Problem statement
The medical field deals with life threatening situations every day. The smallest mistake can mean life or death for a patient. One of the most prominent organizational behavior problems that hospitals face is intimidation between healthcare providers. According to Lamontagne (2010), intimidation is defined as "to make timid, to fill with fear, to overawe or cow, as through the force of personality or by superior display of wealth, talent, etc; to force into or deter from some action by inducing fear" (p. 58). I think one of the biggest reasons people comply is because they fear endangering their job if they don't. Most of the time the person doing the intimidation is in a position of power. Having power, they can easily manipulate new and less experienced employees like students or recent graduates. These individuals also happen to be the easiest to manipulate which is why they fall into being the victim.
The reason I chose this organizational behavior problem to research is because it is a problem that almost every medical organization faces. This problem not only affects the medical field, it also affects about every business organization at one point or another. The research conducted by Hernandez (2018) suggested that one hundred percent of people surveyed experienced intimidation in one way or another (p. e36). Forms of intimidation include: yelling, teasing, and sometimes physical intimidation. If one sampling of individuals proved that everyone was in contact with intimidation, it's very likely to occur across other organizations. Another reason I chose this organizational behavior problem was because of the serious implications it has on patients and coworkers. Intimidation can increase stress rate, anxiety, burn-out, and depression among both physicians and nurses and can lead to mental health issues (Hernandez, 2018, p. e36). Intimidation can also lead to serious complications for patients including death. Certain mistakes can go unnoticed including medication errors.
Reasons for the Problem
Reason #1
One reason intimidation in the workplace exists is due to the existence of hierarchal structure. Intimidation typically occurs by the individual in an authority position (Cannella, 2014, p. e54). Typical pairings of individuals include supervisors and subordinates or registered nurses and student nurses. One in three new graduates consider resigning due to intimidation and humiliation by registered nurses (Lamontagne, 2010, p.58). That can cause a drain in new knowledge and a high turnover rate. In the long run, the higher turnover rate can increase costs from constantly training new employees.
Reason #2
Another reason for the existence of intimidation is a person's need to manipulate others for their own advantage. Many people who act aggressively or try to intimidate others do so in hopes that they will get their way and improve job performance (Bolino, 2003, p.239). Although it might seem like a good way to get ahead, individuals who act aggressively and intimidate colleagues can be seen as more of a liability rather than an asset. Also, you are less likeable in the eyes of coworkers and they will be less likely to want to work with you in the future.
Reason #3
Finally, the last reason why intimidation occurs in medical organizations is because many CEOs and supervisors want to have control over their employees. Some supervisors have a tendency to micromanage employees and harp on small issues. This leads to supervisors who would rather be feared than liked (Harris, 2017, p.3). A common tactic that supervisors have used to gain control and intimidate subordinates is through the use of spies. Spies will gather information from the employee and relay it to the supervisor. Later on, the supervisor will quiz that employee and see if the information they receive is the same as what the spy informed them of earlier (Harris, 2017, p. 3). In this situation, the spy has the power to filter information to whatever favorable outcome they choose. If you cross a spy the wrong way they can easily set you up for a poor year-end review or even termination.
Effects of the Problem
Morale
The effects of intimidation in the medical field on employee morale are quite prominent. Some employees reported that intimidation occurs so frequently that it has been adopted and seen as "just the way things are" Many of the victims are student nurses and novice nurses. Intimidation can decrease students' confidence which in turn can decrease their ability to learn (Lamontagne, 2010, p. 55 – 60). Lamontagne (2010) also reported that some students look at intimidation as a rite of passage (p. 56). Not only is that unprofessional, it can affect the lives of patients and even cause death.
Productivity
Intimidation also has a drastic effect on productivity. It can lead to communication breakdowns which can lead to errors. According to Lamontagne (2010), 38% of missed patient care was related to breakdowns between healthcare providers (p.60). These errors can cause the patient to stay in the hospital longer than necessary which in turn can increase costs for the organization.
Efficiency
The effects of intimidation on efficiency can lead to an increase in preventable medical errors as well as increased rates of employee burn-out, depression, and suicide (Hernandez, 2018, e35). When employees are pressured, it raises stress and anxiety and the employee is focused more on the stress they are feeling rather than the task at hand. Healthcare providers are more likely to make errors while distracted. These errors can lengthen a patient's hospital stay by 4.6 days and cost the hospital on average $4,685 per patient (Lamontagne, 2010, p. 55).
