Nurses play an important role in facilitating the recovery of patients. In addition to providing medical services, nurses also develop relationships with patients. Through these relationships, the nurses are able to accelerate recovery and provide their patients with comfort. While this remains true, it is important to recognize that there are nurses that fail to adhere to the standards that govern the conduct of the members of the profession. There are cases where nurses bully their patients and their colleagues. These cases have tarnished the image of the profession and hindered patient outcomes. Personally, I have witnessed incidents where nurses engage in activities that hamper patient outcomes. In this paper, one these incidents is described. The paper also provides an annotated bibliography in which journal articles that highlight the role that the attitude of nurses play in determining patient outcomes, are summarized and assessed.
Clinical narrative
As a nursing student, I am often required to conduct rotation on Saturdays and Sundays from 7.30 am to 3.3. pm. Essentially, the rotations involve visiting patients and assessing the progress that they are making. I am usually assigned the maternity and pediatric divisions of the Holy Family Hospital. Most of my interactions with the patients at the two visions are rather routine and typical. However, there have been some incidents that have stood out and offered me opportunities for reflection. One of these incidents occurred as I was shadowing a colleague, Sharon. I had been paired with Sharon to conduct patient visits and assessments before so I did not expect this day to be different. It was on a Sunday and we were scheduled to check on a Judith, a mother who had just given birth to a baby boy. Judith was in the company of her husband. The two were evidently elated and this made me recognize the important role that nurses play. I was able to understand that thanks to the efforts of nurses, patients are able to experience joy. Our interaction with Judith and her family was important to me because it allowed me to reflect on the need for nurses to adopt positive and helpful attitudes as they engage with patients. I was able to understand that our attitudes could be more important than the medication and the treatment that we offer our patients.
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The beautiful scene that Judith and her family offered us was soon replaced by an ugly one. Emily, the head nurse at the hospital was hurling insults at everyone and anyone. “What is your problem? You were supposed to be here three hours ago!” This was meant for Kennedy, one of the nursing students who was late for the rotation. Kennedy tried to offer an explanation for being late but Emily would not hear it. Patients were also targets of her insults: “Come on! You must be faking it! We need you to leave so that we give your bed to other patients who need it more.” One of the patients had disappointed Emily with her slow recovery. Emily was under intense pressure to ensure that all patients who required admission were provided with the necessary facilities. The hospital lacked the capacity to attend to the needs of all the patients. As Emily was making enemies at every turn, I began to reflect. I wondered, “Why is she like this?” I also noticed that most of the students and the junior nurses at the hospital seemed to hate what they were required to do. There were clear signs of burnout and exhaustion. The hospital required its nurses to work for very long hours and did not offer them any breaks. The student nurses also suffered as we were required to conduct rotation for long periods. I had a conversation with Anne, one of my colleagues. She opened up and told me that her decision to pursue nursing was unwise. She told me that she had considered abandoning the program and choosing another that was more in line with her personal vision and capability.
As already stated, the events described above offered fodder for reflection. Thanks to these events, I was able to acknowledge the importance of a healthy and friendly hospital environment. The environment at the Holy Family Hospital was clearly toxic and a hindrance to patient recovery. The situation above was important because it highlighted the need for positive nurse attitude. I observed that Emily created tension and fear among all those that she interacted with. My concern was that she would exhaust the patience and energies of her colleagues and the patients. I feared that one of the nurses would snap and create a scene that would force the patients to abandon the hospital and seek treatment elsewhere. Overall, this situation allowed me to understand that the attitudes held by nurses are among the forces that shape patient outcomes and that such issues as bullying hinder the effectiveness of nurses in executing their mandate.
Annotated bibliography
Mott, J. (2014). Undergraduate Nursing Student Experiences with Faculty Bullies. Nurse
Educator, 39 (3), 143-148.
