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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  Photo cr: Unsplash  

 Mental Health 

 Mental health is a level of psychological well-being, or an absence of mental illness. It is the “ psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment” . From the perspective of positive psychology or holism, mental health may include an individual’s ability to enjoy life, and create a balance between life activities and efforts to achieve  psychological resilience . 

 According to the World Health Organization (WHO), mental health includes “ subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential, among others.”  Cultural differences, subjective assessments, and competing professional theories all affect how mental health is defined. 

 Mental health nurses play and important part in helping patients lead a positive life. It is not uncommon for physical disorders to arise from mental issues. It is a field that is growing in awareness. It is estimated that  40% of Malaysians will suffer from mental health issues in their lifetime . 

 Specialization tasks 

 Maintaining good mental health is crucial to living a long and healthy life. Mental health nurses are required to show a considerable amount of empathy towards their patients in assisting them to make a full recovery. Research has shown that there is stigma attached to mental illness. Therefore, it is extremely important that mental health nurses develop excellent observational skills in the treatment of the patient. 

 Activity therapies 

 Activity therapies, also called recreation therapy and occupational therapy, promote healing through active engagement. Making crafts can be a part of occupational therapy. It is very common for nurses to take patients on walks as part of this type of therapy. 

 Psychotherapy 

 Psychotherapy is the general term for scientific based treatment of mental health issues based on modern medicine. It includes a number of schools, such as  gestalt therapy ,  psychoanalysis ,  cognitive behavioral therapy  and  dialectical behavior therapy . 

 Legal requirements 

 Mental health nurses assist in the legal requirements for the patient. Requirements encompass the setting of the patient or a group of patients. 

 Progress monitoring 

 Mental health nurses may have roles that include visiting patients in their home to monitor their progress and carry out risk assessments. While carrying out this task, nurses assess the risks involved to the patients’ safety, health, and welfare. 

 Pathway 

 In order to specialize as a mental health nurse, you must be a registered nurse, practicing for a minimum of three years. A Bachelor’s of Science in Nursing is an advantage. You must take up a psychiatry-based training course with practical hands-on experience. For those courses, you may be able to get accreditation if you have a degree in psychology, or social work. 

 Required skills 

 You will need to display: 

 
	 
	 Exceptional observational skills. You will be required to assess patients and look out for signs of tension or anxiety, which sometimes are not that obvious. 
	 
	 
	 Physical fitness, especially when working in a hospital. Increased stamina and strength is an added bonus. 
	 
	 
	 Emotionally and spiritually resilient to work in a challenging environment. 
	 
 

 Job prospects 

 While a lot of work for mental health nurses is done in the hospital, the majority is community-based in a wide variety of settings. Some of them include community mental health centers, nursing homes for the elderly, rehab units, and private clinics. 

 Working conditions 

 Salaries for mental health nurses will depend on the level of education that they possess. Those with a BSN or MSN will earn more. The type of institution and experience that you have will also factor in your earnings. 

 It is important to have a calm demeanor and able to handle stress well as you will be working with many difficult patients with psychotic episodes. It can be rather jarring to those who are not used to it. However, when approaching these situations without judgement, many mental health nurses manage to overcome these issues and help the patients with their treatment. 

 Career opportunities 

 Search for high-paying mental health nursing jobs on  MIMS Career . Browse, save, and apply for nursing jobs, all in one-click. Take the opportunity for higher pay and better work locations. Our pages are all mobile-responsive, allowing you to take that leap for a better job whenever, wherever you are. All our job postings are heavily screened to  prevent scams and mistrustful behavior . 

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Photo cr: Unsplash Mental Health Mental health is a level of psychological well-being, or an absence of mental illness. It is the “ psychological state of someone who is functioning at a satisfactory level of emotional and...

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  1. Specialization tasks  
 2. Pathway  
 3. Common job scopes  
 4. Common terms  
 5. Career opportunities  

 Cardiology 

 Cardiology is a branch of medicine dealing with disorders of the heart as well as parts of the circulatory system the field includes medical diagnosis and treatment of  congenital heart defects ,  coronary artery disease ,  heart failure ,  valvular heart disease  and  electrophysiology . Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons. The supporting role of the surgeons and physicians are  cardiology nurses . 

 Although the cardiovascular system is inextricably linked to blood, cardiology is relatively unconcerned with hematology and its diseases. Some obvious exceptions that affect the function of the heart would be blood tests, decreased oxygen carrying capacity, and  coagulopathies . 

