Management of Professional conflict in the Workplace

MANAGEMENT OF
PROFESSIONAL CONFLICT
IN THE PERIANESTHESIS AREA
Presented to Nebraska Association of Perianesthesia Nurses
Alegent Creighton Bergan Mercy Medical Center
Presented by Michelle Homme March 23, 2013

GOAL: TO EDUCATE ON WORKPLACE
VIOLENCE AND HOW TO DEAL WITH THOSE
SITUATIONS SHOULD THEY ARISE.
 The definition of workplace violence
 Statistics
 Forms of violence
 Characteristics of attackers
 Types of attacks
 Confrontation levels
 Specific attacks
 Prime targets
Constant Change, LLC © @ItStartsToday
2

GOAL: TO EDUCATE ON WORKPLACE
VIOLENCE AND HOW TO DEAL WITH THOSE
SITUATIONS SHOULD THEY ARISE.
 Needed elements
 Costs
 Why?
 Lookout!
 What can you do?
 Prevention
 Two for one
 Coping
 At the top of your game
3

WORKPLACE VIOLENCE
 Definition:
 Violence or threat against people while they are at work
 Forms of workplace violence
 Threats
 Harassment
 Violence, including assaults
 Damage to property
 Mental anguish
 Physical harm
4

WORKPLACE VIOLENCE
 Statistics (reported)
 Homicide is the third highest leading cause of death
on the job (12% of all fatalities)
 There was a one-third increase in workers who were
killed on the job between the 1980’s and 1992
 75% of all deaths in the workplace are the result of
gun use
 2012 SHRM workplace survey, 36% of organizations
reported incidents
 2 million employees are affected every year (OSHA)
 Violence against women is increasing (perhaps
related to more women working)
 Bureau of Labor Statistics (2011) – Between 1992 and
2010, there were 13,827 victims (about 700/year)
5

WORKPLACE VIOLENCE
6

WORKPLACE VIOLENCE
 Statistics
 Next to auto accidents, homicide is the leading cause of death
in the workplace.
 There were 1,004 workers murdered in 1992 (33% increase since
the 1980’s.)
 Workplace violence in healthcare
 45% of all non-fatal assaults
 1993-1999, 765,000 assaults resulting in time away from work
 8 RN’s were fatally injured at work from 2003-2009
7

MORE HEALTHCARE STATISTICS
4 days away from work was the average
reported by RN’s in 2009 who suffered
from 2,050 attacks
Non fatal assaults included being hit,
kicked or beaten, scratched, squeezed,
punched, and bitten
Patients caused 89% of those assaults
50% of Emergency Nurses experienced
assaults in 2009
8

BULLYING IN NURSING
 Also known as “lateral violence” or “horizontal violence”
 Has been around for decades
 Purposeful in inflicting mental harm on other nurses with verbal and non-verbal
actions
 Threatening body language and strong verbal abuse has been reported by
student nurses (53%) and nurses, pharmacists, and others (48%)
 Nurses also report being threatened as well
 Effects include low morale, increased absenteeism, nurses leaving the
profession
 Patient care deteriorates
 Additional stress and other medical issues
9

WORKPLACE VIOLENCE
 One of the first terrorist attacks that made news
 December 21, 1988
 Lockerbie, Scotland
 Pan Am Flight 103 – 243 passengers and 16 crew were killed in
mid air
 Most recent attack
 Riverside Police Department, Riverside, California –
 One officer was killed, another injured as they sat at a red
light in their marked car. Alleged attacker – former LAPD
Officer. February 7, 2013
10

WORKPLACE VIOLENCE
 Rules & regulations (Nebraska)
 It is unlawful in Nebraska to carry a weapon or a weapon
concealed on or about the person, unless it can be shown that
the person was engaged in lawful business, calling, or
employment at the time the person was carrying any weapon,
and the circumstances justify a prudent person carrying the
weapon to defend his or her person, property, or family.
 It is unlawful to possess a firearm in a school, on school grounds, in
a school-owned vehicle, or at a school-sponsored activity or
athletic event.
 Nebraska is one of 18 states where penalties are increased for
workplace violence against nurses and 9 additional states have
laws in place requiring that workplace violence programs be in
place.
11

FORMS OF WORKPLACE
VIOLENCE
 Threats
 Hostage situations
 Property damage
 Intimidation
 Bullying
 Mental harm
 Physical harm
12

