Introduction
Various studies throughout the world have shown that workplace hostility has negative effects on the people who are connected to it, in this case, patients and their connections towards nurses. These studies have raised concerns regarding the behavior of nurses towards their patients and the long term damages that patients have to face throughout the tenure of their treatment .
Through research, it has been concluded, that if nurses are being subjected to various forms of harassment, threats to harm, physical assault, abuse or any sort of negativity, it reflects in their behavior towards their patients, who are on the receiving end. Furthermore, this negative behavior within work teams can also result in miscommunication, depression, anxiety, bad experiences and in some cases, even misdiagnoses towards a patient’s condition . Hostile clinical behavior always has negative effects on a patient’s care delivery methods, with nurses not showing enthusiasm to cooperate with a patient and their misjudgment towards a patient which stems from a past that hampers their feelings towards working with dedication .
Clinical Question
The research question that the paper aims to answer is related to exploring the relationship between negative, often times aggressive displays of behavior by nurses (in the presence of patients) and whether this impacts the healthcare quality that patients receive from their nurses. Employing the PICOT Model of Evidence Based Practice, the primary clinical question that the paper looks to address is: The impact that incivility and rudeness has on older patients receiving treatment on a long-term basis.
Expanding on the primary research problem stated above, the specific uncivil/negative behaviors most typically exhibited by nurses (both genders), include verbal abuse, inability to provide the level of medical and emotional care required by elderly patients, deliberately withholding crucial information and engaging in intimidating tactics such as bullying.
Level of Evidence and Search Strategy
In order to effectively and comprehensively answer the research question, a qualitative review of evidence-based literature was undertaken, including studies not older than five years and with the elderly population receiving long-term healthcare from nurses, at hospitals, in nursing home or at private residences. The databases used for research include the BioMed Central, National Student Nurses Association and the American Journal of Critical Care. In order to limit the scope of the research articles utilized for this paper, the patient population has been restricted to elderly patients aged above 60 years of age, who are receiving long-term physical and mental care from nurses across America.
The analysis by Hutchinson has revealed several important factors that are considered by researchers to play the central role in how communication breakdown between a caregiver and patient affects the quality of healthcare being administered, even if the most efficient healthcare SOPs are in place .
Most of the research studies that have been conducted so far on the subject have been focused towards establishing a causal relationship between the occurrences of disruptive behaviors among nurses contributes towards deteriorating quality of service and healthcare. Moreover, there is significant evidence to support the premise that when markers of hostility and aggression, whether with the nursing staff or between patient and nurse are exhibited, it has a significant link with extended patient recovery times. In addition to this, this also contributes to an increase in patients holding back on medical information about changing symptoms or medicinal side effects from the nurse because of a lack of trust.
Conclusion
The review of the data that was analyzed has revealed that there are four important areas in which the behavior of the nursing staff significantly impacts the recovery, health and well-being of the patients under their care . First of all, any evidence of intimidation or physical aggression within the staff almost always results in increased patient mortality as well as stress, anxiety and reduced satisfaction among the patients. Furthermore, relationships between doctors and nurses in which open communication, respect and integrity are included enable them to provide the optimal patient care.
Second, Luparell highlights that when the nursing staff is believed to be engaging in bullying tactics during their interaction with elderly patients, this increases the chances of people not recovering from extensive psychological and emotional disorders, this is because of the hostility that they experience causes them to hide crucial medical information which should ordinarily be discussed with the nurses . However certain researchers have identified that nurses are often forced into physical violence to control patient outbursts otherwise it would result in significant injuries for both.
The third important aspect identified by Hutchinson in the research relates to how the clinical staff reacts when they are subjected to inappropriate and often very insensitive working conditions since job security is often an important issue which influences their reactions and attitudes . The hostility and rude behavior that comes their way from their immediate supervisors translates into destructive and avoidance behaviors with the patients. In certain situations this may also result in nurses deliberately avoiding to report changes in a patient’s condition simply because they are fearful of the expected reactions of their colleagues and superiors . Almost 67 percent of the nursing staff within the United States of American has reported that any incident of verbal abuse whether from their superiors, colleagues or patients results in reduced moral and motivation for them . A likely result of this is that the nursing staff doesn’t stay with one institution for an extended period of time. This means that elderly patients not getting the chance to establish a connection to their care givers . Constantly interacting with new faces further adds to the complications of treating of successfully treating complicated health problems.
References
Hutchinson, M. (2013). Hostile clinician behaviours in the nursing work environment and implications for patient care: a mixed-methods systematic review. BioMed Central, 12-25.
Luparell, S. (2014). Incivility in Nursing: The Connection Between Academia and Clinical Settings. Journal of Issues in Nursing, 3-15.
