Bullying in the Workplace: Immature Occurrence, or Symptom of Something Worse?

The noble profession of healthcare; where the work started off from compassion and spirit of alleviating others’ suffering.

It is however, very unfortunate that physicians and nurses are not spared from the issue of bullying. We tend to think that bullying only occurs in schools, and are surprised to hear that it also happens in immature settings.

Bullying is a form of directing the bullies’ dissatisfaction inward or towards each other, themselves, and towards those who are less powerful and influential than themselves.

Examples of bullying in the workplace include being spoken in a belittling manner or being lambasted by the older generation for being weak and spoilt.

Studies show that Asian healthcare workers report the largest quantity of workplace-related bullying. The study was carried out in Singapore, showing abuse by nurse managers and colleagues. It also implies that 70% of the staff choose not to report workplace incidents, suggesting that the number of bullying cases might be even higher.

Bullying cases may not be always obvious. It might not be someone yelling at a poor junior nurse in the OT in front of everyone. Shaming, spreading malicious rumors about a co-worker still is bullying, and so are refraining from promotions or the right to take leave.

Why it happens

As previously mentioned, bullying not only happens at immature settings such as in schools, but also at workplaces all the way up to the higher echelons. A stressful environment, poor working conditions and poor leadership are prime vectors for bullying cases in the workplace.

The perpetrators involved in these cases are usually the ones in power. They exercise their power over helpless individuals, humiliating and belittling them in order to make them feel superior. They are usually authoritative, and oppressive in behavior.

There is also a pattern in the victims of such bullying. Doctors and nurses below the age of 30 reported to be more likely to experience workplace bullying. This is due to their position in the workforce- they are generally the lowest tier amongst everyone else, and are prime candidates to be targeted by perpetrators wanting to flex their authority without much of a pushback.

Another study conducted in Asia showed that nurses with high levels of anxiety were almost five times more likely to experience verbal abuse. Because they are by nature unsure of themselves, they do not have the mental standing to push away from bullies’ abuse. Other personality types that are highly associated with bullying are those who are inexperienced, less assertive with their work, lower confidence, and have vulnerable personalities.

Effects

Decline in productivity and effectiveness of care

The physical and emotional health of the victims decreases, which ultimately leads to worse quality of care for patients.

Victims report headaches, sleeping disorders, and medical errors done, which in turn leads to an increase in absenteeism. An increase in absenteeism due to health issues leads to understaffing of a healthcare institution.

Incur costs

Lower morale from victims results in a higher employee turnover rate. This is costly towards the institution; it is far more expensive to constantly replace employees compared to keeping them and increasing their pay year after year. It just doesn’t make much financial sense.

Higher intetion to quit the job leads to career burnouts whuch are much earlier than normal. Impacting non-workplace relationships as well.

Death

When nurse managers or MOs abuse their co-workers by refusing their right to leave, catastrophic results follow. Malaysian newspaper “The Star” reported in May that concerns have been rising about road accidents among tired and overworked doctors. Not too long ago a houseman in Kota Bharu Hospital hit a cow on the way home and died. Nurul Huda Ahmad, a paediatrician in training, died in a motor vehicle accident after nearly 33 hours on duty.

Ways to Stop It

It is not enough to simply tell the staff to “just stop the bullying.” The superiors of the workplace have to encourage their staff to speak out and report any instances or cases immediately. In addition to promoting a safe environment where employees can do so, employers must train effective communication skills to promote reporting as being viewed as an acceptable and necessary behavior.

Moreover, the training provided must encompass business etiquette that touches upon cultural sensitivity practices, and educate the workforce on negative working behaviors. Sometimes, the bullies may not even know about what they’re doing, until pointed out to them.

In the case of management, policies set in place creates a code of conduct to stop these cases. It is important to enforce it consistently for all staff members. Document any violations. This mitigate behaviors like persistent criticism that has no basis.

The way forwards

The act of bullying in a healthcare settings must not and cannot be left to fester. It creates a lot of damage and losses for both the institution and the people working in them. Most of all, the impact on patient’s safety is hit the hardest.

Patients place their utmost trust in the medical world to help them recover and lead productive lives again. Compromised care can deal potential harm in patients; it can mean the difference between a sound mind and a vegetative state, a living patient or a dead one.

