Week 11 - Incivility, abuse in the workplace Flashcards
What are the shockingly high statistics of new graduate nurse turnover?
30% by year 1; 57% by year 2
What are contributing factors to the higher NGN turnover rate?
Feeling underprepared for practice
Stressful transition period
Expectations vs. reality
Experiences of incivility and bullying
Process of making a significant adjustment to changing personal and professional roles at the start of one’s nursing career
New graduate nurse transition
What are the 3 major sections of the Transition Stages Model?
Doing phase
Being phase
Knowing phase
What are the different factors in the Doing phase of the Transition Stages model?
Learning Performing Concealing Adjusting Accomodating
What are the different factors in the Being phase of the Transition Stages model?
Searching Examining Doubting Questioning Revealing
What are the different factors in the Knowing phase of the Transition Stages model?
Separating Recovering Exploring Critiquing Accepting
Identify what aspect of the Being phase of the Transition Stages model is being described.
A - Looking for meaning in what it is that you are doing, trying to understand why things are the way they are
B - Start to ask why you went into the profession, will you ever be good? As good as your colleagues? What about fatigue and work-life balance?
C - May be trying to figure out the roles of nurses in HC system, may be pondering certain aspects of our unit or organization, how the HC system works itself.
D - Now aware of differences between the way you were taught and what you are actually doing; now looking at things for what they are
E - So much of what we didn’t know, or couldn’t be exposed to is starting to reveal itself, starting to see everything that comes with the nursing profession
A - Searching B - Doubting C - Questioning D - Examining E - Revealing
Identify what aspect of the Knowing phase of the Transition Stages model is being described.
A - starting to spread own wings – moving away from preceptors and mentors – gaining independence and doing things your own way
B - happens after recovering period – starting to think about future, exploring nursing career trajectory – e.g. stay on unit, new type of nursing, leave profession, back to school
C - feeling like what the hell happened, stressful months, feel like you may need to take a break, vacation, take some time off since you feel drained
D - where you accept the profession for what it is – keep moving on or do you move away; do you start asking for changes to happen, or just accept the way things are happening
E - exploring, understanding and reconstructing our vision of nursing and how we fit into it
A - Separating B - Exploring C - Recovering D - Accepting E - Critiquing
Identify what aspect of the Doing phase of the Transition Stages model is being described.
A - Comfortable in learning role – lots to learn about organization, coworkers, new responsibilities, how to manage workload, etc.
B - figuring out who you are as a nurse, and trying to belong
C - shifting to new roles, relationships and responsibilities
D - often feel very insecure about what they do know, but more about what they don’t – will hide and pretend that you know more than you do
E - very concerned about doing skills – feel like you are being watched and want to do everything properly
A - learning B - accommodating C - adjusting D - concealing E - performing
Identify the phase of the Transition Stage model based on the description.
A - Consistent and rapid advanced in their thinking, knowledge level, and skill competency
B - Understanding professional relationships in the HC system
C - Transition from a structured, relatively predictable life into a new set of expectations and responsibilities
D - Increased awareness of professional self
A - Being
B - Knowing
C - Doing
D - Being
Identify the phase of the Transition Stage model based on the description.
A - Feeling unprepared for the responsibilities and workload of their new role
B - comfort and confidence with their roles, responsibilities and routines
C - seeking balance
D - recovery from transition shock
A - Doing
B - Knowing
C - Being
D - Knowing
Identify the phase of the Transition Stage model based on the description.
A - Desire for clarification and confirmation of their own thoughts and actions
B - often lack of support and mentorship
C - increased comfort with roles and responsibilities of being a new nurse
D - desire to keep personal and work life separate
A - Being
B - Doing
C - Being
D - Knowing
Identify the phase of the Transition Stage model based on the description.
A - Idealistic vs. realistic expectations of self and workplace
B - often placed in situations beyond their level of competence and comfort
C - Understanding expectations, doing it well, and completing their tasks primary concerns
D - Seeking balance
E - Increased awareness of professional self
A - Doing B - Being C - Doing D - Being E - Being
What are the phases of skill acquisition?
Novice –> advanced bigger –> competent –> proficient –> expert
The majority of us are in what phase of skill acquisition? After IP?
novice
somewhere in advanced beginner
What are important sources of new graduate support?
Solid orientation
Experienced nurse mentorship
Progressive and thoughtful exposure to progressively challenging situations
Graduates require consistency, predictability, stability and familiarity in their initial practice situations for at least the first ___ months.
4
match with an employer on a specific unit – get 20 weeks of orientation above staff complement – full time guarantee, but working with a preceptor
NGG
What are some common issues with NGNs?
Lack of clinical knowledge low confidence in skill performance relationships with colleagues workload demands organization and time management Decision-making and direct care judgements Communicating with physicians
What is a big focus for issues with NGNs?
Organization and time-management
Negative psychological syndrome characterized by emotional exhaustion and cynicism
Burnout
feel like you cannot deal with people or care for them – feel like you have nothing left to give
Emotional burnout
skeptical of meaningfulness of your work or efforts
Cynicism
What are the two factors that contribute to nurse burnout?
Emotional exhaustion and cynicism
What is the most common type of workplace violence?
Psychological violence
Psychological violence is often due to _______ of _______.
Often perpetrated from ______ powerful to ______.
misuse, power
most, least
What are the three types of violence in the workplace?
Physical, psychological, sexual
Which type of violence is a priority as a workplace concern?
Psychological - hardest to identify, articulate and fix
an incident of aggression that is physical, sexual, verbal, emotional or psychological that occurs when nurses are abused, threatened or assaulted in circumstances related to their work
Violence in the workplace
Name who is impacted by violence based on the description.
