PROPOSED PROBLEM DESCRIPTION

Proposed Problem Description for EBP Project

Deborah K. Gill

Grand Canyon University

NUR 699: Evidence-Based Nursing Practice

Nicolette Estrada, Instructor   

May 11, 2011

Proposed Problem Description for EBP Project

Problem Description

Rocker (2008) indicates that “nurse-to-nurse bullying in the workforce is contributing to the current nursing shortage” (p. 1). Research indicates that bullying in nursing can be difficult to identify because it can be “overt and intimidating” or may also be insidiously invisible to others (Cleary, Hunt, & Horsfall, 2010), and nurses are reluctant to report it (Longo, 2010, p. 3). Surveys show that disruptive behavior is quite common, but because they often go unreported, they often go unaddressed (The Joint Commission, 2008, p. 1). Bullying can become extremely costly to organizations and often creates problems such as increases in leave time and nurse attrition, decreases in nurse productivity, satisfaction and moral (Cleary et al., 2010, p. 331), and physical and emotional maladies that often require counseling (MacIntosh, 2005). The frequency and seriousness of this is such that The Joint Commission (TJC) vehemently urged health care organizations to address the problem of intimidating and disruptive behaviors. These behaviors threaten the performance of the entire health care team and threaten patient safety (The Joint Commission, 2008). Included among these behaviors are “passive activities” such as refusing to perform tasks, the quiet exhibition of an uncooperative attitude, a reluctance or refusal to answer questions, return phone calls or pages, condescending language or voice intonation, and impatience with questions. It erodes professional behavior and creates an unhealthy or even hostile environment (The Joint Commission, p. 1).

TJC stressed that health care organizations develop and implement a “zero tolerance” policy. In a recent interview nurse authors, Clark and Ahten (Stokowski, 2011) reminded readers that “in an ideal world, people would interact with each other respectfully and thoughtfully. “In the real world we wish to prevent the potential escalation that is caused by more damaging and disruptive manifestations” (pp. 2-3).

Overall, the organization was not rated as ready. Overall, the organization was not rated as ready. Overall, the organization was not rated as ready. Overall, the organization was not rated as ready. Overall, the organization was not rated as ready. Overall, the organization was not rated as ready. Overall, the organization was not rated as ready. Overall, the organization was not rated as ready.

Stakeholders/Change Agents

The entire health care organization is the primary stakeholder and the change agent because the continuation of bullying incidents may affect its ability to remain viable. Organizations are obligated to ensure that the work environment is non-threatening and non-intimidating. To ignore or act indifferent toward such unprofessional, unhealthy, hostile behaviors exposes the organization to lawsuits filed by employees and patients (The Joint Commission, 2008, p. 1). Most directly affected are healthcare workers within the intimidating environment. Therefore, administration and all levels of management become stakeholder and change agents by ensuring that anti-bullying policies are aggressively implemented and adhered.

Overall, the organization was not rated as ready. Overall, the organization was not rated as ...