LaGuardia Michael, Oelke Nelly D
School of Nursing, The University of British Columbia, British Columbia, Canada.
Rural Coordination Centre of British Columbia, British Columbia, Canada.
Int J Nurs Sci. 2021 Jun 5;8(3):361-366. doi: 10.1016/j.ijnss.2021.06.002. eCollection 2021 Jul 10.
Countless research studies have demonstrated the detrimental effects of incivility and bullying in healthcare. Despite the abundance of proposed solutions to this issue, many healthcare leaders continue to fail in mitigating the existence of such negative behaviors in the workplace. Personality attributes of perpetrators and victims have received attention, but much less research has examined the organizational and neoliberal causations of incivility and bullying in healthcare. Being the largest occupational group in the health sector, nursing professionals have the greatest influence and are crucial in ending these behaviors. This discussion paper outlines the effects of incivility and bullying in healthcare and provides a critical analysis on how organizational culture and neoliberal ideology influence the pervasiveness and persistence of these negative behaviors. The analysis reveals that organizational cultures that misuse power, disregard equality, and facilitate oppression, foster the existence of incivility and bullying in the workplace. Such cultures permit perpetrators to misuse their authority to control resource allocation, ignorance to social inequalities, and the silence of victims. Furthermore, the neoliberal concept of deregulation, austerity, and individualism further these behaviors. The neoliberal reforms have led to underfunding of anti-bullying programs and policies, use of bullying behaviours as management strategies, and victim-blaming for profit maximization. Financial cutbacks have resulted in denial and acceptance of uncivil and bullying behaviours in healthcare institutions, which endangers the rights of healthcare providers to a safe workplace environment. To curtail these negative behaviors, robust anti-bullying policies and programs must be strictly enforced and sustained in practice. Further exploration on the association of organizational culture and neoliberal principles to incivility and bullying in healthcare is greatly warranted.
无数研究表明，医疗保健领域的不文明行为和欺凌行为具有有害影响。尽管针对这一问题提出了大量解决方案，但许多医疗保健领导者在减轻工作场所此类负面行为的存在方面仍未取得成效。肇事者和受害者的个性特征已受到关注，但对医疗保健领域不文明行为和欺凌行为的组织及新自由主义成因的研究要少得多。作为卫生部门最大的职业群体，护理专业人员具有最大的影响力，对于终结这些行为至关重要。本讨论文件概述了医疗保健领域不文明行为和欺凌行为的影响，并对组织文化和新自由主义意识形态如何影响这些负面行为的普遍性和持续性进行了批判性分析。分析表明，滥用权力、无视平等并助长压迫的组织文化，滋生了工作场所的不文明行为和欺凌行为。这种文化允许肇事者滥用职权来控制资源分配，无视社会不平等现象，并使受害者保持沉默。此外，新自由主义的放松管制、紧缩和个人主义概念进一步助长了这些行为。新自由主义改革导致反欺凌项目和政策资金不足，将欺凌行为用作管理策略，并为实现利润最大化而指责受害者。财政削减导致医疗机构对不文明和欺凌行为予以否认和接受，这危及医疗保健提供者享有安全工作场所环境的权利。为了减少这些负面行为，必须在实践中严格执行并持续实施强有力的反欺凌政策和项目。非常有必要进一步探索组织文化和新自由主义原则与医疗保健领域不文明行为和欺凌行为之间的关联。