If the medical field is to become the bastion of healing and wellness, then it must address this recalcitrant issue and not let it grow like an unwanted tumor, damaging the whole system in the process.



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 A few weeks back Malaysians were shocked to hear of a man  impersonating a medical officer at a hospital  in Alor Setar. What was impressive was that the man kept the act up for about a year before authorities caught him! 

 There have been many cases of people impersonating doctors or surgeons for all kinds of reasons. These are some of the most interesting throughout recent history. 

 1. Kristina Ross 

   

  Fake profession : Plastic Surgeon 

 Kristina Ross frequented bars and pubs, claiming to be a plastic surgeon. She’d approach unsuspecting women, sweet-talk them and get them to know about her “private practice.” Under the guise of a plastic surgeon, she would conduct “breast examinations” on these women, and have them contact her number. 

 Her years of fake activities was brought to a halt when two recipients of her “free breast examinations” contacted the number Ross gave. The number belonged to a real plastic surgery clinic, but had no surgeon that went by the name of Kristina Ross. Their suspicions of the phony surgeon grew, so they called the police. 

 The authorities launched an investigated, and arrested Ross sometime later. But that’s not the last part of the story; upon arrest, it was discovered that she was actually a transgender man who changed his sex. 

 Bottomline: don’t subjugate yourselves to medical exams in non-clinical settings. 

 2. Francisco Rendon 

   

  Fake profession : Dentist 

 Rendon was able to practice his own twisted brand of dentistry for about 16 months before the police finally caught on. 

 His dental clinic was situated between two automobile workshops. His patients grew wary of his dental credentials as they had to sit in a leather office seat instead of a reclining chair. 

 Hygiene was not maintained well; Rendon made his patients spit into a trash can rather than a proper sink. He used unlicensed tools, including a tool which purpose was to polish cars on his patients. 

 When the authorities came to his “office” to arrest him for practicing without a license, he still had many patients in the waiting room. 

 3. Keith Allen Barton 

   

  Fake profession : Doctor 

 This lying physician claimed that he could cure serious diseases like HIV and cancer. He claimed he could “stop the diseases before they spread” and “nip it off from the bud.” He spread lies about the pharmaceutical industry, propagating the myth that corporations were hiding the real cure to those diseases. 

 In reality, what he did was charge his patients exorbitant fees for his homemade cures. Most of his remedies were made of cheap ingredients and did nothing to improve patients’ conditions. Sometimes he even made it worse. 

 He shares the same name as a registered doctor in California, and used this fact to swerve past the authorities. He was finally arrested under charges of identity theft and grand theft. 

 4. William Hamman 

   

  Fake profession : Cardiologist and Medical Speaker 

 Everybody liked him; he flew commercial planes for a living, and was also a cardiologist with 15 years of experience at the side. He frequently published papers in academic journals. He went around delivering lectures at universities and Cardiology seminars. 

 One day he submitted an early draft to a university committee that oversaw publication for their medical journal. One staff member spotted a glaring flaw in the otherwise impeccable paper; he had no M.D. (medical doctor) qualification. 

 What makes Hamman so interesting is that his academic achievements as a fake cardiologist were particularly impressive. His focus was on team-based efforts and how to get cardiology teams to work better together to improve outcomes. It had real academic weight to it. 

 5. William Bailey 

   

  Fake profession : Doctor 

 Bailey was an eccentric man. Being born in the late 1800s, when radioactivity was still a poorly understood science, he was obsessed in marketing the health benefits of consuming radioactive substances for the masses. 

 In 1918, he released Radithor; a tonic that he claimed could cure diseases and restore health by stimulating the endocrine glands. Of course, there was no scientific basis to this. Radithor was made by adding radium crystals into water. It gave off an emission of 1 microcurie per mole of Ra. 

 Despite not being proven to be effective, the public lapped up Bailey’s bogus claims of the healing properties of Radithor. Eben Byers, a young Pennsylvanian competitive golf player, was urged to take the irradiated substance after a consultation with his doctor. He was suffering from pains in his side; so he bought and drank Radithor on a daily basis. 

