8. List 2 role-relationship nursing diagnoses for F. N.

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for about a year on a busy medical/surgical unit in a large hospital. I feel that my experience there gave me the solid foundation I needed to be able to work anywhere. About a year ago, I took a new position working the night shift in the Emergency Department of a smaller facility.After just a short time working there, I began to notice a big difference between the nurses working the day shift and those working the night shift. The day shift nurses have at least 15 to 20 years of work experience and for the most part were educated in associate degree programs. The nurses on the night shift had less than 5 years of experience and were mostly BSN prepared. I began to hear negative remarks from the day shift nurses regarding formal experience with degrees and lack of nursing experience. I would hear them talking and saying some pretty degrading things about the night shift group. I did not pay much attention to the talk. I figured their opinions are too ingrained to change.After the first month I worked there, I was asked to be in charge. This focused the negativity and criticism on me. The experienced nurses were very verbal about what a bad decision this was since I was a new nurse. I was excited to take on this role and accepted the challenge despite all their grumblings. I loved my new position and was told I was a natural at it. I did not realize that those kinds of negative behaviors would arise within my own group of night shift nurses. There is a nurse on my team that has a terrible attitude and pretends she has been a nurse for a long time but in reality she has not. She is a known bully on the unit.One night I asked her to assist me with inserting a urinary catheter in a morbidly obese patient. This nurse made a joke about breaking sterility in front of the patient. I told her I did not appreciate her joke and asked if she would like to take over the procedure. She quickly declined and started laughing about how it was "just a joke" and threatened to leave the room and let me "attempt" the catheterization alone. It was humiliating and I knew the entire episode had caused the patient to lose trust in our professionalism, if not the profession.Although I was upset, I waited until I felt I could control my emotions and had a clear idea of how to handle the situation. I told her it was inappropriate to say something like that in front of a patient. I explained there are better ways to offer assistance or simply take over if there is concern. Since then, she has never made inaccurate remarks about my performance and in fact has become my biggest supporter.Not long after that, I was approached to be the department manager. I have been in training for a month now and I am learning new clinical and leadership skills every day. I feel like I have made progress in dealing with those who previously questioned my abilities. I made it clear to the veteran Emergency Department nurses that I am confident in my ability to lead, but they are my clinical experts and I respect their knowledge. I let them know I would be asking for their opinions and counting on their help. So far I have had nothing but positive feedback. Incivility in nursing is a problem and I am more aware of how negative talk and bullying can directly impact patient care and will try to keep the same thing from happening to the next new recruit. -What kinds of incivility did you identify in this scenario? -What interventions were used to address the behaviors? -In your opinion, were they effective in diminishing the incivility? -Have you seen other strategies or techniques that have been effective to address unprofessional work behaviors? -Can you think of other strategies that could be used to establish or maintain a healthy workplace environment? If so, please describe.
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