   

  source: Resus.me  

 Specialization Tasks 

 All cardiologists study the disorders of the heart and all cardiology nurses are trained to take care of either adult or children conditions. This is due to differing aspects of training for adult and paediatric physiology. Surgical aspects are not included in cardiology and are in the domain of cardiothoracic surgery. 

 For example, coronary artery bypass surgery and cardiopulmonary bypass are both surgical procedures performed by surgeons, and not cardiologists. As a nurse, your task will be that of assisting the cardiologists in this matter. A properly-trained cardiology nurse would have the necessary critical thinking in order to draw conclusions to make meaningful impact of treatment. 

 Common tasks in the wards that you might have to do include the insertion of stents, pacemakers, and valves. 

 Pathway 

   

  source: verywell  

 Cardiology is a specialty of internal medicine. To be a cardiology nurse, a three-year work experience followed by a post-basic or relevant course is required. It is possible to sub-specialize in Malaysia. Recognized sub-specialties in cardiology for Malaysia are cardiac  electrophysiology ,  echocardiography,  interventional cardiology, and  nuclear cardiology . 

 Currently there is insufficient data for Malaysia, for salary, but it is guaranteed to be higher or on par with other similar nursing specialists. 

 Common job scopes 

 Cardiology is a vast field. Not only does it involve the heart and its systems, it also involves supporting systems such as haematology and its diseases. It is important to know and train for this when pursuing this specialization. 

 Cardiac electrophysiology 

   

  An example of echocardiography  

 This is the science of elucidating, diagnosing, and treating the electrical activities of the heart. The term is usually used to desccribe studies of such phenomena by  invasive catheter recording  of spontaneous activity as well as of cardiac responses to programmed electrical stimulations. These studies are performed to assess complex arrythmias, relieve symptoms, evauate abnormal ECGs, assess risk of developing arrhythmias in the future, and to design treatment. 

 Cardiac examination 

 The cardiology nurse is able to carry out cardiac examinations of patients. It is performed as part of a physical examination, or when a patient presents with chest pain suggestive of a cardiovascular pathology. It would typically be modified depending on the indication and integrated with other examinations especially the respiratory examination. Like all medical examinations, the cardiac examination follows the standard structure of inspection, palpation, and auscultation. 

 Paediatric cardiology 

   

  source  

 Paediatric cardiology is a specialty of paediatrics. To be a paediatric cardiology nurse, one must complete at least three years of registered working experience and pass all the required courses. Adult cardiology certifications are not valid due to differences in physiology in children. 

 Common complications that you will see as a nurse practicing paediatric cardiology are  paediatric hypertension ,  paediatric hyperlipidemia , heart palpitations and arryhthmias. 

 Diagnostic tests 

 Diagnostic tests in cardiology are the methods of identifying heart conditions associated with healthy vs. unhealthy pathology heart function. It is commonly started by obtaining a medical history, followed by auscultation. Blood tests soon precede after, and imaging can be done on a need-to-do basis. 

 Common terms 

 1. Tetralogy of Fallot 

 It is the most common congenital ehart disease arising in 1-3 cases per 1000 births. The cause of this defect is a ventricular septal defect and an overriding aorta. These two defects combined causes deoxygenated blood to bypass the lungs and going right back into the circulatory system. The modified  Blalock-Taussig  is used as a treatment for this condition. 

 2. Pulmonary atresia 

 This happens in 7-8 births per 100,000 and is characterized by the aorta brancing out of the right ventricle. It causes deoxygenated blood to bypass the lungs and enter the circulatory system. Fixing it can by done by a team of cardiologists and nurses by redirecting the aorta and fixing the right ventricle-pulmonary artery connection in surgeries. 

 3. Double Outlet Right Ventricle 

 Double outlet right ventricle is when both great arteries, the pulmonary artery and the aorta, are connected to the right ventricle. There is usually a ventricle in different particular places depending on the variations of DORV, typically 50% are subaortic. A VSD closure is the most common form of treatment for this condition. 

 Career opportunities 

 Search for  high-paying cardiology nursing jobs  on  MIMS Career . Browse, save, and apply for nursing jobs, all in one-click. Take the opportunity for higher pay and better work locations. Our pages are all mobile-responsive, allowing you to take that leap for a better job whenever, wherever you are. All our job postings are heavily screened to  prevent scams and mistrustful behavior . 
   