 Byers died in 1932. He had holes in his skull due to radiation poisoning; his jaw even fell off as it degenerated. He had to be buried in a lead coffin to contain the radioactivity from his body. 

 Bailey died after the Second World War, after having suffered from multiple cancers and poisoning. 

 
 Source: 

 
	  http://www.dailymail.co.uk/news/article-1330725/Kristina-Ross-pretended-plastic-surgeon-conduct-bar-room-breast-exams.html  
	  http://www.nbcchicago.com/news/local/francisco-rendon-fake-dentistry-charges-91216374.html  
	  http://www.nbcsandiego.com/news/local/Phony-Doctor-Keith-Barton-Claimed-He-Could-Cure-HIV-Cancer-DA-186240712.html  
	  http://abcnews.go.com/Health/MindMoodNews/fake-cardiologist-william-hamman-duped-real-doctors/story?id=12395288  
	  https://en.wikipedia.org/wiki/Radithor

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 As incidences of chronic kidney disease and other related renal issues continue to rise, the need for adequately trained nurses in those fields continue to grow. Similar conditions are seen in various parts of the world. In 1999, the incidence of patients with kidney conditions requiring long-term care is 340,261. In 2010 it is over 600,000. 

 The diagnosis of renal conditions can be done with a primary care doctor. However, treatment and care of those patients require an understanding of risks, comorbid conditions, complications, and probabilities for loss of kidneys by both physicians and nurses. 

 For nurses, a post-basic renal course can open the doors to working in this area which is sorely lacking in manpower. Here are the reasons why you should consider pursuing a renal post-basic certification. 

 From bedside to business 

 There are a lot of CKD (chronic kidney disease) clinics opening up. Having a renal certification enables you to work at these clinics as your training is aligned with what they have to offer their patients. 

  Pusat Hemodialisis Mawar  is one of them. They are the largest private charity haemodialysis organization in the country. They have 13 centres spread throughout the country. 

 A short search on Google Maps also reveals a lot of haemodialysis centres in Klang Valley. 

 Being a nurse at institutions like those will train your patient management skills as you run the day-to-day administrative tasks in parallel with your nursing duties. 

 Better work setting 

 You’ll have a less erratic schedule than your peers. Dialysis patients require a regular timing on their treatment. Your shifts would be on more regular hours. A more fixed routine can be better for your health and well-being. 

 Better pay 

  On average, renal nurses with post basic certification get about 10% more pay.  

 Hospital dialysis nurses may be offered more pay, but they may also be required for emergency dialysis treatments, making their schedule less average than others in their field of focus. 

 Adjustable pace 

 You can choose to work in smaller dialysis centres for slower pace, or larger nephrology units in hospitals if you wish for a faster paced working environment. Unlike other specialties, you have a choice to work in the kind of environment that suits your working style. 

 Rapid changes in the field 

 Technological advances in the renal treatment field progresses at a rapid pace. Previously, it was slow. Kidney diseases were complex and difficult to study. Therefore treatments were vaguely ineffective. 

 The 21st century brought in upgraded transplantation technologies with breakthroughs in biocompatible materials. 

 As a renal nurse, you will handle the care of post-transplant patients. The tasks and how you perform your duties to these patients have a high probability of changing with the frenetic pace of research. 

 High Demand 

 Renal nurses have good experience in interpreting telemetric data. This makes them efficient at being support units in surgical wards to ensure successful procedures. 

 Dialysis is expensive, costly, and there’re not enough facilities and manpower in public and private hospitals. 

 Conclusion 

 Pursuing a renal post-basic certification is a solid pathway to consider. Nurses with this certification are more in demand, have better pay, and all the listed advantages above. For people who like clinical challenges, treading this path is for you. 

 Already have a post-basic in renal care? Head over to MIMS Career to search and apply for renal care jobs in your area. Just signup and experience our convenient 1-click application process. It’s fast, safe, and easy. MIMS Career also allows you to search in our huge database of employers seeking new staff. You can also save potential jobs for later viewing, and create your own personalized job alert.

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 A common question asked to academic counselors by prospective nursing students is: “So how’s the life of a nurse? What kind of hours to they work?” 

 It depends. It really depends on your location, academic qualifications, experience, country of practice, working environment… Really, I could make a long list but then the article would be way too long. 

