NR 510 Week 5: Conflict at the Office Discussion

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NR 510 Week 5: Conflict at the Office Discussion

NR 510 Week 5: Conflict at the Office Discussion – You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.

Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.

NR 510 Week 5: Conflict at the Office Discussion Question:

  • What is your response to the medical assistant? What actions do you take to redirect the flow away from arguments and back to patient care?
  • Provide rationales and evidence to support your decisions.

NR 510 Week 5: Conflict at the Office Discussion

It has been noted in nursing that work incivility is unfortunately common in the workplace. Incivility can commonly occur because nurses work in fast paced environments that involves human life, numerous workplace hazards and long hours. Because of this high intense situations, this can lead to stress and fatigue that contributes to work incivility. Incivility and bullying are similar but have different definitions as incivility refers to rude and disorderly conduct like gossiping, spreading rumors or refusing to assist the coworker facing the incivility. Bullying takes it one step further because this action is deliberate, occurs with more frequency and intensity. It is not just one occurrence but is carried out in multiple occurrences in an effort to offend, distress and humiliate an intended recipient. Examples of bullying can include hostile remarks, taunting, verbal attacks/intimidation, and withholding support. (Palumbo, 2018)

According to Kisner (2018), there are three different kinds of prevention. Primary prevention aims are designed to prevent incivility, bullying and workplace violence altogether. Secondary prevention aims to reduce the impact of these negative actions on recipients. Tertiary prevention aims to reduce negative consequences through reporting procedures and employer assistance and counseling programs. When experiencing or being in these situations, nurses are advised to address wrongdoers by using skills that combat against it and/or by seeking colleague support. Interventions also include sharing information with employers to set up or refine policies that prevent bullying through follow through interventions to meet the goal of zero tolerance, stopping the person causing the incivility. (Palumbo, 2018)

In the example given above, I would first professional state the importance of patient care and how important vital signs serve as a direct tie to patient care. This situation is complex as one would have to ask the MA what exactly was going on to cause the argument. I would ask her in a more private area like conference room or break room to explain the issue. I would also advice her to talk to management about the issue to see if this can be handled and dealt with. I would also bring this situation up to management to see what can be done about this situation and the rising levels of arguments. I would suggest having a meeting with the whole staff and possible huddles before the beginning of each shift to remind staff the importance of preventing incivility. There should be rules to not have arguments in the hallways, in front of patients or nurses’ station. There should also be zero tolerance in constant arguments. For the first time, a warning, education and a personal meeting with the parties involved should take place. If it keeps happening, a write up and if it keeps going, higher consequences like suspension or termination should occur. Staff should work together to keep a positive flow and energy on the unit as this will help with proper patient care. Combating against workplace violence takes the whole unit to put in positive effort. (McNamara, 2016)

NR 510 Week 5: Conflict at the Office Discussion References:

Kisner, T. (2018). Workplace incivility: How do you address it?. Nursing, 48(6), 36. doi:10.1097/01.NURSE.0000532746.88129.e9

McNamara, S. A. (2016). Column: Incivility in Nursing: Unsafe Nurse, Unsafe Patients. AORN Journal, 95535-540. doi:10.1016/j.aorn.2012.01.020

Palumbo, R. (2018). Incivility in nursing education: An intervention. Nurse Education Today, 66143-148. doi:10.1016/j.nedt.2018.03.024

NR 510 Week 5: Conflict at the Office Discussion

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NR 510 Week 5: Conflict at the Office Discussion

NR 510 Week 5: Conflict at the Office Discussion – You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.

Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.

NR 510 Week 5: Conflict at the Office Discussion Question:

  • What is your response to the medical assistant? What actions do you take to redirect the flow away from arguments and back to patient care?
  • Provide rationales and evidence to support your decisions.

NR 510 Week 5: Conflict at the Office Discussion

It has been noted in nursing that work incivility is unfortunately common in the workplace. Incivility can commonly occur because nurses work in fast paced environments that involves human life, numerous workplace hazards and long hours. Because of this high intense situations, this can lead to stress and fatigue that contributes to work incivility. Incivility and bullying are similar but have different definitions as incivility refers to rude and disorderly conduct like gossiping, spreading rumors or refusing to assist the coworker facing the incivility. Bullying takes it one step further because this action is deliberate, occurs with more frequency and intensity. It is not just one occurrence but is carried out in multiple occurrences in an effort to offend, distress and humiliate an intended recipient. Examples of bullying can include hostile remarks, taunting, verbal attacks/intimidation, and withholding support. (Palumbo, 2018)

According to Kisner (2018), there are three different kinds of prevention. Primary prevention aims are designed to prevent incivility, bullying and workplace violence altogether. Secondary prevention aims to reduce the impact of these negative actions on recipients. Tertiary prevention aims to reduce negative consequences through reporting procedures and employer assistance and counseling programs. When experiencing or being in these situations, nurses are advised to address wrongdoers by using skills that combat against it and/or by seeking colleague support. Interventions also include sharing information with employers to set up or refine policies that prevent bullying through follow through interventions to meet the goal of zero tolerance, stopping the person causing the incivility. (Palumbo, 2018)

In the example given above, I would first professional state the importance of patient care and how important vital signs serve as a direct tie to patient care. This situation is complex as one would have to ask the MA what exactly was going on to cause the argument. I would ask her in a more private area like conference room or break room to explain the issue. I would also advice her to talk to management about the issue to see if this can be handled and dealt with. I would also bring this situation up to management to see what can be done about this situation and the rising levels of arguments. I would suggest having a meeting with the whole staff and possible huddles before the beginning of each shift to remind staff the importance of preventing incivility. There should be rules to not have arguments in the hallways, in front of patients or nurses’ station. There should also be zero tolerance in constant arguments. For the first time, a warning, education and a personal meeting with the parties involved should take place. If it keeps happening, a write up and if it keeps going, higher consequences like suspension or termination should occur. Staff should work together to keep a positive flow and energy on the unit as this will help with proper patient care. Combating against workplace violence takes the whole unit to put in positive effort. (McNamara, 2016)

NR 510 Week 5: Conflict at the Office Discussion References:

Kisner, T. (2018). Workplace incivility: How do you address it?. Nursing, 48(6), 36. doi:10.1097/01.NURSE.0000532746.88129.e9

McNamara, S. A. (2016). Column: Incivility in Nursing: Unsafe Nurse, Unsafe Patients. AORN Journal, 95535-540. doi:10.1016/j.aorn.2012.01.020

Palumbo, R. (2018). Incivility in nursing education: An intervention. Nurse Education Today, 66143-148. doi:10.1016/j.nedt.2018.03.024

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