1 / 24

Oppressed Group Behavior and Ways to Improve Empowerment

Oppressed Group Behavior and Ways to Improve Empowerment. Jill A. Marsteller, PhD, MPP Associate Professor of Health Policy and Management Johns Hopkins Bloomberg School of Public Health and the Armstrong Institute for Patient Safety and Quality Johns Hopkins School of Medicine.

Download Presentation

Oppressed Group Behavior and Ways to Improve Empowerment

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Oppressed Group Behavior and Ways to Improve Empowerment Jill A. Marsteller, PhD, MPP Associate Professor of Health Policy and Management Johns Hopkins Bloomberg School of Public Health and the Armstrong Institute for Patient Safety and Quality Johns Hopkins School of Medicine

  2. Learning Objectives • By the end of the presentation, you will be able to: • Identify oppressed group behaviors • Consider whether they are present among coworkers at your institution • Enumerate ideas for combating these behaviors in the workplace

  3. What is “Oppressed-Group Behavior” (OGB)? • A response of non-dominant groups to their lower position in the hierarchy, lack of autonomy in work, lack of control • Feelings of powerlessness • Lack of pride, devaluing of self and own group

  4. Observed behaviors within oppressed groups • Silencing the self and passive-aggressiveness • Defeatism or apathy • Behaviors of insecurity • e.g., aggressive communication; inflexibility; blaming; extreme sensitivity to slights; grudge holding; fear of/anger toward dominant group • Imitation of the dominant group to succeed • b/c leadership granted by the powerful, leaders in non-dominant group more supportive of the powerful than their own group • Horizontal violence • e.g., unwarranted criticism of peers and lower status groups; • bullying or hazing; • infighting and internal divisiveness; • disruptive behavior (violence, psychological aggression, workplace incivility)

  5. OGB in Nursing • Often found among nurses but not openly acknowledged (lit. dates to 70s) • Roots in historical female and male roles (female predominance in nursing and male predominance in medicine) • Lack of autonomy; obedience to physician • Value of nursing care poorly recognized (no accounting available) • Nurses not included in decision-making; little control over own working conditions; expected to take on non-nursing tasks (e.g., cleaning the floor)

  6. OGBs may exacerbate disempowered status • Hierarchical, competitive relationships amongst nurses; no cohesive action to increase power • Take sides with those outside nursing in cases of conflict • Indirect communication styles can be hard to follow or seem irresolute, indecisive • Sometimes talking about each other; complaining; holding grudges; acting in a petty fashion • Most common management styles used by nurses are avoiding and compromising (Valentine 2001).

  7. Disempowering Nurse Behaviors • 20 interviews with Canadian nurses 1998-1999 (17F, 3M; experienced & new; diploma through masters candidates) • Nurses value collaboration and acceptance outside nursing • Freq. failed to advocate for patient wishes and needs b/c of need to fit in with team values, other professionals’ opinions Daiski 2004

  8. Daiski 2004 Examples • “Nurses eat their young” • Worst scheduling for new staff; ignoring requests • Concentration on mistakes; lack of praise for good work • Holding back information and letting new nurses flounder; seeing who is going to “make it;” • Criticizing nurses who object to cleaning and other non-nursing tasks • Insistence on the same ways of doing things, rejection of new approaches • Shunning/ bullying those who are different or breach “the rules”

  9. Disruptive Behavior • 10 Focus groups of 96 RNs (Hopkins) • 225 disruptive behavior events • Nurse instigators in 29% (n = 66) • “Gossiping is huge . . . [it] can be quite maligning and very vindictive.” • Presence of intimidating cliques on the nursing unit that “police” other nurses’ practice • Passive-aggressive email • Actual or perceived lack of competency in a new RN as justifying “being harsh and critical” toward the new nurse Walrath, Dang and Nyberg 2010

  10. Disruptive Behavior • Survey of 1559/5710 respondents (27.3%) • RNs experienced higher frequency of disruptive behaviors and triggers than MDs • Unlike MDs, RNs experienced almost monthly occurrence of malicious gossip, self-centeredness, and inappropriate use of communication technology • Both MDs (45% of 295) and RNs (37% of 689) reported that the disruptive behavior of a member of their own discipline affected them most negatively • 189 incidences of harm to patients as a result of disruptive behavior were reported Walrath, Dang and Nyberg 2013

  11. Bigger than OGBs: The Bullying Organizational Context • Workplace bullying--repeated, intentional, masked negative behaviors or actions in imbalanced power relationships • Wider environmental/organizational issues may help normalize bullying (not just within-group OGBs) (Hutchinson et al. 2006) • Increasingly complex systems of control within organizations can be co-opted by bullies • Bullying may be condoned/rewarded as appropriate use of power when bullied person is cast as the problem