In this article, Mott explores the experiences of nursing students who have suffered bullying perpetrated by faculty members. Mott interviewed a group of students from different nursing institutions. His primary objective was to examine the impacts of bullying on the students and to identify the values that the students can embrace in an effort to withstand the pressure that they face. One of the striking observations that Mott made was that the bullying that the students suffered left emotional wounds. The bullying that the students suffered range from being demeaned and intimidated to failure by the faculty to demonstrate respect and setting the students up for failure. Mott also learnt that the bullying left the students feeling depressed and that their self-confidence suffered. Furthermore, the bullying had the impact of causing frustration and anger. Overall, it was noted that bullying had a damaging effect on the students. Mott attempts to identify the factors that could be driving the bullying. He argues that the generational differences between the faculty and the students could be to blame. Since they are from different generations, the faculty and the students have different approaches and uphold different values. These differences create an environment that allows for bullying to occur. Mott goes beyond describing the experiences of the students. He proceeds to highlight the values that the students should embrace so as to survive bullying. Resilience and persistence are among these values. He concludes his article by urging victims of bullying to remain focused on their aspirations and to develop thicker skin. Mott’s article is indeed relevant and helpful. This is because it examines the experiences of nursing students. As mentioned in an earlier discussion, I witnessed bullying at the hospital where I conducted rotation. I am able to relate with the participants in Mott’s study who also suffered bullying. The information that Mott shares in the article can be considered to be reliable. The scientific methods and the lack of conflict of interest are what make the article reliable. Mott makes it clear that there is no conflict of interest and he offers a description of the scientific methods and techniques such as interviews that he used to obtain data. The article succeeds at achieving its goal of highlighting the experiences of nursing students who endure bullying. As I reflected on Mott’s article, I found that not only was it reliable but that it also fit into my research topic. My topic focuses on how nursing attitudes shape patient outcomes. While the article addresses a different issue, I still think that it presents insights that I can integrate into my research. For example, the experiences of the students could affect how they deliver services. Since they have suffered bullying, it is possible that they will become perpetrators of bullying. Mott’s article is also helpful as it shapes my thinking. Now I understand that bullying leaves scars that may never heal. I observed that the article is related to my experiences at the hospital. The patients and junior nurses at the hospital suffered bullying in the same way that the students endured harassment and mistreatment perpetrated by the faculty. The article has done little to change how I regard my research topic. I still think that nurse attitudes affect patient outcomes.
Coursey, J. H., Rodriguez, R. E., Dieckmann, L. S., & Austin, P. N. (2013). Successful
Implementation of Policies Addressing Lateral Violence. AORN Journal , 97 (1),
101-108.
The question of violence among members of the nursing community is the subject of this article. Coursey begins by lamenting that the policies that are being implemented are failing to protect nurses from violence by their colleagues. They also identify some of the impacts that lateral violence has on the delivery of healthcare. They argue that the violence causes disruptions and causes nurses to be dissatisfied with their jobs. Coursey and his colleagues then highlight some of the policies and standards that have been developed to combat lateral violence. They then proceed to conduct an appraisal of the literature that focuses on lateral violence within the nursing community. Most of the literature reviewed offer recommendations on the best practices that should be adopted to shield nurses from violence. The recommendations vary from establishing legislative bodies to engaging clinicians on the need for collaboration and harmony. Coursey and his team also identify some of the measures that have been effective in combating lateral violence. These measures include administrator involvement and implementing policy and behavior changes. The assessment of the article above allows for a determination to be made on its usefulness and reliability. I found this article to be both helpful and reliable. It was helpful in that it allowed me to understand that such issues as bullying and violence within the nursing community are not without solutions. This article stands apart from the other sources that were consulted. It offers actual solutions that can be implemented to address violence and bullying. The information presented in the article is also reliable. The vast literature that the authors appraised lends the article credibility. The article’s main goal was to shed light on the policies and measures that organizations have adopted as they seek to tackle lateral violence. It manages to achieve this goal as it identifies many effective policies and measures. The article by Coursey and his colleagues will be an invaluable source of insight as it fits perfectly into my research. As is already clear, my research focuses on the impacts of nurse attitudes on patient outcomes. Since the article identifies policies for addressing lateral violence, it will allow me to identify the measures that nurses can adopt to improve their attitudes, thereby enhancing patient outcomes. I found the source to be helpful and that it shaped my thinking. After examining the article, I understand that nurses do not need to suffer in silence. There are solutions that can be implemented to address the challenges that they grapple with. My thinking regarding my research topic has been expanded by the article. I am now able to recognize that there is hope for addressing such issues as violence and bullying which impair service delivery.
