Academic journal article Online Journal of Issues in Nursing

Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment

Academic journal article Online Journal of Issues in Nursing

Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment

Article excerpt

Abstract

Disruptive behaviors among healthcare workers threaten the safety and well being of both patients and staff. The Joint Commission now charges healthcare organizations seeking accreditation to address these behaviors. All members of the healthcare team need to be knowledgeable about disruptive behaviors. In this article the author reviews the causes and consequences of disruptive behavior for both patients and healthcare workers, discusses initiatives for addressing disruptive behaviors, and provides specific steps for nurse managers and staff nurses to combat disruptive behaviors.

Citation: Longo, J., (Jan. 31, 2010) "Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment" OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 1, Manuscript 5.

DOI: 10.3912/OJIN.Vol15No01Man05

Keywords: bullying, conflict, disruptive behaviors, eliminating disruptive behaviors, healthy work environment, horizontal violence, job satisfaction, patient safety, sentinel alert, zero tolerance

Disruptive behaviors among healthcare workers threaten the safety and well being of both patients and staff. Although disruptive behaviors have long been a concern among healthcare workers, they have often gone unchecked, or even worse, accepted as part of the system. By not addressing these behaviors, organizations silently supported and reinforced them. The good news is that these disruptive behaviors among healthcare workers have recently come under increased scrutiny. The American Medical Association (AMA) (2002) has stated: "Personal conduct, whether verbal or physical, that affects or that potentially may affect patient care negatively constitutes disruptive behaviors" (para. 1). The American Association of Critical Care Nurses (AACN) (2005) has noted that collaboration among healthcare providers, which is paramount to establishing and sustaining a healthy work environment, is lost in the presence of disruptive behaviors. In 2008 a sentinel event alert was issued by the Joint Commission (TJC) to warn organizations of the safety risks posed by disruptive behaviors and to increase awareness of this risk for both individual workers and healthcare organizations.

Those exposed to disruptive behaviors can experience stress, frustration, and physical and psychological disorders. Nurses have been reported to leave a particular place of employment due to disruptive behaviors (Veltman, 2007), and this drain on resources can further compromise care. In order to address this threat the Joint Commission, in January of 2009, instituted a leadership standard mandating that facilities seeking accreditation institute policies to address disruptive behaviors among healthcare workers.

Now all workers are charged with understanding and addressing this necessary culture change within healthcare. In this article the author will review the causes and consequences of disruptive behavior for both patients and healthcare workers. Initiatives to address disruptive behaviors will be discussed, and specific steps nurse managers and staff nurses can take to combat these behaviors will be provided.

The Nature of Disruptive Behavior

Disruptive behaviors include overt and covert actions that are displayed by any healthcare worker and that threaten the performance of the healthcare team (TJC, 2008). The most frequently reported type of behaviors includes emotional-verbal abuse (Anderson, 2002; Anderson & Parish, 2003; Hader, 2008; Hesketh et al., 2003). For nurses this verbal abuse is frequently reported as coming from other nurses (Hegney, Plank, & Parker, 2003; Hesketh et al., 2003; Rowe & Sherlock, 2005). Examples of these behaviors include using threatening or abusive language; making demeaning or degrading comments; humiliating someone in front of others, including staff and patients; rolling eyes in disgust; sending nasty emails; refusing to mentor; refusing to help others; ignoring attempts at conversations; throwing items; physically assaulting team members; and intimidating others (Capitulo, 2009; Hader, 2008; North Carolina Physicians Health Program, 2009; Porto & Lauve, 2006; Rocker, 2008). …

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