FORMS OF WORKPLACE
VIOLENCE
 Threats
 Job related
 Forms of aggression
 Hostage situations
 Need to be heard
 Want something to be fixed
13

FORMS OF WORKPLACE
VIOLENCE
 Property damage Alfred P. Murrah Federal Building
April 19, 1995
168 lives lost, including 19
children
Cost: appox. $652 million
14

FORMS OF WORKPLACE
VIOLENCE
 Intimidation
 Stalking
 rumors
 Bullying
 Why has it escalated?
 What can be done about it?
15

FORMS OF WORKPLACE
VIOLENCE
 Mental harm
 Additional stress
 Sick time taken
 Question one’s ability
16

FORMS OF WORKPLACE
VIOLENCE
 Physical harm
 Most severe
 Wounded
 Lives lost
17

CHARACTERISTICS OF POTENTIAL
ATTACKERS
 Loners
 Mental health issues
 Emotionally charged
 Intoxicated people
 Big ego/control freaks/”untouchable”
18

CHARACTERISTICS
Loners
 Never has
friends
 Plays the
victim
 Complains
19

CHARACTERISTICS
 Mental health issues
 May not be known
 Subtle signs where something is not
“right’
20

CHARACTERISTICS
 Emotionally charged
 Life and death of loved one
 Helpless feeling
 Intoxicated
 Indications include:
 Slurred speech
 Difficulty in following conversation
 Level of speaking is louder than most
conversations
 No regard for attention that it brings
21

CHARACTERISTICS
 Big ego
 No vanity or “God” like
 Control freaks
 Micro managers
 Untouchables
 Above the law
22

CHARACTERISTICS
The ones you
don’t see
coming
 Don’t fit normal
profiles
 Keep things
hidden well
23

THE 4 TYPES OF ATTACKS
 Strangers
 Terrorists
 September 11, 2001
 Politics
 Assassinations of Abraham Lincoln and
John F Kennedy
 Customers
 Educational locations
 Columbine
 Virginia Tech University
 Employees
 Postal workers
 LA Police Officer
 Relationship-based
 Domestic violence
24

 Strangers
 Someone that has no known ties to the workplace
environment
 Random
 85% of all attacks
Tucson, AZ January 28, 2011. US
Rep Gabrielle Gifford was among
the injured that left 6 dead.
Aurora, CO July 20,
2012. 12 dead and 58
injured
**side note: in
Omaha, a
basketball referee
was attacked and
his glasses broken
by an angry fan
during the week of
February 10, 2013
after a game
between two
church affiliated
teams.
25

 Customers or clients
 Someone who has used services/products from
the workplace
 3% of attacks
Columbine High School,
CO April 20, 1999. 12
students and 1 teacher
were killed. 21 were
injured.
Virginia Tech University,
Blacksburg, VA. April 16, 2007.
32 were killed and 17 were
injured.
26

THE 4 TYPES OF ATTACKERS
 Employee or former employee
 Someone who is a current employee or was an employee
 Usually target authority figures (supervisors)
 7% of attacks
Fort Hood, TX
November 5, 2009. 13
dead and 29 injured
“Going postal”
First attack
regarding postal
workers was in
Australia in 1926.
Between 1991 and
1997, there were 10
shootings alone in
the US, and the first
one took place on
August 19, 1983
where one person
was killed and two
were injured.Constant Change, LLC © @ItStartsToday
27

THE 4 TYPES OF ATTACKERS
 Personal relationship
 Someone that comes to the workplace because of a
relationship with an employee at the workplace
 Domestic violence – “Nationally, over 13,000 attacks against
women are made at work each year by partners.”
 5% of attacks
Seal Beach, CA October 12,
2011. 8 killed. Alleged
gunman’s former wife was an
employee and victim.
28

LEVELS OF CONFRONTATION
Day-to-day
Moderate
Severe
July 7, 2005,
EnglandConstant Change, LLC © @ItStartsToday
29

 Day-to-day
 Road rage
 Inpatient
30

 Moderate
 Someone who is upset about a situation
and you are the one they direct their
frustration towards
31

 Severe
 With weapons
 Casualties
Millard South High School,
Omaha, NE January 5,
2011. Assistant Principal
killed. Principal injured.
32