 So our team at MIMS Career has sifted through the working hours of a lot of different types of nurses, so you can have an idea of what kind of career choices you’d have to make to go towards that kind of life. We’ve categorized it in five parts: a little, a bit, normal, a bit more, and a lot. 



 A little (3-5 hours a day) 

 Part-time nurse practitioners 

 These nurses mostly work doing house calls, or are doing contract jobs with non-medical institutions like schools or companies. Their employers do not require their presence most of the time, so as little as 3-5 hours per work session is pretty common. Part-time nurse practitioners usually have another job other than their nursing one. 

  Find out how to become a part-time nurse practitioner in our in-depth nursing career advancement guide HERE.  

 A bit (5-8 hours a day) 

 Locum nurses 

 Locum nurses work part time shifts in clinics or hospitals or other medical-related institutions. They are not on the payroll of the institution they work with; as they are only meant to supplement the institution’s own workforce. On average a locum nurse’s shift is about 5-8 hours. 

 It is more common to see nurses doing locum jobs to supplant their monthly income, but nurses who exclusively do locum jobs exist, albeit rare.  

  Find out part-time locum jobs for nurses on our career portal HERE.  

 Normal (8-10 hours a day) 

 Nurse instructors, academicians, dialysis nurses 

 These nurses work office hours. This is as normal as it gets. Dialysis centers and nursing schools all have regular, fixed schedules that don’t demand anything more than the usual office workday. 

 Same goes for those who work in nursing schools as teachers, trainers, or professors.  You can find out what it takes to be an academician in the nursing world in our article about lifelong learning HERE.  

 These kinds of nurses don’t normally work weekends, and their schedules are mostly the same and predictable. 

 A bit more (10-14 hours a day) 

 Those involved in direct patient care, like emergency room nurses 

 Most of the time, when nurses at the ER say they work a 12-hour shift from 7am to 7pm, they almost always never get to get out on time. There’s always something to do, someone else to cover, or some loose ends to tie up. 

 This is made even worse by working in hospitals with a shortage of staff. Nurses would be brought in to do things that are not in their job scope, because they can do those tasks. But people who are not nurses do not do nursing tasks because they cannot do those tasks. How many times have you been to an ER, and see a nurse doing clerical work at the front desk because the hospital doesn’t have a secretary or clerk? 



 A lot (14-24 hours a day) 



 Paediatric intensive care, intensive care, surgical, labor and delivery. 

 It is very common to see nurses doing double shifts in these wards. Their shifts might be 12 hours, but are sometimes to do two of those shifts back-to-back to reduce shift handovers, staffing overlap, and reduce costs. 

 Moreover, the type of work that this category of nurses do are a bit on the lengthier side. Surgeries can go up to 24 hours, including perioperative care. Intensive care can be very demanding as patients hover around critical states. 

 There is a variety of workloads for nurses. Each type of work suits different people who prioritize different things. With MIMS Career you have the opportunity of applying with ease to the jobs that you want to go into. Signup and apply with our easy, 1-click application process. Browse for jobs in Malaysia, Singapore, Philippines and Indonesia. Save jobs for later if you’re still on the fence. Also, you can opt for job alerts if nothing fancies you. 

  Signup and apply today! It’s fast, secure, and free.

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 Think about working in Australia. The salary of nurses are one of the highest in the world. They have a large, interesting country with endless things to explore. The quality of life is great; it is second best globally. People live outside a lot more than they do here, are laidback, and friendly. 

 Working overseas, while initially scary, can be one of the best decisions you ever make. Being outside your comfort zone forces you to grow as you are tested by challenges that not many people will get the opportunity to go through. 

 Depending on where you go, it can be very different from back home. This change in environment builds confidence as a result of changes in your perspective. Not only will it look good on your resume for future career opportunities, a new country is a land of endless discovery that you can make during your downtime after work. 

 Want to work as a nurse in Australia? Read on to find out. 

