Individual Critical Thinking Assignment

In her article “The New Age of Bullying and Violence in Health Care,” Fink-Samnick uses qualitative ethnographic research method to explore the incidence, scope, and organizational impact of workplace bullying and violence (WPV). In addition, the expert observes its implications for the emerging interprofessional practice culture in the health industry. The author expresses her elation experience on joining the health profession which made her feel too busy to muse about personal safety concerns. Although managing intimidating and posturing has been part of the healthcare practice for the past few decades, its scope and impact cannot be compared to today’s virulent workplace bullying and lateral violence.

Healthcare workers have to remain ever vigilant because of verbal threats towards them from disgruntled family members of a patient under their care. Unfortunately, the need to be concerned about personal safety has increased due to the high contagion rate of WPV. Such behavior obstructs the care process, hinders ethical practice, and ultimately puts the patients at grave risk. The aim of this essay is to present an analytical summary of the article “The New Age of Bullying and Violence in Health Care” and evaluate the significance of its content.

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Incidence and Implications

Even if bullying and workplace violence cut across all career industries, health care demands special and urgent attention considering that hospitals are ranked among the most hazardous employment environments. Similarly, according to Radoslovich’s observation, hospitals and healthcare industry in general have the highest level of bullying. These health-harming mistreatments are typically characterized by threats, intimidation, humiliation, sabotage, verbal abuse, and deliberate destruction of relationships that can be perpetrated by an individual or a group towards one person or more. Unsurprisingly, a significant number of employees accept this behavioral epidemic as a hierarchical stratification. Due to this failure to confront such behaviors, bullies’ antagonistic interactions continue freely leaving other staffs scared or unwilling to work in close collaboration with such individuals. Consequently, team communication exists in shambles, and the quality of care is potentially damage due to the inability of healthcare teams to dialogue coherently.

Lateral violence occurs when individuals who are both victims of a hostile dominance situation turn on each other instead of confronting the oppressive system. People experiencing lateral violence internalize feelings of anger and rage which may be manifested through unethical behaviors such as gossip, jealousy, obscenity, and blame games. Similar to bullying, these behaviors are on the rise in the healthcare sector with staggering figures being recorded as pressure mounts due to the nurses-physicians impaired relationships. Presumably, daily pressures experienced by case managers result in frustrations increasing the likelihood of projecting their emotions towards team members. Consequently, trust and respect among colleagues are damaged because of fragmentation replacing cohesion. Rainford et al. express concern over the frequency with which feelings associated with lateral violence are being reported across the health industry.

In addition to the aforementioned adverse impacts, Fink-Samnick notes that organizations plagued with lateral violence and bullying are more unlikely to retain best talents. According to Gaugler, bullying and lateral violence are the key contributor to the workforce retention challenge experienced in the long-term healthcare sector. Admittedly, nurses exposed to regular verbal abuse either from colleagues or from the physicians and other supervisors report a greater intent to leave their workplace or have an entire change of career. Moreover, they make more medical errors resulting in preventable adverse and lethal outcomes due to disruptive and intimidating behavior. By all standards, lateral violence and bullying violate all that health care strive to be: patients-centered and quality-driven to interprofessional team efforts characterized by respectful and coherent communication.

Case Management

Based on the connections linking such disparaging and obstructive behaviors to lowered level of quality care, case managers bear the burden of intervention even where circumstances impede them from taking actions. Moreover, it is a requirement for case managers always to act with integrity when dealing with other professionals in order to maximize clients’ benefits. However, it is critical to note that lateral violence and bullying are still paradoxical to existing case management as well as ethical codes and standards.

Consequently, these behaviors present considerable implications for interprofessional practice culture being inculcated into the healthcare sector. Practically, cooperation, coordination, and collaboration are fundamental elements of any paradigm of teamwork appearing across an industry; hence, they should characterize patient-centric professionals. Fink-Samnick believes that success in the implementation of interprofessional practice culture is likely to promote practitioner coherence instead of the dominant unhealthy fragmentation and competitions between healthcare industry disciplines. Moreover, it has the potential to stimulate workers to purpose and commit to creating effective, safer, and more efficient healthcare systems.

Fink-Samnick maintains that industry experts are in agreement that care coordination requires maximum team collaboration and communication. Failure to recognize the value and contribution made by every person and discipline in the field will inevitably hamper the quality of care. Workplace violence influences staff satisfaction, physical and mental health, patient satisfaction, and employee turnover. Therefore, WPV can only be classified as an emerging health hazard that has created a need to educate health professionals on its identification, reduction, and elimination. The article further states that lack of strong WPV prevention programs, outdated protection regulations, beliefs that violence is part of the job, and undermining the risk involved have contributed to the rising cases of workplace violence. The author claims that the first step in solving this problem is to kill the notion that WPV is part of the job and treat it with the seriousness it deserves.

Moreover, Fink-Samnick argues that employers should control their workers stop bullying and lateral violence considering they incur extra costs through loss of skilled labor and regular recruitment costs. For this purpose, employers can implement mandatory training, better incidents recording process, provide innovative equipment such as attack alarms, enact pair visiting policy, improve risk assessment, and add the police force to strategic partners list. Moreover, reporting offenders to the FBI will deter other service receivers from turning on and assaulting or even shooting their caregivers. Although handing over a patient to the authorities may not be among the actions nurses anticipated when joining the field, they have to manage such harsh realities in the course of their career. As expected, shifting the focus of caregivers from that core role to address bullying and violence directly impacts the organizational performance.


Fink-Samnick recognizes the emotional toll associated with WPV on the mental health of the employees which is being manifested through increasing cases of Posttraumatic Stress and Disorders (PTSD). Organizational leaders should create and maintain safety and quality culture by developing proactive codes of conducts and implementing a process for managing WPV behaviors. It can be performed through consistent monitoring, confidential reporting, and creating an atmosphere of safety and support to bullying victims. Moreover, federal and state governments can play a role by increasing the penalties of those convicted of assaulting nurses and other healthcare personnel. In the absence of a safe atmosphere for both the patient and the workforce, the enhanced focus on quality delivery of care might gives little result.