A - decreased level of nursing care, decrease patient safety
B - high turnover rate, less staffing, lower productivity, increased costs for retention and recruitment
C - fear, anxiety, dissatisfaction with job, impact on patient care, isolation, self-esteem diminished, fatigue, sleep disturbance, increased sickness, poor retention, depression
A - Patient care
B - Organization/workplace
C - individual
describes low-intensity, rude or disrespectful behaviours with an ambiguous intent to harm others
incivility
Described as interpersonal conflict in which the target is subjected to systematic stigmatization, harassment, and social isolation over an extended period of time
Bullying
rude, unreasonable, bad manners, disrespectful, impolite, discourteous – common in any profession, but especially here
Incivility
If not checked, _________ can escalate into bullying
incivility
Effects of bullying are ______-lasting and ____________ leading to poor health outcomes, increased absenteeism and high job turnover
long
multidimensional
There are three recommendations/factors for the prevention of violence in the workplace, name them
system recommendations
organizational factors
environmental factors
(team/individual recommendation)
Name the recommendation/factor for the prevention of violence in the workplace based on the description.
A - teaching HCPs de-escalating course; policies and procedures that address it; addressing people who are violent in the workplace
B - like government involvement – e.g. mandatory reporting of violence; monitoring organizational accountability; research – measuring incidence and studying mitigating factors
C - proper lighting, security, making workplace accommodations when necessary
A - organizational factors
b - system recommendations
C - environmental factors
What is the biggest factor for prevention of violence in the workplace?
Speaking up = team/individual recommendation
What are the resources by the Ontario nurse organizations for violence in the workplace?
CNO - conflict prevention and management practice guideline
ONA - workplace violence prevention campaign
RNAO - BPGs; position statements
impacts the way we interact with the environment – aka personal resources
psychological capital
What are the different factors encompassed within psychological capital?
Self-efficacy
Hope
optimism
resiliency
Name the factor based on the description.
A - setting goals and believing you can meet them
B - belief about ability to be successful in executing a task or successful in a particular situation
C - Ability to bounce back from adversity
D - positive outlook on an event
A - hope
B - self-efficacy
C - resiliency
D - Optimism
The higher the psychological capital, the lower the….?
emotional exhaustion, bullying, cynicism, burnout, etc.
Bullying has a significant positive effect on _______ development.
Positive workplaces protect against ________ ________.
Burnout has a significant negative effect on NGN’s ______ and _______ health
burnout
emotional exhaustion
mental, physical
What are the 6 significant areas of worklife for employees?
Workload control rewards sense of community fairness values congruence
Name the area of worklife for employees based on the description.
A - may want to know what the role looks like and how much governance there is over how you perform the job
B - want to look at relationships between efforts and recognition on that particular floor
C - level of justice and managerial support within the organization
D - matching values and beliefs between employee and organization
E - when choosing place to work, want to know what resources are necessary to meet the demands of the job
F - quality of the relationships on that unit or organization
A - control B - rewards C - fairness D - values congruence E - workload F - sense of community
What are the three characteristics of healthy workplaces?
Positive, supportive organizational culture
Physical environment and occupational health and safety
Health and lifestyle (corporate wellness)
Name the characteristic of healthy workplace from the definitions below.
A - Mindfulness, wellness exercises, yoga, step classes, zoomba, etc.
B - Policies and procedures to protect us; proper training of staff, maintenance of equipment, given proper patient assignments
C - managers open for you to share your perspectives
A - health and lifestyle/corporate wellness
B - physical environment and occupational health and safety
c - Positive, supportive organizational culture
Work engagement is a positive work-related state of fulfillment characterized by feelings of?
Vigour, dedication, absorption
high energy levels, that mental tenacity when conducting work – putting in 100% and persevering when things are tough
vigour
state of concentration or deep enthrallment into your job
absorption
__________ is the most common thing that helps to increase work engagement, especially for newer nurses.
Leadership
factors of effectively functioning social groups – things like interpersonal relationships, the ways we interact with each other; norms, values and beliefs
social capital
What are the descriptors of authentic leadership?
Self-awareness, transparency (True self), balanced processing, moral and ethical integrity
refers to access to organizational structures that enable employees to accomplish their work in meaningful ways
Structural empowerment
What is the assumption of structural empowerment?
nurse managers can create effective work environments by providing access to structures of opportunity and power
What are the four core components of structural empowerment?
Access to:
- opportunities
- information
- support
- resrouces
Name the access type for structural empowerment based on the description.
A - time, supplies, and equipment to accomplish organizational goals
B - knowledge and expertise, awareness of organizational goals
C - a sense of challenge and changes to learn and grow
D - feedback and guidance received from superiors, peers, and subordinates
A - resources
B - information
C - opportunities
D - support
resources or credits created by and embedded within social relationships within an organization
Social capital in organizations
What is the assumption of social capital in organizations?
positive relationships with others at work lead to increased exchange of social resources such as ideas, advice, cooperation and help. Social resources require investment in relationships and is not readily transferable.
What are the three main types of social capital in organizations?
Structural
Relational
Cognitive
Name the type of social capital in organizations based on the description.
A - describes who knows who and how they know each other – social network or web
B - refers to the nature or quality of relationships that people have with one another
C - refers to the shared ways of thinking about work, shared jargon and common experiences
A - structural
B - relational
C - cognitive
Describe the link between authentic leadership, structural empowerment and social capital.
Authentic leadership influences social capital through structural empowerment
quality of ________ is an additional mediator between leader behaviours and NGNs job satisfaction
relationships
Your manager makes sure that you have the equipment and information you need to do your job, provides you with support, and gives you funding to attend an annual nursing conference for professional development.
Structural empowerment
According to the NGN Transition model, new nurses go through which stages?
Doing, being, knowing
A nurse is regularly excluded from social events on her unit.
Bullying
