Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings
- Mammen, Bindu, Hills, Danny, Lam, Louisa
- Authors: Mammen, Bindu , Hills, Danny , Lam, Louisa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 591-599
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- Description: Background: Workplace incivility is a well-documented issue of concern known to negatively impact on new graduate nurses’ confidence, which in turn may affect the quality of patient care. However, there is lack of qualitative research that solely focuses on workplace incivility experiences of new graduate registered nurses enrolled in graduate nurse programs. Aim: This paper aims to explore new graduate nurses’ experiences of workplace incivility while enrolled in graduate nurse programs Method: A descriptive-qualitative method was used to discover the ‘who, what, and where’ of events and experiences, and assist in understanding the perceptions of newly qualified nurses, through face-to-face, in-depth interviews. After transcription, the interviews were analysed by thematic analysis. Findings: Four major themes emerged: ‘realising vulnerability’ ‘sensing self actualisation’ ‘changing expectations’ and ‘yearning for respect, support & information’. Discussion: Our interpretations of what participants said suggest that workplace incivility is an extant issue in nurses’ supportive graduate year, with the temporary employment status offered by the graduate nurse program being identified as a major contributing factor. Paradoxically, the relatively short duration of clinical rotation was also found to be a morale booster, as the new graduate nurses knew that any conflict experienced would cease, which therefore acted as a decisive factor for their continuation in nursing. Conclusion: This study has provided more depth and insight into the experiences of incivility experienced by new graduate nurses, highlighting that the role of temporary employment as a major causative element for exposure to workplace incivility. Graduate nurse programs could be strengthened, with additional support provided for each rotation and throughout the graduate year.
Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings
- Authors: Mammen, Bindu , Hills, Danny , Lam, Louisa
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 591-599
- Full Text:
- Reviewed:
- Description: Background: Workplace incivility is a well-documented issue of concern known to negatively impact on new graduate nurses’ confidence, which in turn may affect the quality of patient care. However, there is lack of qualitative research that solely focuses on workplace incivility experiences of new graduate registered nurses enrolled in graduate nurse programs. Aim: This paper aims to explore new graduate nurses’ experiences of workplace incivility while enrolled in graduate nurse programs Method: A descriptive-qualitative method was used to discover the ‘who, what, and where’ of events and experiences, and assist in understanding the perceptions of newly qualified nurses, through face-to-face, in-depth interviews. After transcription, the interviews were analysed by thematic analysis. Findings: Four major themes emerged: ‘realising vulnerability’ ‘sensing self actualisation’ ‘changing expectations’ and ‘yearning for respect, support & information’. Discussion: Our interpretations of what participants said suggest that workplace incivility is an extant issue in nurses’ supportive graduate year, with the temporary employment status offered by the graduate nurse program being identified as a major contributing factor. Paradoxically, the relatively short duration of clinical rotation was also found to be a morale booster, as the new graduate nurses knew that any conflict experienced would cease, which therefore acted as a decisive factor for their continuation in nursing. Conclusion: This study has provided more depth and insight into the experiences of incivility experienced by new graduate nurses, highlighting that the role of temporary employment as a major causative element for exposure to workplace incivility. Graduate nurse programs could be strengthened, with additional support provided for each rotation and throughout the graduate year.
Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel
- Hills, Danny, Lam, Louisa, Hills, Sharon
- Authors: Hills, Danny , Lam, Louisa , Hills, Sharon
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 575-582
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- Description: Background: Workplace aggression is a major work health and safety, and public health concern. To date, there has been limited investigation of population level exposure and responses to workplace aggression from all sources, and little evidence on the experiences, reporting and support-seeking behaviour of nurses, midwives and care personnel in Australian settings. Aim: To determine the 12-month prevalence of aggression experienced by nurses, midwives and care personnel from sources external and internal to the organisation, and the reporting behaviours and support sought from employers, health services, Trade Unions, work health and safety agencies, police and legal services. Methods: An online survey of the membership of the Australian Nursing and Midwifery Federation – Victorian Branch was conducted between 1 st May and 30th June 2017. Findings: In the previous 12 months, 96.5% of respondents experienced workplace aggression, with 90.9% experiencing aggression from external sources and 72.3% from internal sources. A majority indicated they just accepted incidents of aggression, and most rarely or never took time off work, sought medical or psychological treatment, or sought organisational or other institutional support, advice or action. Levels of satisfaction with institutional services were mostly neutral to poor. Discussion: Victorian nurses, midwives and care personnel work in aggressive and violent workplaces. The incivility endemic in health care likely sets the climate for the generation of and exposure to so much explicit aggression and violence. It appears that any systems or processes instituted to protect health care personnel from harm are failing. Conclusion: More targeted and effectively operationalised legislation, incentives and penalties are likely required. Further research may elaborate the extent of the impact of exposure to workplace aggression over time.
- Authors: Hills, Danny , Lam, Louisa , Hills, Sharon
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 575-582
- Full Text:
- Reviewed:
- Description: Background: Workplace aggression is a major work health and safety, and public health concern. To date, there has been limited investigation of population level exposure and responses to workplace aggression from all sources, and little evidence on the experiences, reporting and support-seeking behaviour of nurses, midwives and care personnel in Australian settings. Aim: To determine the 12-month prevalence of aggression experienced by nurses, midwives and care personnel from sources external and internal to the organisation, and the reporting behaviours and support sought from employers, health services, Trade Unions, work health and safety agencies, police and legal services. Methods: An online survey of the membership of the Australian Nursing and Midwifery Federation – Victorian Branch was conducted between 1 st May and 30th June 2017. Findings: In the previous 12 months, 96.5% of respondents experienced workplace aggression, with 90.9% experiencing aggression from external sources and 72.3% from internal sources. A majority indicated they just accepted incidents of aggression, and most rarely or never took time off work, sought medical or psychological treatment, or sought organisational or other institutional support, advice or action. Levels of satisfaction with institutional services were mostly neutral to poor. Discussion: Victorian nurses, midwives and care personnel work in aggressive and violent workplaces. The incivility endemic in health care likely sets the climate for the generation of and exposure to so much explicit aggression and violence. It appears that any systems or processes instituted to protect health care personnel from harm are failing. Conclusion: More targeted and effectively operationalised legislation, incentives and penalties are likely required. Further research may elaborate the extent of the impact of exposure to workplace aggression over time.
Nurse leadership in promoting and supporting civility in health care settings : a scoping review
- Ota, Marianne, Lam, Louisa, Gilbert, Julia, Hills, Danny
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
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- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
- Full Text:
- Reviewed:
- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
- Hills, Sharon, Crawford, Kimberley, Lam, Louisa, Hills, Danny
- Authors: Hills, Sharon , Crawford, Kimberley , Lam, Louisa , Hills, Danny
- Date: 2021
- Type: Text , Journal article
- Relation: Collegian Vol. 28, no. 1 (2021), p. 18-26
- Full Text: false
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- Description: Background: Workplace aggression in the health and care sectors is a major work health and safety and public health concern, worldwide. In Australia, rates of exposure to workplace aggression are consistent with those experienced by nurses internationally, and have not decreased over the past 35 years. Objectives: To explore the experiences and perspectives of nurses, midwives and care personnel relating to experiences of verbal or written and physical aggression from external sources (patients, patients’ relatives or carers and others external to the workplace) and internal sources (co-workers). Design: A pragmatic, descriptive, qualitative study, integrating themes emerging from online survey comments and follow-up, in depth interviews. Settings: Health and aged care services in the Australian State of Victoria. Participants: Nurses, midwives and care personnel who were members of the Australian