INTERACTIVE WORK PLACE TRAUMA (IWPT)/TRAUMATISME INTERACTIF EN MILIEU DE TRAVAIL (TIMT)

Canadian Operating Room Nursing Journal,  Jun 2005  by Shewchuk, Muriel

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"A Pervasive Condition Requiring Immediate Isolation and Treatment"

Aufeure; Muriel Shewchuk

TRAUMATISME INTERACTIF EN MILIEU DETRAVAIL (TIMT)

« Une condition médicale envahissante nécessitant isolement et traitement immédiats »

Jusqu'à quel point le traumatisme interactif en milieu de travail, ou TIMT*, a-t-il envahi votre milieu péri-opératoire ? Se cache-t-il dans les coins, les salons et les salles d'opération...ou peut-être même dans votre propre bureau ? Qui y est impliqué ? Le personnel infirmier ou de soutien, les médecins, les leaders ? Une combinaison de ceux-ci ? tes-vous au courant ? Pratiquez-vous une politique d'autruche en vous cachant la tête dans le sable du déni ? Le déni et les rêves en couleur à eux seuls ne sauront vous en sortir !

* Le traumatisme interactif en milieu de travail (TIMT) est un néologisme proposé par l'auteure dans le contexte de cet article.

How much Interactive Work Place Trauma, or IWPT*, has invaded your perioperative environment and is lurking in the corners, lounges, and theatres... or even exuding from your office? Who is involved? Nurses, support staff, physicians, or leaders? Or a combination of all? Do you know about it? Are you demonstrating ostrich characteristics by "sticking your head in the sands of denial"? Denial and wishful thinking will not cut-it!

Whether the IWPT is horizontal violence (co-worker to co-worker), bullying, hostile aggressive behaviour or any other form of disruptive activity, it is totally unacceptable. A number of key leaders are themselves a major part of the demoralizing IWPT. Where and why do you have IWPT occurring? What strategies can be put in place to identify, isolate and successfully treat the condition?

Most workplaces generate policies, programs and signage related to "abuse in the workplace". Legislation has been developed on many fronts. Schools, communities and towns are developing "bully free" concepts, practices and education programs. We only have to reflect on the mass shootings in workplaces and schools to fully recognize the magnitude, seriousness, and full impact of IWPT. What recognition strategies, educational elements, proactive plans, and treatment measures have you established?

What is IWPT?

Interactive Work Place Trauma may be defined as the impact, outcome or result of pathopsycho-social activities conducted by an individual, group of individuals, or "gang", who choose subversive, destructive, and demoralizing tactics to gain power and take control of a work environment. Yes, there are many perioperative environments with this type of culture and behaviour firmly entrenched and out of control. The intensity of activity will vary from time to time, as will the impact, depending on the players and their participation at any given moment. There are perpetrators, victims, knowing bystanders or "fence-sitters", as well as the abdicators of responsibility, all playing a key role in the continuation of IWPT. Generally IWPT is not physical in nature; however, the impact on the victim can readily lead to work dysfunction and mental or physical breakdown.

Common terms used to describe IWPT are horizontal violence and bullying. It is often excused with statements like "Oh, that's just her way..." The Internet and book stores all have extensive information on the subject - from grade school up through the workplace, including nursing behaviour. Everyone needs to pay attention and stop the ruthless attack on fellow colleagues, subordinates, bystanders and persons in senior positions of power.

IWPT severely inhibits the development of a trusting, positive, learning culture. Defense mechanisms become the order of the day for coping with intimidation, verbal abuse and negative body language. Patients can also be at risk when the staff is in "survival mode" - busy protecting themselves against a bully and perhaps dealing with daily fear, anxiety, depression and a lack of focus. Efficiency, effectiveness and progressive performance only occur in a safe, cooperative, trusting and supportive environment - not under a reign of terror.

Perpetrators and their Actions

Bullies are very clever, they excel at manipulation and deny any wrong doing, playing people off against each other, often with great satisfaction as others get destroyed. The manager, or other leaders, may be the target of the action and having no understanding of what is really happening to them.

Perpetrators may present a domineering, superior presence with the intent of assuming power over the victims. Attitude and arrogance will be observed through both body language and verbal expression. To many, the perpetrators appear to be very friendly, charming, helpful, and competent. They are very clever and avoid being pinpointed as the source of the problem. Body language is one of the common forms of discriminating actions. The perpetrator uses such actions as rolling of eyes in disgust for many to see (implying stupidity), aggressive folding of arms in a "refusal to help" posture, or huffing and stomping around the room. Verbal abuse comes with ease to these individuals. Criticism of others (in an effort to make themselves look superior), nitpicking, hurtful sarcasm, and negative gossip or name calling are some of the tactics used. Undermining of instructions, processes, threats, slurs and jokes of a discriminatory nature further attack the vulnerable victim. Actions of isolating, or "freezing out", individuals occur frequently in staff lounges and lunchrooms. In its more serious form IWPT surfaces as threats that extend to an individual's family and property. Perpetrators work to increase the size of the "in group", through peer pressure, thus increasing the victim's isolation. The outcome can be a toxic environment that is emotionally oppressive, demoralizing, and stressful... with threads of fear woven through it.