Moore, L. W., Leahy, C., Sublett, C. & Lanig, H. (2013). Understanding Nurse-to-Nurse
Relationships and their Impact on Work Environments. MEDSURG Nursing, 22 (3),
172-179.
In this article, Moore and his colleagues examine the effect of the relationships among nurses of the nature of the work environment. They begin by recognizing the need for nurses to create healthy relationships. Moore and his team cover a wide range of topics. These include the importance of healthy relationships and the damage that results when nurses fail to pull in the same direction. The authors also identify the factors that constitute a healthy working environment. Positive interpersonal relationships and effective communication are among these factors. If someone were to ask what the subject of the article is, the response would be that the authors examine the effects of the interpersonal relationships among nurses have on how well they perform their functions. An assessment of the article summarized above reveals that is effective, reliable and helpful. It is helpful because it allows one to understand the devastation that can be experienced when nurses fail to work together. It derives its reliability from the fact that the authors are medical professionals and are therefore competent to address the issue of nurse relationships. The article adds weight to the issues that the other sources discussed above shed light on. The article also manages to attain its goal of highlighting the impacts of nurse relationships on the work environment. This article is relevant to my research topic as it points out the realities that result from unhealthy nurse relationships. It also shaped my thinking as it enabled me to understand the fact that work environments are shaped by the relationships among practitioners. If these relationships are unhealthy, it will become nearly impossible for a conducive work environment to be created. The article also relate to what I witness at the hospital. The article somewhat predicted the unhealthy environment at the hospital which was the result on the poor relationships among the nurses and students. Overall, the article has broadened my perspective.
Conclusion
The discussion above has shed light on the need for a healthy work environment in medical facilities. It is important for administrators to promote healthy and collaborative relationships among their staff. The articles explored above make this abundantly clear. In addition to underscoring the need for healthy relationships, the articles also shed light on the situation that I witnessed. In the situation, nurses suffered bullying and this hindered their capacity to effectively deliver care to the patients. The articles speculate that a situation like this might arise when nurses and other medical practitioners fail to work together.
Most of the elements of the literature discussed above were related to the clinical situation that I witnessed. For instance, Moore and his colleagues examine the impacts of unhealthy relationships on the work environment and patient outcomes. I observed that the patients were disturbed by the scuffles among the nurses at the hospital. This serves as evidence that poor relationships hamper healthcare delivery. There are other elements that are not directly linked to the situation but are still relevant. For example, Coursey and his team identify some of the measures that can be employed to promote healthier relationships among medical practitioners. While the clinical situation did not involve the application of any of these measures, it is possible to adopt the measures to ensure that the situation does not occur again. While they tackle different issues, the articles are brought together by the common approach that they suggest. Collaboration and respect are the main measures that all the articles advise should be adopted. Thanks to the articles, I have developed a clearer understanding of the importance of healthy relationships among nurses. I think that I lack the capacity and authority to change the situation that I witness even after interacting with the literature. However, I find that the literature remains relevant and helpful for clinical practice as it offers insights into healthy relationships among practitioners.
References
Coursey, J. H., Rodriguez, R. E., Dieckmann, L. S., & Austin, P. N. (2013). Successful Implementation of Policies Addressing Lateral Violence. AORN Journal , 97 (1), 101-108.
Moore, L. W., Leahy, C., Sublett, C. & Lanig, H. (2013). Understanding Nurse-to-Nurse Relationships and their Impact on Work Environments. MEDSURG Nursing, 22 (3), 172-179.
Mott, J. (2014). Undergraduate Nursing Student Experiences with Faculty Bullies. Nurse Educator, 39 (3), 143-148.
