OR Manager - January 2018 - 13

Leadership
Bullying
One nurse leader's story
Continued from page 1
physicians, administrative staff, environmental
services staff, anesthesia
providers, and others work closely together,
creating multiple dynamics not
present on a typical nursing unit, explains
Dellasega, author of Toxic Nursing
and When Nurses Hurt Nurses.
In this three-part series, OR Manager
explores what OR leaders can do to address
and prevent bullying. First, they
must understand what constitutes bullying
and the wide-ranging damage it can
cause. Even experienced leaders may
not recognize all the behaviors that signal
bullying-or the fact that they may
be guilty of such behaviors.
What is bullying?
Conflict is a part of daily life in the OR,
and most leaders would agree it can
even be healthy and productive. But
when does conflict cross over to bullying?
WBI
says bullying is the " repeated,
health-harming mistreatment of one or
more persons (the targets) by one or
more perpetrators. " It's marked by repetition
(as opposed to a single act),
harmful effects, and an imbalance of
power.
And others besides the
bull y's
target
are
Cheryl
Dellasega,
PhD, NP
harmed. " [In healthcare]
we look at potential or
direct harm to patients, "
says Renee
Thompson, DNP, RN,
CMSRN, a workplacebullying
expert. Those
who witness bullying
suffer from fear that they will be next,
guilt at not taking action, or even anxiety
and depression.
It's difficult to precisely define bullying,
so Dellasega uses the term relational
aggression (RA), which is harming
others through purposeful manipulation
www.ormanager.com
Brenda Burk, MSN, RN, NEA-BC, CNOR, held a senior leadership position in the
OR and felt good about her effectiveness. All that changed when she met her new
manager.
" During our first conversation, she said I wasn't good enough to be on her team because
I only had a diploma, " recalls Burk. After Burk got her degree, her manager claimed that
staff and surgeons were complaining about her. When Burk asked them for feedback, they
said there were no problems. " She was fabricating the whole thing to break me, " Burk says.
As the situation worsened, the manager told Burk, " This is not an abusive relationship
because if you don't like it, you can leave. "
Burk says she became an emotional wreck. " I couldn't cope. Every time I turned
around, she was critical. After 18 months, she broke me personally, but I wasn't going to
let her break me professionally, " Burk says. When she resigned, the manager told her,
" I'm surprised it took you so long. "
and damage of relationships. " Relational
aggression is operationalizing bullying
through specific behaviors such
as gossiping, exclusion, and belittling,
which can be in person or online, " she
says. The three roles that occur with
RA are aggressor, victim, and bystander
(witness).
Dellasega adds that bullying is in the
eye of the beholder when it comes to
generations. " Younger people grew up
with this language and are more sensitized
to it, so what they consider to be
harsh treatment may be very different
from what an older person considers
harsh treatment. "
Thompson notes that bullying can
be overt or covert. Overt weapons of
bullies include sarcasm, name-calling,
intimidation, blaming, or even threatening
physical violence. Covert weapons
include sabotage, withholding information,
excluding others, unfair assignments,
undermining, and downplaying
accomplishments.
Those who are bullied may not report
it, particularly if the bully has threatened
them, so managers must be alert to
subtle signs in their employees, such
as a change in behavior.
Although bullying discussions commonly
focus on behavior at work and
person-to-person interactions, Dellasega
says online bullying,
including
via social media when the bully isn't
at work, is increasingly common. " As
we're switching to a more online form
of communication, we have to be really
careful not to lose the context of the
communication [voice, facial expression], "
she says.
Cynthia Clark,
PhD, RN,
ANEF, FAAN
A common misconception
is that all bad behavior
is bullying. " There
is a difference between
bullying and incivility, "
Thompson says. " There
is not a lot of bullying in
organizations, but there
is a lot of incivility. " Unchecked
incivility, however,
can lead to bullying.
Cynthia Clark, PhD, RN, ANEF, FAAN,
locates bullying further along the continuum
of incivility, with behaviors causing
increased risk of harm. " Bullying is always
targeted; usually, but not always,
intentional; and typically prolonged, "
says Clark, strategic nursing advisor
for ATI Nursing Education and professor
emeritus at Boise State University,
Boise, Idaho. " It's almost always done
to demean, demoralize, and diminish. "
Clark, who is the founder of Civility
Matters™, served as co-chair for the
American Nurses Association Professional
Panel for Incivility, Bullying, and
Workplace Violence.
Part 3 of this series will discuss how
to prevent bullying by promoting civility
as part of a healthy work environment.
Continued on page 14
OR Manager | January 2018 13

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OR Manager - January 2018

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