.

Key Results: Improved Patient Care and a Change in the Environment

Results of this training initiative included:

  • Decreased union activity now that nurses were feeling more positive about their work environment
  • Increased job satisfaction due to a more positive culture
  • Increased trust in leadership; the nurses felt heard and that their concerns were being addressed
  • A more productive work environment as less time was spent on resolving conflict and bullying, and more time could be spent on patients and offering excellent care

The change in the work environment was so drastic, that the hospital invited Civility Partners back to offer training in two other departments where bullying had begun to take hold of the culture.

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