Dataset Information

Not Just How Many but Who Is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes.

ABSTRACT:

Background and objectives

Much of the literature examining the staffing-care quality link in long-term care (LTC) homes focuses on staffing ratios; that is, how many staff are on shift. Far less attention is devoted to exploring the impact of staff members' workplace relationships, or who is on shift. As part of our work exploring workplace incivility and bullying among residential care aides (RCAs), we examined how RCAs' workplace relationships are shaped by peer incivility and bullying and the impact on care delivery.

Research design and methods

Using critical ethnography, we conducted 100 hr of participant observation and 33 semistructured interviews with RCAs, licensed practical nurses, support staff, and management in 2 nonprofit LTC homes in British Columbia, Canada.

Results

Three key themes illustrate the power relations underpinning RCAs' encounters with incivility and bullying that, in turn, shaped care delivery. Requesting Help highlights how exposure to incivility and bullying made RCAs reluctant to seek help from their coworkers. Receiving Help focuses on how power relations and notions of worthiness and reciprocity impacted RCAs' receipt of help from coworkers. Resisting Help/ing outlines how workplace relationships imbued with power relations led some RCAs to refuse assistance from their coworkers, led longer-tenured RCAs to resist helping newer RCAs, and dictated the extent to which RCAs provided care to residents for whom another RCA was responsible.

Discussion and implications

Findings highlight "who" is on shift warrants as much attention as "how many" are on shift, offering additional insight into the staffing-care quality link.

SUBMITTER: Cooke HA

PROVIDER: S-EPMC8248975 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Not Just How Many but Who Is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes.

Cooke Heather A HA Baumbusch Jennifer J

The Gerontologist 20210601 4

<h4>Background and objectives</h4>Much of the literature examining the staffing-care quality link in long-term care (LTC) homes focuses on staffing ratios; that is, how many staff are on shift. Far less attention is devoted to exploring the impact of staff members' workplace relationships, or who is on shift. As part of our work exploring workplace incivility and bullying among residential care aides (RCAs), we examined how RCAs' workplace relationships are shaped by peer incivility and bullying ...[more]

PMID: 33320166

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Project description:IntroductionDespite a growing body of evidence on academic incivility, limited information exists on workplace incivility perceived by nursing students in nursing schools. This study, conducted amid the COVID-19 pandemic, explores nursing students' perceptions of workplace incivility in Jordanian nursing schools and investigates demographic-based differences.MethodsThis study employed a descriptive cross-sectional design, using an online survey for data collection. A convenience sample of 104 nursing students from diverse backgrounds and various Jordanian universities participated, allowing for a comprehensive examination of workplace incivility perceptions at a specific point in time. The online survey ensured efficient data collection, enhancing accessibility and ease of participation. This approach aimed to capture a snapshot of nursing students' perspectives on workplace incivility within a given time frame and across multiple educational institutions, efficiently gathering data from a geographically dispersed and demographically varied sample.ResultsStudents perceived workplace incivility in nursing schools as "mild," with moderate confidence in schools' ability to address it. Workplace civility was rated between 60.00% and 70.00% on a 0-100 scale. The overall mean for uncivil behaviors was "sometimes," with criticism of expertise as the most common. Incivility in the past year was seen as "rare," with misusing authority being the most frequent. Male and low-GPA students reported higher perceptions of incivility. Stress was the most perceived contributing factor, and a lack of administrative support was the main barrier. Establishing codes of conduct was considered the key strategy for fostering workplace civility.ConclusionWorkplace civility is prevalent in Jordanian nursing schools, even amid the COVID-19 pandemic. However, the occasional occurrence of incivility behaviors should be approached with caution. To enhance perceptions of workplace civility, nursing schools should prioritize effective teaching, a friendly environment, and respectful relationships. Encouraging faculty members to reassess their performance, starting with identifying academic workplace incivility, is crucial.

Project description:ImportanceThe culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender).ObjectiveTo evaluate academic medical culture, faculty mental health, and their relationship.Design, setting, and participantsA total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health.ExposuresMinoritized identity based on gender, race and ethnicity, and LGBTQ+ status.Main outcomes and measuresThree aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health.ResultsOf the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis.Conclusions and relevanceHigh rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.

Dataset Information

Not Just How Many but Who Is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes.

Background and objectives

Research design and methods

Results

Discussion and implications

Publications

Not Just How Many but Who Is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes.

Similar Datasets

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