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Removing Disruptive Behavior from the Workplace. Renee Alexander Heather Jones Tracy Lindquist Amy Martin Nicole Rogers. Clemson University, HRD 860, Dr. Bronack, December 4, 2011. Acknowledgements. SC Pioneers in Disruptive Behavior Research & Education:. Karen Stanley, APRN, BC

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Removing disruptive behavior from the workplace

Removing Disruptive Behavior from the Workplace

Renee Alexander

Heather Jones

Tracy Lindquist

Amy Martin

Nicole Rogers

Clemson University, HRD 860, Dr. Bronack, December 4, 2011


SC Pioneers in Disruptive Behavior Research & Education:

Karen Stanley, APRN, BC

Mary Martin,DNS,ARNP,NAP

Yvonne Michel,PhD

Lynne Nemeth, PhD, RN

Medical University of SC

Peggy Dulaney, MSN, RN, PMHCNS, BC

Independent Consultant

Upstate AHEC

Research conducted in Nursing, Upstate AHEC


  • Define disruptive behavior

  • Discuss causes of disruptive behavior

    • Identify key characteristics of the 4 generations in today’s workplace

    • Discuss the impact of behavior styles on communication

  • Review policy and procedure

  • Develop an action plan for dealing with disruptive behavior in the workplace

  • Objectives

    Old problem new names
    Old problem…New names

    Workplace incivility

    Disruptive behavior

    Horizontal hostility

    Lateral violence

    Horizontal violence



    Disruptive behavior what is it
    Disruptive Behavior …What is it?

    Lateral Violence (Disruptive Behavior) in nursing is defined as “…nurses covertly or overtly directing their dissatisfaction inward toward each other, toward themselves, and toward those less powerful than themselves.” Griffin, 2004

    Joint Commission (2008) calls it “disruptive behavior.”

    Forms of disruptive behavior

    • One-on-one aggression

    • Inter-group conflict

      • Shift-to-shift

      • Cliques within a workgroup

      • Department-to-department

    Forms of Disruptive Behavior

    Disruptive behavior
    Disruptive Behavior…

    Behaviors that undermine a culture of safety

    Overt actions such as verbal outbursts and physical threats

    Passive actions such as refusing to perform assigned tasks and quietly exhibiting uncooperative attitudes during routine activities

    Sentinel Event Alert #40, July 9, 2008, The Joint Commission

    Faces of disruptive behavior

    • Facial expressions, gestures (non-verbal)

    • Direct negative or hurtful words

    • Undermining activities

    • Withholding information

    • “Setting someone up” to look bad

    • Bickering between groups

    • Blaming everything on one person

    • Backstabbing

    • Failure to protect privacy/broken confidences/gossip

    • Unfair work assignments

    “Faces” of Disruptive Behavior

    • New employees (may be new graduates)

    • Experienced employees, but new to the area or department

    • Temporary staff or someone covering from another area

    • PRN staff

    • Students or trainees

    • Persons in lower hierarchical positions

    Common Targets

    How db lv is handled
    How DB/LV is Handled


    Upstate AHEC, 2008

    Healthcare is a high stress environment
    Healthcare is a High Stress Environment

    Heavy workloads/short staffing

    Patients/customers are under stress

    Rapid turn-around times

    Patients’ lives are at risk

    Unpredictability of the work


    Generally negative personality

    Personal issues impacting work life

    What s the impact

    Patient Safety

    What’s the impact?

    Low morale

    Decreased teamwork

    Increased stress

    Decreased quality of patient care

    Increased absenteeism

    High turnover rates

    Increased labor costs

    Difficulty in recruiting new staff

    • Gender differences

    • Cultural/religious differences

    • Generational differences

    • People are ashamed of being a victim and don’t report the behavior

    • We come to accept bad behavior from some people

    • Fear of retaliation if we do report

    • Behavior styles

    Other Contributing Factors

    Raise awareness of the problem
    Raise Awareness of the Problem

    • Discuss with manager and co-workers

    • Research disruptive behavior individually or as a team

    • Encourage others to take this class

    • Other?

    Adopt professional standards of behavior
    Adopt Professional Standards of Behavior

    • Workplace Standards

    • Professional Organization Standards

    • Department Standards

    • Personal Standards

    Communication basics
    Communication Basics

    • Take time to calm down; be aware of your feelings

    • Talk directly to the person, not other co-workers

    • Holds discussions in private

    • Always be respectful of the other person

    • Listen carefully

    • Avoid blaming or retaliation

    • Use “I messages”

    • Consider the position/needs of the other person

    • Maintain a safe environment

    Desc format for effective feedback
    DESC Format for Effective Feedback

    • Describe the situation (“When …happened,”)

    • Explore or express your thoughts, feelings or concerns giving the benefit of the doubt (“I felt …..” or “Was it your intent to…?”)

    • Specify what you want them to do differently next time (“In the future, would you…?”)

    • Consequence-state the positive consequence when they do as you ask

    Cognitive rehearsal techniques
    Cognitive Rehearsal Techniques

    • Recognize the behavior when it occurs

    • Plan ahead for ways to respond

    • Practice new responses before you need them




    When you hit a wall
    When You Hit a Wall

    Your best efforts

    No change

    Next steps
    Next Steps

    • Keep a record of the negative behavior. Write down the date, time, witnesses, and describe exactly what was said or done.

    • Keep a record of your attempts to deal with the negative behavior. Write down the date and time when you spoke with the person and describe what you said.

    • Share these records with your supervisor and ask for their help.

    The tipping point
    The Tipping Point …

    …when a few people begin to do the right thing, others join in and it CAN change the environment.

    We are all either part of the problem

    or part of the solution !

    Questions answers
    Questions & Answers

    Renee Alexander

    Heather Jones

    Tracy Lindquist

    Amy Martin

    Nicole Rogers

    Thank you!