Margaretha Strandmark NHPRC 2013

Developing and integrating an intervention program to

prevent and combat bullying in daily practice

Margaretha Strandmark K

Professor

Karlstad University,Sweden

The research group – a collaboration between Public Health Sciences and Nursing

Margaretha Strandmark, RN, Professor GullBritt Rahm, Lic.

psychotherapist, PhD Ingrid Rystedt, MD, PhD Bodil Wilde-Larsson,

RN, Professor) Gun Nordström

RN, Professor)

An intervention study in collaboration with workplaces

Ongoing during four years Granted by AFA Insurance

A part of a larger research project

Definition of bullying

Repeated, systematic, negative, hostile and/or unethical actions over time, where one of the participants is in a disadvantaged position and cannot defend her/himself towards the others or the group.

Olweus 1992; Björkqvist et al., 1994; Leyman, 1996.

The aim

In collaboration with the workplaces, develop and implement an intervention program to prevent and combat bullying.

Research approach and sample The research approach was participatory and

community based. Based on questionnaire scores and the presence of

bullying problems, workplaces were selected, in collaboration with the upper level managers: two eldercare wards and one geriatric psychiatric ward.

Targeted occupational included assistant nurses, nurses, physicians, physiotherapists, occupational therapists, counselors and nurse’s assistants.

Interested employees voluntarily enrolled in the focus groups upon our presentation of the project.

Individual and focus group interviews

In the first focus group, we investigated how bullying was manifested in the workplace.

In the second focus group, we focused on intervention components which prevented and combatted bullying.

In the third focus group, we discussed the suggestions concerning the presented action plan, based on the previous interviews.

The interviews were analyzed according to Grounded Theory methodology (Charmaz 2006).

Preliminary findings

Zero-tolerance

Zero-tolerance

Zero-tolerance

Zero-tolerance Zero-tolerance

Zero-tolerance

Zero-tolerance Zero-tolerance

Value-systemAtmosphere

Awareness

Group collaboration

Conflict resolution

Organization

Co-workers

The head

Zero-tolerance (no bullying)

• The actors consist of the head of the wards, co-workers and the remaining organization.

• Work with the value-system, to be aware of the bullying, an open atmosphere, group collaboration, and conflict resolution are requirement to attain zero-tolerance against bullying.

Preliminary findings

These categories consist of a connection between feelings and rational arguments.

Sometimes, there are discrepancies between the ideal and the reality.

The head of the ward has an intermediate position in which she/he will be a listener, be emphatic, be resolute and call for demands.

The co-workers have a responsibility to behave professionally towards patients, clients and the head of the ward.

The executive level of the organization is a ‘black box’, and the co-workers experience unfairness concerning staffing, work load, and employments.

The actors’ roles

A humanistic value system

• Respect others’ opinions, not listen to rumour• Tolerate that people are different• Concern about the others, be more sensitive,

and engage in an empathic view • Reducing the values of depreciate and

disloyalty against established decisions show a contradiction and disrespect

Awareness about bullying Behavior – rumor, deceit, stigmatization,

freezing out, own interpretation Feelings – alone, outside, insulted,

deterioated self-esteem, afraid, angry Cause – not work well, different, push

away people, go their own way Conscious malevolent or un-conscious

habit

An open or concealed atmosphere

Open – allowable environment, safety in the group, talk freely

Concealed – stuck in the walls, pressed atmosphere, afraid, un-safety, suspicious

Collaboration within the group and between groups

Support over limits Creation of mutual routines Building clicks Informal chiefs

Conflicts resolution

Put the foot down Play down with humor Compromises Not increase the conflict

Intervention program

From the findings of the interviews an intervention was developed. Desires from the first focus group.

a) a half day lecture about bullying, conflict management, communication, feeling of shame.

b) we also discussed in small groups with all employees using playing-cards containing bullying situations and possible solutions.

Example from the playing cards ’Mobilizing against bullying’

Situation: You see a colleague in the corridor, far away. Suddenly, the colleague changes the direction and takes the step downstairs without looking at you.

How do you react?

a)Ask the colleague if she/he did not see you.

b)Become sad and say nothing.

c)Complain on the colleague to other colleagues.

d)Something else?

Intervention program

c) From the separate interviews and the two first focus groups interviews a suggustion for a concrete action plan was compiled.

The plan included the value-system, the recognition of bullying and the calling out of problems, a treatment which creates confidence and trust, conflict management, the roles of supervisor’s and the co-workers’, the dynamics of group processes, and the arenas to keep the discussions alive.

c) The action plan has been presented and discussed in the steering groups at the workplaces.

Follow-up the action plan at the workplaces

All employees shall sign the action plan. New co-workers are assigned a mentor. The head of the ward is responsible for

the plan is followed. The participants of the focus groups are

responsible for keeping the discussions alive.

Conclusion

Zero-tolerance against bullying shall prevail. Through a humanistic value-system, the head of the ward, the co-workers and the remaining organization work together towards this goal, by being aware of the bullying, having an open atmosphere and good collaboration in groups, and by resolving conflicts. These factors are necessary to prevent and combat bullying.

Thank you for your attention!Margaretha.Strandmark@kau.se