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      The impacts of organizational culture and neoliberal ideology on the continued existence of incivility and bullying in healthcare institutions: A discussion paper

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          Abstract

          Countless research studies have demonstrated the detrimental effects of incivility and bullying in healthcare. Despite the abundance of proposed solutions to this issue, many healthcare leaders continue to fail in mitigating the existence of such negative behaviors in the workplace. Personality attributes of perpetrators and victims have received attention, but much less research has examined the organizational and neoliberal causations of incivility and bullying in healthcare. Being the largest occupational group in the health sector, nursing professionals have the greatest influence and are crucial in ending these behaviors. This discussion paper outlines the effects of incivility and bullying in healthcare and provides a critical analysis on how organizational culture and neoliberal ideology influence the pervasiveness and persistence of these negative behaviors. The analysis reveals that organizational cultures that misuse power, disregard equality, and facilitate oppression, foster the existence of incivility and bullying in the workplace. Such cultures permit perpetrators to misuse their authority to control resource allocation, ignorance to social inequalities, and the silence of victims. Furthermore, the neoliberal concept of deregulation, austerity, and individualism further these behaviors. The neoliberal reforms have led to underfunding of anti-bullying programs and policies, use of bullying behaviours as management strategies, and victim-blaming for profit maximization. Financial cutbacks have resulted in denial and acceptance of uncivil and bullying behaviours in healthcare institutions, which endangers the rights of healthcare providers to a safe workplace environment. To curtail these negative behaviors, robust anti-bullying policies and programs must be strictly enforced and sustained in practice. Further exploration on the association of organizational culture and neoliberal principles to incivility and bullying in healthcare is greatly warranted.

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          Most cited references39

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          Acute Stress Disorder, Coping Self‐Efficacy, and Subsequent Psychological Distress among Nurses Amid COVID‐19

          Abstract Purpose Healthcare professionals, particularly nurses, are considered a vulnerable group to experience acute stress disorder (ASD) and subsequent psychological distress amid COVID‐19 pandemic. This study aims to establish the prevalence of acute stress disorder and predictors of psychological distress among Jordanian nurses. Methods A quantitative, cross‐sectional, descriptive and comparative design was used. Data was collected using a web‐based survey. A total of 448 Jordanian nurses (73% females) completed and returned the study questionnaire. Results The majority of nurses (64%) are experiencing ASD due to the COVID‐19 pandemic and thus are at risk for PTSD predisposition. More than one third of nurses (41%) are also suffering significant psychological distress. Among our sample, age, ASD, and coping self‐efficacy significantly predicted psychological distress. More specifically, younger nurses are more prone to experience psychological distress than older ones. While higher scores on ASD showed more resultant psychological distress, coping self‐efficacy was a protective factor. Conclusion Given that individuals who suffer from ASD are predisposed to PTSD, follow‐up with nurses to screen for PTSD and referral to appropriate psychological services is pivotal. Coping self‐efficacy is found to ameliorate the effect of psychological distress on nurses' traumatic experience. Such findings warrant intensive efforts from healthcare institutions to provide psychosocial support services for nurses and ongoing efforts to screen them for traumatic and psychological distress symptoms. Implications for Nursing Management Nursing leaders and managers are in the forefront of responding to the unique needs of their workforces during the COVID‐19 crisis. They need to implement stress‐reduction strategies for nurses through providing consecutive rest days, rotating allocations of complex patients, arranging support services, and being accessible to staff. They also need to ensure nurses’ personal safety through securing and providing personal safety measures and undertake briefings to ensure their staff's physical and mental well‐being, as well as providing referrals to appropriate psychological services.
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            Workplace bullying in the UK NHS: a questionnaire and interview study on prevalence, impact and barriers to reporting

            Objectives To examine the prevalence and impact of bullying behaviours between staff in the National Health Service (NHS) workplace, and to explore the barriers to reporting bullying. Design Cross-sectional questionnaire and semi-structured interview. Setting 7 NHS trusts in the North East of England. Participants 2950 NHS staff, of whom 43 took part in a telephone interview. Main outcome measures Prevalence of bullying was measured by the revised Negative Acts Questionnaire (NAQ-R) and the impact of bullying was measured using indicators of psychological distress (General Health Questionnaire, GHQ-12), intentions to leave work, job satisfaction and self-reported sickness absence. Barriers to reporting bullying and sources of bullying were also examined. Results Overall, 20% of staff reported having been bullied by other staff to some degree and 43% reported having witnessed bullying in the last 6 months. Male staff and staff with disabilities reported higher levels of bullying. There were no overall differences due to ethnicity, but some differences were detected on several negative behaviours. Bullying and witnessing bullying were associated with lower levels of psychological health and job satisfaction, and higher levels of intention to leave work. Managers were the most common source of bullying. Main barriers to reporting bullying were the perception that nothing would change, not wanting to be seen as a trouble-maker, the seniority of the bully and uncertainty over how policies would be implemented and bullying cases managed. Data from qualitative interviews supported these findings and identified workload pressures and organisational culture as factors contributing to workplace bullying. Conclusions Bullying is a persistent problem in healthcare organisations which has significant negative outcomes for individuals and organisations.
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              Is adolescent bullying an evolutionary adaptation?

              Bullying appears to be ubiquitous across cultures, involving hundreds of millions of adolescents worldwide, and has potentially serious negative consequences for its participants (particularly victims). We challenge the traditionally held belief that bullying results from maladaptive development by reviewing evidence that bullying may be, in part, an evolved, facultative, adaptive strategy that offers some benefits to its practitioners. In support of this view, we draw from research that suggests bullying serves to promote adolescent bullies' evolutionarily-relevant somatic, sexual, and dominance goals, has a genetic basis, and is widespread among nonhuman animals. We identify and explain differences in the bullying behavior of the two sexes, as well as when and why bullying is adaptive and when it may not be. We offer commentary on both the failures and successes of current anti-bullying interventions from an evolutionary perspective and suggest future directions for both research and anti-bullying interventions.

                Author and article information

                Contributors
                Journal
                Int J Nurs Sci
                Int J Nurs Sci
                International Journal of Nursing Sciences
                Chinese Nursing Association
                2096-6296
                2352-0132
                05 June 2021
                10 July 2021
                05 June 2021
                : 8
                : 3
                : 361-366
                Affiliations
                [a ]School of Nursing, The University of British Columbia, British Columbia, Canada
                [b ]Rural Coordination Centre of British Columbia, British Columbia, Canada
                Author notes
                []Corresponding author. Alumnus, School of Nursing, The University of British Columbia, 1147 Research Road, Kelowna, British Columbia, V1V 1V7, Canada. mlaguard@ 123456mail.ubc.ca
                Article
                S2352-0132(21)00066-1
                10.1016/j.ijnss.2021.06.002
                8283713
                34307787
                408ac4f5-e5c3-437c-b085-29ee5c7712cf
                © 2021 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 24 April 2021
                : 1 June 2021
                : 1 June 2021
                Categories
                Discussion

                austerity,bullying,health personnel,incivility,neoliberalism,organizational culture,resource allocation

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