  12. OGBs can be addressed • Interventions can decrease OGBs • Decrease in OGBs has been found to be related to increased work force performance, satisfaction and retention (Roberts, DeMarco and Griffin 2009)

  13. Combating OGBs/ Bullying • Recognize and expose oppressed group behavior • “For many focus group participants, these sessions served as a catharsis for pent-up emotions resulting not only from personally observing or experiencing disruptive behavior but also from the fact that when such behavior did occur, the instigators were not consistently and equitably addressed across professional disciplines. –Walrath et al. 2010

  14. Combating OGBs/ Bullying • Encourage staff to appreciate and compliment each other • Create an avenue for complaints/ positive criticism of system; encourage them to make a solid case with data and documentation

  15. Combating OGBs/ Bullying • Advocate for collaboration among staff; create joint projects and opportunities for positive interactions (e.g., writing group) • Create a buddy system/mentorship system • Reward helping behaviors and promote solidarity, esprit de corps • Create opportunities for communication across shifts and units (validates views and builds consensus within group)

  16. Combating OGBs/ Bullying • Address issues raised by non-dominant groups • Recognize good work and those working to improve quality • Encourage involvement on hospital committees and decision-making bodies • Emphasize group’s contributions to hospital • Train on appropriate assertion and conflict resolution • Deal with negative/ bullying coworkers consistently and equitably

  17. Combating Oppressed Group Behaviors/ Bullying • Train on structured communication strategies • Offer scripted responses to most common instances of horizontal violence or bullying

  18. Measure OGBs to Intervene • Silencing the Self Scale Workplace Scale (STSS-W) for nurses (DeMarco et al. 2007) • Lateral Violence in Nursing Survey (Stanley et al. 2007) • Nurse Workplace Behavior Scale (NWS) (DeMarco et al. 2008) • Disruptive Clinician Behavior Survey for Hospital Settings (Walrath et al. 2013) for nurses and physicians

  19. Relational Coordination • Measure between-group relationships (Gittell et al. 2008): • Frequency, timeliness, accuracy of communication • Shared knowledge • Shared goals • Mutual respect • Joint problem solving behavior

  20. On your own • List non-dominant/ low autonomy groups in your organization and any OGBs you notice • Describe roots of the OGBs, ideas for improvement • Generate 3 actions that could support the improvement plans

  21. References • Daiski, Isolde. ”Changing nurses’ dis-empowering relationship patterns,” Journal of Advanced Nursing, 2004, 48(1), 43–50. • DeMarco R. F. & Roberts S. J. (2003) Negative behaviors in nursing: looking in the mirror and beyond. American Journal of Nursing 103(3), 113–116. • DeMarco R., Roberts S. & Chandler G. (2005) The use of a writing group to enhance voice and connection among staff nurses. Journal for Nurses in Staff Development 21 (3), 85–90. • DeMarco R., Roberts S., Norris A. & McCurry M. (2007) Developing of the silencing the self scale (work) (STSS-W) for nurses. Journal of Nursing Scholarship 39 (4), 375–378.

  22. References • DeMarco R., Roberts S., Norris A. & McCurry M. (2008) The development of the Nurse Workplace Scale (NWS): self-advocating behaviors and beliefs in the professional workplace. Journal of Professional Nursing 24, 196–301. • Gittell, J.H., Weinberg, D., Pfefferle, S., Bishop, C. (2008).  “Impact of relational coordination on job satisfaction and quality of care: A study of nursing homes,” Human Resource Management Journal, 18(2): 154-170. • Hutchinson M, Jackson D, Vickers M and Wilkes L. “Workplace bullying in nursing: towards a more critical organisational perspective,” Nursing Inquiry 2006; 13 : 118–126.

  23. References • Roberts S . J . , Demarco R. & Griffin M. (2009) The effect of oppressed group behaviours on the culture of the nursing workplace: a review of the evidence and interventions for change. Journal of Nursing Management 17, 288–293. • Sieloff, Christina Liebold. “Staying Power,” Recruitment and Retention Report, Nursing Management, November 1999. • Stanley K., Martin M., Michel Y., Welton M. & Nemeth S. (2007) Examining lateral violence in the nursing workplace. Issues in Mental Health Nursing 28, 1247–1265.

  24. References • Walrath JM, Dang D, Nyberg D. An organizational assessment of disruptive clinician behavior: findings and implications. J Nurs Care Qual. 2013 Apr;28(2):110-21.   • Walrath JM, Dang D, Nyberg D. Hospital RNs' experiences with disruptive behavior: a qualitative study. J Nurs Care Qual. 2010 Apr-Jun;25(2):105-16.   • Valentine P. (2001) Gender perspectives on conflict management strategies of nurses. Journal of Nursing Scholarship 33 (1), 69–74.

More Related