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1. Specialization tasks 2. Pathway 3. Common job scopes 4. Common terms 5. Career opportunities Cardiology Cardiology is a branch of medicine dealing with disorders of the heart as well as parts of the circulatory...

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 Geriatrics is the specialty of care of the elderly. The main goal is to assist aging patients to improve their health by preventing or treating illnesses or disabilities. 

 Currently the mean age of the global populace is increasing[1]. Demand for geriatric care has rapidly risen within the past 10, 20 years. This trend is also seen in Malaysia. Unfortunately, it is a profession that not many young nurses or doctors would want to pursue[2]. 



 Definition: 

 The word geriatrics is derived from Greek. “Geron” means “old man.” “Iatros” is defined as “healer.” 

 Gerontology, a word commonly used together with geriatrics, is the study of the aging process itself. 

 Duties: 

 Geriatric nurses assist their patients in their daily life. They help them to live healthily, and improve their independence by treating or staving off disabilities that cause dependency of care. 

 It is not uncommon for geriatric nurses to ensure the comfort of their patients is taken care of as well. They also assist in recognizing and managing syndromes that are common to older adults. 

 Educating the family members of the elderly patient is also a key responsibility in the geriatric nurse. The nurses have to ensure the care provided by the family are only good practices. 

 Ultimately their job scope depends on the institution they work in. 



 Education: 

 The study of geriatrics and gerontology itself is a relatively new branch of medicine. Medical capabilities have progressed to the point where people are now living longer than ever before.  

 The global average life expectancy was at 45[3] years old in 1950-55, and it has now jumped to 76. Recently, the Baby Boomer generation has started to encroach the age of 60-70. As a result there are only a few established centers of learning for the advancement of this field of medicine. 

 Post-basic or advanced diploma courses in geriatrics can also be listed under the name of elderly care[4]. Unfortunately, not many learning institutions or hospitals offer this in Malaysia, as of time of writing. 



 Workload and Working Conditions: 

 It depends on the institution they work in. Geriatric nurses can work in mental health facilities, hospitals, private hospitals, private practices, clinics, and also nursing homes. 

 Some wards may employ geriatric nurses to assist in treatment and recovery of their older patients. For example, renal, cardiology, and neurology all often do this in larger hospitals. 



 Opportunities in Geriatric Nursing 

 As it is a rapidly growing field of high importance, the opportunities for academic study and research are very high. There is a big need for healthcare workers to be trained in the field of gerontology, so local healthcare can keep up with global standards. 

 Some geriatric nurses even can opt to open up their own practices as well. 

  Read more on advancing your nursing career into nursing education HERE . 



 Salary and income 

 The median salary of geriatric nurses is higher than that of a registered nurse[5]. However this depends on many factors, such as duties/responsibilities, experience, and work location. 

 This is expected to increase as demand for geriatric nurses continues to grow ever-rapidly. 

  Read more on how nurses can increase their income HERE.  

 Source:  
    1.  http://today.mims.com/topic/what-are-the-options-for-aged-care-in-singapore-?country=Malaysia&channel=GN-Health-Wellness   
    2.  http://today.mims.com/topic/specialist-spotlight–geriatricians   
    3.  https://upload.wikimedia.org/wikipedia/commons/2/29/Life_Expectancy_at_Birth_by_Region_1950-2050.png   
    4.  http://www.imc.edu.my/elderly-care-setting-standards-elderly-care/   
    5.  http://www1.salary.com/Staff-Nurse-RN-Geriatric-Salary.html  

 Search for high-paying geriatric nursing jobs here at  MIMS Career . Sign up and apply today with our safe, secure, and free site. MIMS Career is an extensive job portal for healthcare practitioners such as nurses, doctors, and dentists throughout Malaysia, Singapore, Indonesia and the Philippines. 

 Browse through our vast directory of job vacancies by top healthcare employers. See any jobs you like? Apply with one click, or save it for later if you need some time to think about it.  

 Can’t find what you’re looking for? Set up an email alert, and we’ll notify you when a job vacancy that meets your desired criteria becomes available.

Career Highlight: Geriatric Nursing

Geriatrics is the specialty of care of the elderly. The main goal is to assist aging patients to improve their health by preventing or treating illnesses or disabilities. Currently the mean age of the global populace is increasing[1]....

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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.

How Many Hours do Nurses Work?

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,...

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