Yewande Sanusi, DNP, MSN, FNP

Abstract:

Background: Bullying culture is pervasive in all levels of nursing and results in poor retention, direct financial losses for hospitals, poor patient outcomes, and higher rates of suicidality among nurses (Edmonson & Zelonka, 2019). The literature directly cites 60% of new graduate nurses leave their first job within their first year as a result of bullying related behaviors among colleagues (Edmonson & Zelonka, 2019). Nursing education traditionally includes some content pertaining to incivility- related behaviors. The limited scope of this content does not fully prepare pre-licensure nursing students for bullying-related experiences they may encounter in the health care workplace. Nurse educators can impart this knowledge but also teach the skills necessary to support a successful career that encompasses safety, advocacy, and wellness. Design: This DNP Scholarly Project used a quasi-experimental design to evaluate a two-session cognitive rehearsal training (CRT) educational intervention. Setting: The setting was at the University of California Los Angeles (UCLA) School of Nursing; Nursing Leadership and Management Course (N168). Participants: Participants in the project were 53 senior Bachelor of Science (B.S.) pre-licensure nursing students. Methods: In the first session, the Negative Acts Questionnaire-Revised (NAQ-R) and pre-surveys were administered followed by a 1.5-hour power point presentation on methods of identifying, responding to, and addressing bullying behaviors in the health care workplace. The second session consisted of the intervention of anti-bullying cognitive rehearsal training (CRT) with two scenarios that can occur in the healthcare workplace. Students participated in group roleplay with both scenarios, answered discussion questions, and concluded each scenario with a class debriefing with the researcher. The post-survey was administered after both scenarios were completed. Results: The NAQ -R scores illustrated that pre-licensure nursing students have observed or experienced bullying behaviors. Post-survey scores measuring the ability to identify, address, and respond to bullying behaviors significantly increased from an average score of 3.1 to 4.2 (N=53; p<0.001) after anti-bullying related CRT. In the qualitative assessments, pre-licensure nursing students gave more in depth examples of bullying and de-escalation techniques in the post-survey.  Conclusion: The conclusion is that anti-bullying CRT for senior pre-licensure nursing students increases the ability to identify and know how to report bullying behaviors. There was an increase in knowledge about how to respond to and address bullying behaviors that they personally experienced or witnessed; and there was also an increase in the confidence level in utilizing strategies to respond to and address bullying behaviors that they personally experience or witness. Anti-bullying CRT should be considered for incorporation into the UCLA SON curriculum.

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