SPECIFIC ATTACKS
 Sandy Hook Elementary School
 Newtown, CT
 Lives lost:
 20 students
 6 staff
33

SPECIFIC ATTACKS
September 11, 2001
The Pentagon, Washington, DC – 59 lives lost
World Trade Center, New York City, NY - nearly 3,000 lives lost
Shanksville, PA
– 44 lives lost
34

SPECIFIC ATTACKS
 Von Maur Department Store
 Omaha, NE
December 5, 2007.
8 killed, 5 injured.
35

PRIME ENVIRONMENTS FOR
ATTACKS
Employees working
with the public are
at the most risk
36

TOP 10 INDUSTRIES FOR ATTACKS
1. Manufacturing
2. Health care & social assistance
3. Professional, scientific, and technical services
4. Finance and insurance
5. Educational services
6. Transportation and warehousing
7. Public administration
8. Retail trade
9. Construction of buildings; heavy & civil engineering
construction; specialty trade contractors
10. Accommodation and food services
37

TOP 10 ENVIRONMENTS OF ATTACKS
January 2013
38

HEALTH CARE ENVIRONMENTS
Why?
• Emotions are peaked
• Access to medications
• Mentally unstable people
39

NECESSARY ELEMENTS TO
VIOLENCE
• Emotional
• Involves people
• Location, location, location!
40

VIOLENCE
Emotional
Feelings get in the way
Not rational
There does not have to be an
explanation
41

VIOLENCE
 Involves people
 Makes the biggest impact
 We pay attention
 It makes us angry
 Senseless, regardless of the explanations
42

NECESSARY ELEMENTS TO VIOLENCE
 Location, location, location!
 Where are the innocent?
 Where no one would ever imagine it
happening?
 Where is the biggest impact?
43

ASSOCIATED COSTS
$120 billion a year
44

COSTS ASSOCIATED WITH WORKPLACE VIOLENCE
1. Management time
2. Loss of productivity
3. Replacing staff/turnover
4. Additional training expenses
5. Increased security
6. Debriefing with staff (after an incident)
7. Communication costs increase
8. Legal expenses are higher
9. HR expenses
10. Increased absenteeism
45

EXPLANATIONS OF WHY
Unfairly treated
Lost their job
Someone else is
responsible
46

EXPLANATIONS OF WHY
Unfairly treated
 It doesn’t have to make sense –
the person just has to feel like they
were wronged
47

EXPLANATIONS OF WHY
 Lost their job
 It doesn’t matter if it was legitimate or not
 No future
48

EXPLANATIONS OF WHY
Someone else is responsible
 It doesn’t matter if they believe that they have
any part in what is happening or not
 Holding onto what got them there instead of
how to make it better
 Holding grudges
49

BE ON THE LOOKOUT!
Possible signs
Trust your gut
Ask for help
50

BE ON THE LOOKOUT!
Possible signs
challenges authority
Has no accountability
Stalks other employees
Disregard for normal accepted society
practices
51

BE ON THE LOOKOUT!
Possible signs:
Words used
References to violence or weapons
Enjoys making people nervous
52

BE ON THE LOOKOUT!
Possible signs
 Threatening demeanor
 Changes in behavior
 Abusing drugs or alcohol
 Emotional state
53

BE ON THE LOOKOUT!
Trust your gut
 Hide
 Report
54

BE ON THE LOOKOUT!
Ask for help
Find co-workers who will listen
Talk to law enforcement
55

WHAT TO DO
Communicating
 Stay calm (Breathe)
 Don’t show fear (Breathe)
 Don’t disregard their feelings (Breathe)
 Indicate your willingness to help (Breathe)
 Don’t argue (Breathe)
56

WHAT TO DO
Keep your distance
Be on the same level
(don’t be sitting if they are
standing)
57

PREVENTION
Have a plan
Access your surroundings
Address the situation immediately
Environment
Ask for help
Talk to law enforcement
58

PREVENTION
Have a plan
Use technology
Send emails to all employees
Mass callout on all phone lines
Intercom system
Install cameras
59

PREVENTION
 Access your surroundings
 Are their triggers that might upset someone?
 Go outside your box
 Know your fellow employees
 Acknowledge those that are new
 Learn people’s names
 Assist strangers
 Greet them
 Make eye contact
 Ask questions
60

