Removing Disruptive Behavior from the Workplace

1. Removing Disruptive Behavior from the Workplace Renee Alexander Heather Jones Tracy Lindquist Amy Martin Nicole Rogers Clemson University, HRD 860, Dr. Bronack, December 4, 2011

2. Acknowledgements SC Pioneers in Disruptive Behavior Research & Education: Karen Stanley, APRN, BC Mary Martin,DNS,ARNP,NAP Yvonne Michel,PhD Lynne Nemeth, PhD, RN Medical University of SC Peggy Dulaney, MSN, RN, PMHCNS, BC Independent Consultant Upstate AHEC Research conducted in Nursing, Upstate AHEC

3. Define 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 Objectives

4. Old problem…New names Workplace incivility Disruptive behavior Horizontal hostility Lateral violence Horizontal violence Bullying Mobbing

5. Disruptive Behavior …What is it? 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.”

6. One-on-one aggression • Inter-group conflict • Shift-to-shift • Cliques within a workgroup • Department-to-department Forms of Disruptive Behavior

7. Disruptive Behavior… 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 Sentinel Event Alert #40, July 9, 2008, The Joint Commission

8. 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 “Faces” of Disruptive Behavior

9. 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

10. How DB/LV is Handled IGNORED Upstate AHEC, 2008

11. Healthcare is a High Stress Environment Heavy workloads/short staffing Patients/customers are under stress Rapid turn-around times Patients’ lives are at risk Unpredictability of the work Recession Generally negative personality Personal issues impacting work life

12. Patient Safety What’s the impact? Low morale Decreased teamwork Increased stress Decreased quality of patient care Increased absenteeism High turnover rates Increased labor costs Difficulty in recruiting new staff

13. 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

14. How Can We Stop Disruptive Behavior?

15. 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?

16. Adopt Professional Standards of Behavior • Workplace Standards • Professional Organization Standards • Department Standards • Personal Standards

17. Know Your Policy

18. Address Behaviors as They Occur

19. 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

20. 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

21. Cognitive Rehearsal Techniques • Recognize the behavior when it occurs • Plan ahead for ways to respond • Practice new responses before you need them

22. Identify specific situations as targets for interventions • Plan responses • Rehearse your new behaviors • Develop a support system • Discuss with your manager My Personal Plan

23. When You Hit a Wall Your best efforts No change

24. 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.

25. 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

26. Questions & Answers Renee Alexander Heather Jones Tracy Lindquist Amy Martin Nicole Rogers Thank you!