The Context,Content, and Consequences of Disruptive Behavior among Nurses through Participant Observation and Interviews Public Deposited

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  • March 19, 2019
  • Leiper, Jacoba
    • Affiliation: School of Nursing
  • Disruptive behavior (DB) is a term used in health care to describe a wide variety of unhelpful, hostile, and hurtful behaviors that occur between health care workers. The consequences of disruptive behavior are significant for both nurses and health care organizations. Most studies on DB examine type, frequency, and consequences of disruptive behavior, while few explore how and why it occurs. While DB occurs among all healthcare workers, this study focused on DB among nurses and aimed to understand how it occurred. The research questions were: a) how do nurses perceive DB in their interactions with other nurses, and b) under what circumstances and in what context does DB among nurses occur. Data collection methods included participant observation, semi-structured interviews, and contextual documents. Data analysis was done using grounded theory techniques and included coding, comparison of data, developing diagrams and matrices, and in-depth exploration of categories. Findings included that two types of nurses regularly initiated DB on the nursing unit: disruptive nurses (individuals who had a pattern of continual DB) and stress-reactive nurses (individuals who initiated DB only under stressful circumstances). Responses of nurses to DB consisted of a pattern of managing, recovering, and preparing for DB. Solving DB on the unit was difficult for the nurses and unit manager, and in their effort to address DB nurses reported, confronted, or surrendered to the situation. Each of these strategies had unsatisfactory consequences which lead to the nurses becoming despondent. The result was a seemingly never-ending rise and fall of DB. Lastly, this study identifies that public DB (constant stream of negative comments and complaining to no one in particular) is a form of DB and is very disturbing to nurses. This study adds to a broader understanding of the occurrence of DB in the nursing workplace and may provide opportunities for the design of preventative interventions at nursing practice and organizational levels for the promotion of a safe and healthy work environment.
Date of publication
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  • In Copyright
  • Esposito, Noreen
  • Beeber, Linda
  • Havens, Donna
  • Parker, Patricia
  • Leeman, Jennifer
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2014
Place of publication
  • Chapel Hill, NC
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