PREVENTION
 Address the situation immediately
 Better to be safe
 Take every threat seriously (you can
apologize later for a false alarm)
 Treat every employee with respect
61

PREVENTION
Environment
Develop relationships with nearby
businesses
Have well lighted parking lots
Advertise that even threats are taken
seriously
Hire security guards
62

PREVENTION
Ask for help
Difficult but necessary
Expertise
63

PREVENTION
 Talk to law enforcement
 Ask them to review your procedures
 Have numbers close by
 Evacuation
 Do you have a plan?
 Is it practiced?
 How do you know that everyone is accounted for?
64

TWO FOR ONE!
Not only can you be a victim
of an attack, but you are
involved with victims of an
attack that took place
elsewhere.
65

HOSPITAL STAFF ASSAULTS
 St. Vincent’s Hospital
 Birmingham, AL
Gunman walked in with a gun and
started shooting, injured 3 and
then was killed by an officer.
66

TWO FOR ONE!
Keep emotions in check
Difficult
Think first
Ignore insults
67

TWO FOR ONE!
Sudden, quick decisions
Have to react
Life and death related
68

COPING
Employee Assistance Program
(EAP)
Writing
Talking
Reporting
69

COPING
 EAP (Employee Assistance Program)
 Most employers have a program to help with work situations
 Very inexpensive or no cost
 Professionals
70

COPING
 Writing
 Start a journal
 Write letters you never mail
 Why? To get it “off your chest”
71

COPING
Talking
Family
Friends
Co-workers (compare
stories)
Helps to process
Becomes a teaching
moment
72

COPING
Reporting
Statistics
Document the event
73

AT THE TOP OF YOUR GAME
 Why nursing?
 You can make a difference
 Helping others brings you joy
 Monotony is not for you!!
 Fast paced environment
 No chance for errors
74

RESOURCES
 U.S. Department of Labor, OSHA
 American Nurses Association
 The National Institute for the Prevention of
Workplace Violence, Inc.
 And many others!
 Printed OSHA checklists & OSHA factsheet
75

SOURCES
 Society for Human Resource Management
 OSHA
 Bureau of Labor Statistics
 US Dept of Justice
 Violence and Theft in the Workplace, July 1994
 National Traumatic Occupation Fatality Study,
1994
 Workplaceviolence911.com
 US Dept of Labor
 American Nursing Association
 Nursingworld.org
 Neckerman.com (Neckerman Insurance,
March 19, 2012)Constant Change, LLC © @ItStartsToday
76

HOW DO WE KEEP IT GOING?
 Truth is, workplace violence is a part of our
society it is very depressing
 What did we learn?
 What workplace violence is and how to
identify it
 The signs we need to look for to identify
possible attackers and potential situations
 What to do in case we are victims of
workplace violence
 How to deal with the after effects of
workplace violence
 How can we use this knowledge?
 We can report ALL acts of workplace
violence, regardless of how minor they
may seem and if we feel anything
changes
 Prepare our work environment to be as
safe as possible
 Being better people makes better nurses
77

BEING A NURSE
 Can you sell it?
78

STRESS IS EVERYWHERE
 Do you carry stress? How do you relieve it?
 I carry it in my shoulders and I run to relieve it
 How does it affect you?
 I don’t sleep like I should
 We cannot carry our burdens all of the time – we have to set it down
 “Use what you have learned and then make a choice…you either keep it &
let it weigh you down OR you lose it & never let it slow you down.”
 Sayings to keep you grounded:
 Accept the fact that some days you are the pigeon and some days you are
the statue.
 Always read stuff that will make you look good if you die in the middle of it.
 It may be that your sole purpose in life is to serve as a warning to others.
 Nobody cares if you can’t dance well. Jut get up and dance.
 When everything’s coming your way, you are in the wrong lane.
 We are like crayons – different colors, different shades, but all have to live in
the same box
79

WHY A NURSE? WHY A
PERIANESTHESIA NURSE?
 Why do you keep coming back? What do you love
about nursing?
80

MOMENTS OF INSPIRATION
 Seeing you in action
 1995 baseball game
 2013 volleyball game
81

HOW TO BE BETTER PEOPLE
 Give more
 Always have hope because miracles happen
 Never give away YOUR power!
 It Matters
 Show MOXIE! (Making Ourselves Xtraordinary In
Everything)
 Positive ATTITUDE
 It Starts Today!Constant Change, LLC © @ItStartsToday
82

