Workplace bullying in healthcare professions

Workplace bullying in healthcare professions内容摘要：

Workplace Bullying in Healthcare Professions Gayle Brewer Abstract Workplace violence presents a substantial and increasing risk to employee health and wellbeing. In particular, healthcare professionals are at heightened risk of workplace bullying, also commonly known as mobbing, aggression, emotional abuse, lateral violence, horizontal violence, undermining and incivility etc. It is therefore often argued that bullying has become ‘endemic’ within healthcare. The physical and psychological consequences of workplace bullying include sleeping disorders, substance use, stress, chronic pain, anxiety, depression, cardiovascular disease and post-traumatic stress disorder. In addition, workplace bullying impacts on the delivery of high quality patient centred care and the wellbeing of those witnessing the bullying behavior. The current article highlights the prevalence of workplace bullying experienced by healthcare professionals and the consequences of this exposure. The organizational (e.g. job insecurity) and individual (e.g. personality) factors contributing to workplace bullying are also discussed. Keywords: Bullying, Healthcare, Perpetration, Victim, Violence 1 Introduction Healthcare professionals are at substantial and increasing risk of workplace violence [1-4], defined by the International Labour Organization as “Any action, incident or behaviour that departures from reasonable conduct in which a person is assaulted, threatened, harmed, injured in the course of, or as a direct result of, his or her work” (2004, p4). For example, Spector, Zhou and Che (2013) report nurse exposure rates of 36.4%, 66.9%, 39.7% and 25.0% for physical violence, non-physical violence, bullying and sexual harassment respectively. Prevalence rates do however display considerable variation [7], reflecting differences in the recognition or classification of workplace violence and actual incidence of this behavior. Those working in related professions and environments such as psychiatric services [8] and facilities for eldercare [9] are also at greater risk of workplace violence than other non-health oriented professions. The figures currently available are of course underestimates as victims are often unwilling to report workplace violence for a variety of reasons such as lack of evidence or fear of reputational damage [10]. Previous research indicates that exposure to workplace violence is associated with a range of negative consequences such as intrusive memories and hypervigilance [11], burnout [12], and reduced productivity [13]. Furthermore, workplace violence impacts on the healthcare services provided to patients or clients [14], quality of care [15] and professional standards [16]. Therefore, the subject requires considerable attention. Healthcare leaders often fail to recognize the existence of workplace violence however and the issue has not been adequately addressed [13]. Furthermore, though previous research indicates that patients and visitors are the most frequent perpetrators of workplace violence [14-16], healthcare professionals are less concerned by aggression perpetrated by patients than the bullying perpetrated by colleagues [15]. Hence, a greater understanding of workplace bullying in particular is required in order to protect the health and wellbeing of healthcare professionals. Definitions of workplace bullying At present, there is no single accepted definition of workplace bullying [21]. Furthermore, a range of terms have been employed by researchers and practitioners to refer to bullying behavior. These include mobbing [22, 23], harassment [24], psychological harassment [25], aggression [26], emotional abuse [27], lateral violence [28], horizontal violence [29], inappropriate behavior [30], undermining [31] and incivility [32]. In part, the specific term adopted may reflect the bullying behaviors most frequently experienced. For example, researchers in Germany often employ the term mobbing, reflecting the greater prevalence of bullying perpetrated by more than one individual [22, 23]. Though these terms are often used interchangeably, it is important to note that differences do occur, most notably between the term mobbing and other labels, with mobbing referring to behavior involving more than one perpetrator. This lack of standardization within the field hinders comparisons between studies and undermines our understanding of prevalence rates etc. Therefore, researchers and practitioners each acknowledge the