An Integrative Review of Nurse-to-Nurse Incivility, Hostility, and Workplace Violence: A GPS for Nurse Leaders.

Bullying, lateral violence, and incivility are real phenomena in the nursing workplace and remain widespread across all care settings. The American Nurses Association recommends zero tolerance for any form of violence from any source and adopting evidence-based strategies to mitigate incivility and bullying. This integrative review examined the evidence regarding nurse-to-nurse incivility, bullying, and workplace violence for 4 nurse populations-student, new graduate, experienced, and academic faculty. Ganong and Cooper's review methodology structured the evidence synthesis. Twenty-one articles pertained to the clinical inquiry. The evidence consistently described the incidents, instigators, and targets of incivility/bullying, which contributes to 84 negative academic, organizational, work unit, and personal outcomes. A safe and just organizational culture demands a comprehensive systems-level approach to create civil environments. The evidence-based structures, processes, and recommendations serve as a Global Positioning System for practice and academic leaders to use in creating a healthy work environment where nurses are encouraged and empowered. The critical choices by nurse leaders will determine not only the future of 21st century professional nursing practice but how the public views the nursing profession for many years to come.

Learning from mistakes in a simulated nursing leadership laboratory.

Human patient simulation in nursing education has become an accepted and expected form of pedagogy. Research on the use of human patient simulation to evaluate student performance, however, is still at an early stage. The vast majority of these sources report the unit of analysis as the nurse-patient dyad (one nurse-one patient) situated in an infrequently occurring, high-risk, or costly event such as a code blue, and the literature reveals little evidence on the efficacy of the use of simulation for the care of multiple patients. The teaching innovation, discussed herein, involving a simulation, used a leadership scenario of a routine day in an acute-care hospital unit. The aim of the project was to provide a high-fidelity simulation of the competing demands on a nurse's time and attention while caring for multiple patients. Working as a team, using principles of prioritization, delegation, scope of practice, and communication, senior baccalaureate nursing students assumed the various roles of interdisciplinary team members as they moved through staged sequences of changing patient and unit conditions. This was followed by debriefing session that prompted the students to identify their errors in judgment, including sending the wrong patient to the operating room, failing to rescue a patient, and failing to delegate critical tasks to other nursing team members.