Effectiveness
Intimidation can create a hostile work environment in many hospitals and doctor offices. These hostile environments typically occur when there is a hierarchal structure. Whether it be between registered nurses and student nurses or doctors and nurses, intimidation can cause all individuals involved to become less effective. Many healthcare providers can agree that patient safety is the number one concern. Intimidation inhabits healthcare providers to effectively do their work and thus can compromise a patience safety. While under the influence of intimidation, healthcare providers can compromise patient safety, decrease quality of care, suppress communication, allow errors to go unreported, and increase cost (Cannella, 2014, e54).
Goal Attainment
The goal of every healthcare providers is to keep people healthy and living. Even the slightest errors can have dire consequences. On a yearly basis, about 98,000 people die due to preventable medical errors. 70% of preventable medical errors were due to poor communication between healthcare providers (Lamontagne, 2010, p. 54). Healthcare providers are less likely to communicate if they feel like they are being harassed or intimidated. They are also less likely to work well with someone who is hostile and intimidating.
Possible Solutions
Possible Solution #1
The first possible solution and possibly the most effective would be implementing a zero-tolerance policy for intimidation. This means that the zero-tolerance policy must be applied consistently across all professions (Lamontagne, 2010, p. 56). As a recurring problem, the only solution would be to continually enforce the zero-tolerance policy. Supervisors should be weary of favoritism and punish everyone equally. This ensures that everyone is treated fairly and the policy is looked at as a serious threat.
Possible Solution #2
The next possible solution would be to enforce a professional work environment. This means focusing at the task at hand and not blaming others for your shortcomings (Lamontagne, 2010, p. 57). As healthcare providers, the patient should always be the focus. Any conflict should be handled like adults. Supervisors as well as employees should enforce professionalism on a continual basis. If employees cannot seem to resolve conflict in a professional way, they can have a mediator supervise and help find some common ground. Another huge component of professionalism is learning how to communicate with coworkers in a respectful way even if you have differing views.
Possible Solution #3
Finally, the last possible solution would be to have a neutral voice that employees can seek advice from. "take care of yourself, always take the high road, assume that a workable relationship can be established, and reach out to experts for advice" (Lamontagne, 2010, p. 57). This would be a good time for employees to utilize their human resource personnel. Most new employees come into a job somewhat intimidated or are inexperienced in handling conflict. The best way to learn without effecting your position would be to get suggestions from someone who knows company policy well and knows how to handle conflict. It also helps to hear what an unbiased person feels about the situation.
Recommendation
I recommend that hospitals as well as medical offices should implement a zero-tolerance policy regarding intimidation between employees. This is the most effective and efficient way to make sure intimidation stays out of the organizations. If employers and management implement this policy, it can create a positive atmosphere for everyone. This can create a safe place for employees, so they can focus on the task at hand which is patient safety. Once an atmosphere like that is created, it can allow employees to speak up if they do face intimidation from a coworker (Lamontagne, 2010, p. 57). Most of the time supervisors don't see everything that employees see, and this would allow supervisors to keep a handle on their employee culture.
When employees use intimidation tactics they are seen as forceful and aggressive by other employees and less likeable (Bolino, 2003, p. 239). The second reason to adopt a zero-tolerance policy would be so employees don't act aggressively and are more likeable. When working in a public setting like a hospital, it can become very apparent when employees are aggressive towards one another. Finally, the last reason to implement a zero-tolerance policy would be to reduce errors. If hospitals and medical offices have a stable environment, employee verbal abuse will occur less frequently (Cannella, 2014, e53). This can reduce the amount of errors from miscommunication.
The only way for a zero-tolerance policy to be successful is if it is enforced consistently by all professionals. If not consistently enforced, this policy will be short lived and employee intimidation will continue to occur. Another way to implement this policy is to educate healthcare members on how to communicate professionally and to enforce a code of conduct (Lamontagne, 2010, p. 56-57). For hospitals that have any employee intimidation, they will need to change how each employee feels about the work they do and how they feel towards each other. If employees are more open to change, they will be better at implementing new policy. Those doing the intimidation will now be as open as new employees. Supervisors should remind employees of the strict policy and the serious consequences.
Implementing a zero-tolerance policy can reduce errors caused by miscommunication as well as reduce the length of time a patient needs to stay. This in turn will cost the organization drastically less. This policy can also lower the turnover rate for new employees and student nurses. That can allow new knowledge to come to the organization as well as lower costs caused by training new employees. On an individual perspective, each employee will have been able to work more effectively and have better morale. Employees will feel better about the work they do and want to continue to provide hospitals with their service. Another affect would be safer and healthier patients. The death rate for patience caused by treatable medical errors will also decrease.