  About Australia  
 Register with NMBA  
 Apply for skills assessment with AMNAC  
 Get on AHPRA online public register  
 Pass the AMNAC skills assessment  
 Living in Australia  

 About Australia 

 Because it was geographically isolated as an island for millions of years, many species can only be found on the Australian sub-continent. Australia is a rapidly advancing country: it is the 13th-largest economy, and is ninth on the list of income-per-capita. It ranks highly in terms of quality of life, healthcare, education, economic freedom, civil liberties and human rights. An influx in migration from all over the globe to Australia has resulted in the country becoming a rich, diverse, and friendly melting pot of cultures and ideas. 

 Register with NMBA 

 The process of migrating to Australia for work as a nurse involves a few regulating bodies. In a nutshell, in order to practice nursing, you’d have to register with the Nursing and Midwifery Board of Australia (NMBA). This board handles your qualifications, and deems your education to be relevant, meeting Australian standards. Then you have to apply with the Australian Nursing and Midwifery Accreditation Council, or ANMAC. This body takes into account your work experience, and handles your migration to Australia. It is possible to be accepted by the NMBA, but rejected by the ANMAC. 

 The suggested pathway is to register with the NMBA first. For registration, they will assess you on three things: 

 
	 Criminal history
	 
		 English language skills (a recent result of tests like IELTS or TOEFL is needed) 
		 Recency of practice. You need to clear this part if you’ve already been practicing as a registered nurse here in Malaysia. Recent grads without prior work experience need not do this step. 
	 
	 
 

 Apply for skills assessment with AMNAC 

 Once this is done, and approved by NMBA, you then apply to AMNAC for a skills assessment. This is the application that will approve your migration to Australia. 

 They have five criteria to submit: 

 
	 Proof of identity 
	 English language proficiency (similar to NMBA criterion) 
	 Educational equivalence (whether or not the nursing degree or training is the same standard as AMNAC’s standards) 
	 Professional Practice 
	 Fitness to practice. 
 

 Get on AHPRA online public register 

 If you’ve graduated from Malaysia, you would have to complete some further training. This is because you do not meet Criteria 3- Education equivalence. Hence you would not be suitable for a skills assessment from AMNAC, which prevents your migration. 

 To get over this hurdle, you need to be on AHPRA’s online public register, which determines that you are fit to practice, and that your education and training are both deemed usable for their healthcare system. 

 This training can be in the form of a bridging program or something similar. Contact the Dept of Immigration and Border Protection for a visa to go to Australia to complete your training. 

 Pass the AMNAC skills assessment 

 Then there’s only left the final step! AMNAC will approve your application to go through their skills assessment. Once that’s done, they will issue a Letter of Determination. If you are suitable for migration, congrats! Head back over to Department of Immigration and Border Protection website to start the visa process. 

 Living in Australia 

 Australia has seven of the top 100 universities in the world so great place for education. Also, each year Australian Government provides approx $200 million dollars in scholarships for local and international students. It’s a good opportunity to raise your children there. 

 Australia is a safe, multicultural, friendly and harmonious society. It has a comparatively very low crime rate and strict gun control laws providing a safe place to live. 

 Medical insurance, healthcare facilities and doctor’s prescription medications are cheaper than many developed countries. So you can have a peace of mind whenever misfortunes happen. 

 Halal food is relatively easy to get in the larger cities. Lately the vegetarian movement has been very well-liked with the local populace. Regardless of your dietary needs, Australia is open enough to accommodate everyone. 

 Conclusion 

 Migration to another country can be scary. There are no certainties. No guarantees. You’d be leaving familiar environment behind, and embracing the change that will happen. Be proud of yourself for taking this next big step in your career. 

 As the world gets smaller and more connected, employers are more in need of healthcare practitioners who are open-minded, culturally-exposed, and competent to meet the needs of 21st century challenges. 

 You stand to gain a new skillsets from experienced specialists who work in challenging environments. It will solidify your confidence - and compassion. That compassion will come from the realization that despite differing borders and flags, we are still one big family. The realization that we’re not so different after all, and that access to health care is a basic human right. 

 Start applying for nursing jobs overseas with MIMS Careers. Just signup, input your details and resume, and you will be able to apply for those job posts with a single click. Not only that, you can save jobs you are interested in for later viewing. 

 Can’t find what you’re looking for? Set up job alerts so we can notify you of new employers that meet your search criteria.

How to Work as A Nurse in Australia

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