In Chapter 2 of the book, Basic Concepts of Health Care Human Resource Management, the author talks about Legal, Ethical, and Safety Issues in the Healthcare Workplace. Healthcare Organization (HCO) Human Resource (HR) managers are responsible for insuring that the actions of each individual employee and the collective efforts of all employees as an organization follow the rules set forth by the laws that are applicable to any industry along with those that are designed specifically for health care.
The Equal Pay Act of 1963, the Civil Rights Act of 1991 and Family Medical Leave Act (FLMA) of 1993 are a few examples of laws applicable to all industries.
Whereas, the Health Information Technology for Economic and Clinical Health Act of 2009 and the HIPAA National Standards to Protect Patient’s Personal Medical Records of 2002, though all industry must follow, the rules of the law are most applicable to the actions within the healthcare industry. Ethical standards established by HR management are a level higher than the rules required by law.
These standards outline the “right thing to do” expectations as perceived by society and the individual.
An on-going challenge to the standards established by health care HR management is workplace action bullying. A survey of over 2000 respondents in 2004 by the Institute for Safe Medication Practices identified that more than 50% of those surveyed believed they were verbally abuse by a physician when seeking a better understanding of a prescription order. Currently, there is no federal legislation that forbids workplace bullying and very few state laws have been created addressing workplace bullying, resulting in about 20% of incidences breaking a law.
Fortunately, most instances of bullying are learned behaviors, responses to stress, or social norms of an organization, these behaviors can be unlearned (Berry, Gillespie, Fisher, & Gormley, (2016).
With the actions of action bullying being identified as behaviors that can be unlearned, HR management has a large opportunity to stop and eliminate these undesired activities. With this in mind, let’s explore the Real-Life Application Case Scenario #4 for chapter 2. “You have been experiencing some negative behavior from a physician you are working with and your nursing supervisor”. You speak to the HR department to find out more about bullying and lateral violence and what the organization can do the rectify these ongoing problems”. What information could you expect to receive from HR?
HR management would start by broadly defining action bullying as a negative behavior repeated over an extended period. These behaviors include, snide comments verbal or non-verbal threats and not excluding items being thrown. Lessor aggressive behaviors such as demeaning of work or gossiping about the person on a continual basis would also constitute bullying. The definitions will help clarify the current reported and future reported behaviors as a bullying or lateral violence (nurse to nurse) interaction as opposed to a one-time occurrence in which the individual has proactively eliminated the behavior from being repeated.
The HR associate would give reassurance that the HCO adheres to a Zero Tolerance Policy and the discipline measures outlined within it. To move forward with eliminating the individuals action bullying behaviors, the HR associate would refer to the Leadership Standards Code of Conduct, which all employees pledge to follow. An implemented Code of Conduct is required to receive a Joint Commission Accreditation. The reported behaviors would be matched in more defined specificity as acceptable, inappropriate or disruptive. After matching, the pre-determined process for managing disruptive and inappropriate behaviors will be initiated. The process for managing and eliminating the behaviors may require the reported individual to complete educational programs on actions that represents workplace bullying.
The Center for Professional Health (CPH) at the Vanderbilt University Medical Center offers continuing medical education (CME) courses that deal with unprofessional behavior. The CPH has also found that many factors impact a physician’s behavior when dealing with stress in the workplace. “Disruptive physicians often lack insight into the impact of their behavior on others” (Swiggart, Dewey, Hickson, Finlayson, & Spickard, 2009, pp. 9). “Feedback, monitoring, and educational interventions can be effective in changing disruptive behavior” (Swiggart, Dewey, Hickson, Finlayson, & Spickard, 2009a, pp. 9).
The result of action bullying in the workplace is increased stress causing dysfunctional teams, retention issues and poor quality of care that could possible result in litigation. Unfortunately, the behaviors of bullying are primitive and learned reactions to stress that are invisible to self-awareness. Luckily, through feedback awareness and education these reactions to stress can be changed and unlearned. The elimination of workplace bullying, and lateral violence is directly dependent upon the recipient or observant reporting the behaviors to HR management.