RENEE ALEXANDERHEATHER JONES

TRACY LINDQUISTAMY MARTIN

NICOLE ROGERS

Removing Disruptive Behavior

from the Workplace

Clemson University, HRD 860, Dr. Bronack, December 4, 2011

SC Pioneers in Disruptive Behavior Research & Education:SC Pioneers in Disruptive Behavior Research & Education:

Karen Stanley, APRN, BC Mary Martin,DNS,ARNP,NAP

Yvonne Michel,PhDLynne Nemeth, PhD, RNMedical University of SC

Peggy Dulaney, MSN, RN, PMHCNS, BC

Independent ConsultantUpstate AHEC

Acknowledgements

Research conducted in Nursing, Upstate AHEC

ObjectivesDefine disruptive behavior

Discuss causes of disruptive behavior

Identify key characteristics of the 4 generations in today’s workplace

Discuss the impact of behavior styles on communication

Review policy and procedure

Develop an action plan for dealing with disruptive behavior in the workplace

WORKPLACE INCIVILITY

DISRUPTIVE BEHAVIOR

HORIZONTAL HOSTILITY

LATERAL VIOLENCE

HORIZONTAL VIOLENCE

BULLYING

MOBBING

Old problem…New names

Lateral Violence (Disruptive Behavior) in nursing is defined as “…nurses covertly or overtly directing their dissatisfaction inward toward each other, toward themselves, and toward those less powerful than themselves.” Griffin, 2004

Joint Commission (2008) calls it “disruptive behavior.”

Disruptive Behavior …What is it?

Forms of Disruptiv

e Behavior

One-on-one aggression

Inter-group conflictShift-to-shift

Cliques within a workgroup

Department-to-department

•Behaviors that undermine a culture of safety

•Overt actions such as verbal outbursts and physical threats

•Passive actions such as refusing to perform assigned tasks and quietly exhibiting uncooperative attitudes during routine activities

Disruptive Behavior…

Sentinel Event Alert #40, July 9, 2008, The Joint Commission

“Faces” of

Disruptive

Behavior

Facial expressions, gestures (non-verbal)

Direct negative or hurtful words

Undermining activities

Withholding information

“Setting someone up” to look bad

Bickering between groups

Blaming everything on one person

Backstabbing

Failure to protect privacy/broken confidences/gossip

Unfair work assignments

New employees (may be new graduates)

Experienced employees, but new to the area or department

Temporary staff or someone covering from another area

PRN staff

Students or trainees

Persons in lower hierarchical positions

Common Targets

How DB/LV is Handled

IGNORED

Upstate AHEC, 2008

Heavy workloads/short staffing Patients/customers are under stressRapid turn-around timesPatients’ lives are at riskUnpredictability of the workRecessionGenerally negative personalityPersonal issues impacting work life

Healthcare is a High Stress Environment

Low moraleDecreased teamwork Increased stressDecreased quality of patient careIncreased absenteeismHigh turnover ratesIncreased labor costsDifficulty in recruiting new staff

What’s the impact?

Patient Safety

Gender differences

Cultural/religious differences

Generational differences

People are ashamed of being a victim and don’t report the behavior

We come to accept bad behavior from some people

Fear of retaliation if we do report

Behavior styles

Other Contributing Factors

How Can We Stop Disruptive Behavior?

Raise Awareness of the Problem

Discuss with manager and co-workers

Research disruptive behavior individually or as a team

Encourage others to take this class

Other?

Adopt Professional Standards of Behavior

Workplace Standards

Professional Organization Standards

Department Standards

Personal Standards

Know Your Policy

Address Behaviors as They Occur

Communication Basics

Take time to calm down; be aware of your feelings

Talk directly to the person, not other co-workers

Holds discussions in private

Always be respectful of the other person

Listen carefully

Avoid blaming or retaliation

Use “I messages”

Consider the position/needs of the other person

Maintain a safe environment

DESC Format for Effective Feedback

Describe the situation (“When …happened,”)

Explore or express your thoughts, feelings or concerns giving the benefit of the doubt (“I felt …..” or “Was it your intent to…?”)

Specify what you want them to do differently next time (“In the future, would you…?”)

Consequence-state the positive consequence when they do as you ask

Cognitive Rehearsal Techniques

Recognize the behavior when it occurs

Plan ahead for ways to respond

Practice new responses before you need them

My

Personal

Plan

•Identify specific situations as targets for interventions

•Plan responses

•Rehearse your new behaviors

•Develop a support system

•Discuss with your manager

When You Hit a Wall

No changeYour best efforts

Next Steps

Keep a record of the negative behavior. Write down the date, time, witnesses, and describe exactly what was said or done.

Keep a record of your attempts to deal with the negative behavior. Write down the date and time when you spoke with the person and describe what you said.

Share these records with your supervisor and ask for their help.

The Tipping Point …

…when a few people begin to do the right thing, others join in and it CAN change the environment.

We are all either part of the problem or part of the solution !

www.upstateahec.org

Questions & Answers

Renee AlexanderHeather Jones

Tracy LindquistAmy Martin

Nicole Rogers

Thank you!