An Exploration of Discourses of Workplace Bullying of Organizations, Regulatory Agencies and Hospital Nursing Unit Managers

Abstract

Purpose: The purpose this dissertation was to explore discourses of workplace bullying and workplace bullying management used by managers of hospital nursing units, the hospitals in which they were employed, and agencies responsible for regulating these hospitals. Methods: The study was conducted in Washington State. Data for managerial discourses were collected via interviews with fifteen hospital nursing unit managers. Interview data were analyzed using Willig's Foucauldian Discourse Analysis. Data for organizational discourses were collected from documents that were produced by the seven hospitals in which managers worked. Data for regulatory agencies came from official websites for agencies responsible for regulating hospital workplaces. Hospital and regulatory agency documents were analyzed using Fairclough's Critical Discourse Analysis. Results: Analysis of the hospital (n=14) and regulatory agency (n=8) documents indicated there was no common label for bullying-type behaviors within or across the documents. In these documents, discourses of patient safety were mentioned more often than occupational safety discourses. Discussions of the needs of targets of bullying were minimal. Analysis of managerial discourse revealed that bullying was characterized as an interpersonal issue attributable to both the target and the perpetrator, an intrapersonal issue related to characteristics of the perpetrator, or an ambiguous situation that was difficult to classify. Two discourses of managing bullying were identified: bullying that was the responsibility of the staff to resolve and bullying that was the manager's responsibility to resolve. Actions that were available to managers in the discourse included doing nothing, actions other than progressive guidance, and progressive guidance. When managerial discourses were compared with hospital organizational discourses, differences were found in the words used to label bullying-type behaviors, the assignment of responsibilities for managers and staff, and the actions available to managers within the discourse. Conclusions: This study is believed to be the first to examine discourses of workplace bullying from hospital documents, regulatory agencies, and hospital nursing unit managers. The results indicate that obstacles to the resolution of workplace bullying include omission of the needs of the targets from the documents. Managerial actions in response to complaints of bullying were dependent upon their characterization of the incident. Differences in managerial and hospital discourses allow managers to address bullying in ways not sanctioned by their organization.