Nursing and Midwifery Federation – Victorian Branch in May and June 2017. Method: Thematic analysis was undertaken on the combined comments provided in up to seven free-form text fields of an online survey questionnaire and the content of follow-up interviews of selected survey participants. Results: From the online survey data, comments from 623 participants were able to be included in analyses. Of the 293 respondents initially indicating a willingness to be contacted by researchers, a sample of 29 participated in in-depth interviews. Eight thematic categories emerged from the data, relating to patient aggression, contextual categories (three sub-categories – care of older people, mental health care and emergency department settings), co-worker aggression (two sub-categories – aggression from managers/supervisors, aggression from colleagues/peers), reporting behaviours, trade union involvement, security personnel and police involvement, legal action and the impacts of workplace aggression. Conclusions: Over the past 35 years, little progress has been made in mitigating the likelihood and consequences of this serious work health and safety, and public health issue. There appears to be have been a sustained failure to implement co-ordinated, multi-sectorial, system-wide and targeted interventions to reduce what seem to be growing levels of harmful exposure to incivility and aggression in care settings in Victoria. There is an urgent need to strengthen and enforce existing legislation, introduce new laws and develop more effective systems and practices to adequately protect the health and safety of nurses, midwives and other care personnel in their daily work. Stronger evidence for system and service level interventions to prevent and minimise workplace aggression in care settings is also required. © 2020 Australian College of Nursing Ltd
Newly qualified graduate nurses’ experiences of workplace incivility in healthcare settings : an integrative review
- Mammen, Bindu, Lam, Louisa, Hills, Danny
- Authors: Mammen, Bindu , Lam, Louisa , Hills, Danny
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Nurse Education in Practice Vol. 69, no. (2023), p.
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- Description: Aim: To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility. Background: Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture. Design: An integrative review of the global literature, conducted according to the Whittemore and Knafl framework. Methods: Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes. Results: This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6–87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses. Conclusion: Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions. © 2023 Elsevier Ltd
- Authors: Mammen, Bindu , Lam, Louisa , Hills, Danny
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Nurse Education in Practice Vol. 69, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Aim: To explore, identify and integrate the existing knowledge to categorise the characteristics, likelihood, and consequences of workplace incivility among newly qualified graduate registered nurses. A particular focus of this review is on the experiences of new nurses related to these negative workplace behaviours and the strategies employed by these nurses and their organisations to manage workplace incivility. Background: Workplace incivility has been widely recognised as a global problem in healthcare settings and is known to affect nurses in all facets of their professional and personal life. This might be particularly harmful for newly qualified graduate nurses, as they are unprepared to deal with this uncivil culture. Design: An integrative review of the global literature, conducted according to the Whittemore and Knafl framework. Methods: Database searches (CINAHL, OVID Medline, PubMed, Scopus, Ovid Emcare and PsycINFO), and manual searching generated an aggregate of 1904 articles, which were further screened based on inclusion criteria and eligibility using the Mixed Methods Appraisal Tool (MMAT). Peer-reviewed empirical studies that explored the workplace incivility experiences of new graduate nurses were included in this review. Extracted data were grouped to develop themes and sub-themes. Results: This review included 14 studies in total with seven quantitative and seven qualitative studies. The data collected from these studies were categorised according to the research questions into a) expectations of civility, b) experiences and exposure to workplace incivility, c) forms and characteristics of incivility, d) sources of incivility, e) consequences of incivility, and f) managing and coping with incivility. Across studies, graduate nurses' views about the prestige and power of the nursing profession are conflicted due to experiences of incivility in clinical practice. New graduate nurses experienced a high but variable prevalence of incivility from their co-workers (25.6–87 %), with manifestations of incivility varying greatly, including eye rolling, yelling, exclusion and sexual harassment. Included studies primarily focused on professional and organisational effects and their outcomes relative to the physical and psychological effects on new nurses. Conclusion: Findings from the literature demonstrate that incivility directed toward newly qualified graduate nurses is prevalent and can have significant negative impact on their self-esteem and confidence, which may ultimately impact on their workforce participation decisions and the quality of patient care. Supportive and empowering work environments are vital not only for improved nurse health and well-being, but also to retain new graduate nurses. The current nursing shortage emphasises the need for such conditions. © 2023 Elsevier Ltd
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