GIVE MORE
 Give unconditionally…always
 Give because you want to, not out of obligation
 Give away a smile, compliment, or hug – they are free!
 “No one ever wishes they had done less. They always wish
they had done more.”
83

FIND INSPIRATION
 It will be where you least expect it
 In a song, movie, or book -- or in everyday moments
 My favorites are quotes (I get these from Pinterest)
 How do you know if it is true inspiration? It touches you! You
feel something and you remember it.
84

ALWAYS HAVE HOPE
 Hope is what you have left to hold onto, despite what you have
in front of you
 Sometimes, it is the ONLY thing you have
 When do you see hope? When miracles happen!
85

NEVER GIVE AWAY YOUR POWER
 What happens when something or someone upsets us?
 We can let it ruin our mood and how we take on the world
 Why are bullies successful? Because we allow them to be.
 “No one can make you feel inferior without your consent.” -
Eleanor Roosevelt
86

IT MATTERS!
Do you think it matters?
“Living with failure is easier than living with
regret.”
Because we NEVER know if something we
do or say can affect someone, we have
to believe that everything can.
87

SHOW MOXIE!!!
Making
Ourselves
Xtraordinary
In
Everything
“To get
something
you never
had, you
have to do
something
you never
did.”Constant Change, LLC © @ItStartsToday
88

POSITIVE ATTITUDE
How do you get a positive
ATTITUDE?
Achieve
This
Through
Insight
Time
Understanding
Dedication
Empowerment
89

IT STARTS TODAY
SUN MON TUES WED THUR FRI SAT
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24/31 25 26 27 28 29 30
90

TO INSPIRE YOU
 Sara Tucholsky’s unforgettable
home run – April 28, 2008
 A rendition of the National Anthem
I will never forget
 A football player carries a
teammate off the field
 The story of Shay
91

ARM IN ARM, CROSSING THE FINISH LINE
June 5, 2012
Ohio Division III Girls
State Track Meet
3,200 meter run
Meghan Vogel helps
Arden McMath cross the
finish line
92

5 WAYS TO ENERGIZE!
 Here are 5 ways to help you feel energized and that momentum will keep you riding the
waves all day:
 1. Exercise. Yes, we have all heard this one before, but it can truly change your outlook and
"pump you up." You don't have to run a marathon in one day, but moving your body and
pushing yourself to do what we all need is never a bad thing. Even if I walk in the mornings,
by 6am I am so ready for what happens next!
 2. Smile. I know, this one is easy too. But when you wish someone a "Good morning" with a
smile or just say hello, you pass along your energy to someone else and that starts a ripple
effect. This world needs more smiles.
 3. Sing. And not just sing, but dance too. Who cares what everyone else thinks? Secretly,
they are wishing they had your confidence to sing "Call me Maybe" as you drive your co-
workers back to work. It's ok, I know who they are and yes, that was me. Give those people
in the car next to you something to smile about too!
 4. Find your joy. What gives you joy? It doesn't have to cost much and it won't consume all
of your time. What do you love to do that fills your heart? I love to write and to give to
others. When you find it, make your joy as much of a priority in your life just as everything
else is because it makes dealing with everything else better. It just does.
 5. Surround yourself with energized people. I know negativity when I see it and hear it. So
do you. Make a conscious effort to be around people who bring you up, not down. Ask
them what energizes them and some of it may actually surprise you. It is not difficult to be
drawn to those that inspire you, but you do have to make an effort to seek them out.
93

THANK YOU
 Gayle Kiviniemi & Kristy Iwansky
 Alegent Creighton Bergen Mercy Medical Center
 Nebraska Association of Perianesthesia Nurses
94

MICHELLE HOMME
CONSTANT CHANGE, LLC
WWW.CONSTANTCHANGETODAY.COM
EMAIL: MICHELLE@CONSTANTCHANGETODAY.COM
95

Management of Professional conflict in the Workplace

Recommended

Recommended

More Related Content

What's hot

What's hot (19)

Viewers also liked

Viewers also liked (15)

Similar to Management of Professional conflict in the Workplace

Similar to Management of Professional conflict in the Workplace (20)

More from Michelle A. Homme

More from Michelle A. Homme (14)

Recently uploaded

Recently uploaded (20)

Management of Professional conflict in the Workplace

Editor's Notes