{"version":"1.0.0","segments":[{"startTime":37.12,"endTime":41.76,"body":"Welcome to this episode of NLN podcast "},{"startTime":37.12,"endTime":41.76,"body":"Nursing EDge Unscripted. I'm your host,  "},{"startTime":41.76,"endTime":47.92,"body":"Dr. Steven Palazzo, a member of the editorial "},{"startTime":41.76,"endTime":47.92,"body":"board for Nursing Education Perspectives. In this  "},{"startTime":47.92,"endTime":52.64,"body":"episode, we will discuss how bullying behaviors "},{"startTime":47.92,"endTime":52.64,"body":"may contribute to medication administration  "},{"startTime":52.64,"endTime":59.36,"body":"errors. My guest today is Dr. Donna Rutherford, "},{"startTime":52.64,"endTime":59.36,"body":"adjunct clinical instructor at Salem State  "},{"startTime":59.36,"endTime":64.72,"body":"University in Salem, Massachusetts, although I "},{"startTime":59.36,"endTime":64.72,"body":"believe she's actually in Ketchikan right now.  "},{"startTime":64.72,"endTime":69.36,"body":"We will discuss their innovation article, "},{"startTime":64.72,"endTime":69.36,"body":"Bullying Behaviors in Clinical Settings:  "},{"startTime":69.36,"endTime":75.2,"body":"Potentially Harmful Distractions. This article "},{"startTime":69.36,"endTime":75.2,"body":"can be found in the July-August issue of Nursing  "},{"startTime":75.2,"endTime":82.48,"body":"Education Perspectives. Well, welcome. How are "},{"startTime":75.2,"endTime":82.48,"body":"you today, Dr. Rutherford? I'm well. Thank you  "},{"startTime":82.48,"endTime":87.44,"body":"for having me. Oh, you're very welcome. Thank you "},{"startTime":82.48,"endTime":87.44,"body":"for letting us meet with you and have a discussion  "},{"startTime":87.44,"endTime":93.12,"body":"about the work that your team did. If you could "},{"startTime":87.44,"endTime":93.12,"body":"start off and just let us kind of define for our  "},{"startTime":93.12,"endTime":98.72,"body":"audience how you all define bullying behaviors "},{"startTime":93.12,"endTime":98.72,"body":"and how they may contribute to distractions in  "},{"startTime":98.72,"endTime":107.2,"body":"the clinical setting. Okay. Well, bullying itself "},{"startTime":98.72,"endTime":107.2,"body":"it kind of encompasses a range of disruptive,  "},{"startTime":107.2,"endTime":116.0,"body":"repetitive and ineffective behaviors. For example, "},{"startTime":107.2,"endTime":116.0,"body":"criticism, humiliation, negative activities,  "},{"startTime":116.0,"endTime":122.96,"body":"all perpetrated by an individual of supposed "},{"startTime":116.0,"endTime":122.96,"body":"power. There's usually a a power imbalance and  "},{"startTime":122.96,"endTime":130.72,"body":"it's targeted against some in our instance we "},{"startTime":122.96,"endTime":130.72,"body":"were looking at it target was targeting nursing  "},{"startTime":130.72,"endTime":139.68,"body":"students. So, what's interesting I've had people "},{"startTime":130.72,"endTime":139.68,"body":"ask me, it's like, well, you say it's repetitive.  "},{"startTime":139.68,"endTime":146.64,"body":"Nursing students aren't in the clinical setting... "},{"startTime":139.68,"endTime":146.64,"body":"Right. ...every single day. However, what we did, our team  "},{"startTime":146.64,"endTime":155.68,"body":"did, we took bullying behaviors which would come "},{"startTime":146.64,"endTime":155.68,"body":"comes to like the criticism and things of that  "},{"startTime":155.68,"endTime":164.88,"body":"nature and took that little snippet and that's "},{"startTime":155.68,"endTime":164.88,"body":"what we used to to do our simulation. And I I'm  "},{"startTime":164.88,"endTime":169.6,"body":"assuming during the pre-brief of the simulation or "},{"startTime":164.88,"endTime":169.6,"body":"before students were introduced to the concept of  "},{"startTime":169.6,"endTime":175.84,"body":"bullying behaviors and what that looked like "},{"startTime":169.6,"endTime":175.84,"body":"in the clinical space and what that entailed  "},{"startTime":176.48,"endTime":181.36,"body":"definition-wise. And I'm sure some of them have "},{"startTime":176.48,"endTime":181.36,"body":"already felt like they witnessed or experienced  "},{"startTime":181.36,"endTime":187.12,"body":"themselves some of those bullying behaviors. "},{"startTime":181.36,"endTime":187.12,"body":"What's actually interesting when I brought  "},{"startTime":187.12,"endTime":195.92,"body":"them into the simulation that we withheld from "},{"startTime":187.12,"endTime":195.92,"body":"them we introduced that we want to see how they  "},{"startTime":195.92,"endTime":205.6,"body":"would perform u basic medication administration. "},{"startTime":195.92,"endTime":205.6,"body":"We used students that had already successfully  "},{"startTime":205.6,"endTime":211.52,"body":"passed medication and then we looked and said, "},{"startTime":205.6,"endTime":211.52,"body":"\"Hey, this is a we're just seeing how you do the  "},{"startTime":211.52,"endTime":220.0,"body":"how the process is done, how you are doing this.\" "},{"startTime":211.52,"endTime":220.0,"body":"They did not know that we had a an actor or we had  "},{"startTime":220.0,"endTime":228.24,"body":"several different actors come in and pose as the "},{"startTime":220.0,"endTime":228.24,"body":"nursing instructors. Oh, good. So, they weren't  "},{"startTime":228.24,"endTime":231.6,"body":"prepped beforehand. They were separated. "},{"startTime":228.24,"endTime":231.6,"body":"the groups they were separated into,  "},{"startTime":231.6,"endTime":236.32,"body":"I think there were three groups, correct? So, the "},{"startTime":231.6,"endTime":236.32,"body":"intervention group with the bullying behaviors  "},{"startTime":236.32,"endTime":240.32,"body":"was the one where they weren't they didn't know "},{"startTime":236.32,"endTime":240.32,"body":"they were going to have somebody play a role of a  "},{"startTime":240.32,"endTime":248.48,"body":"bullying person in the role. Right. Correct. Yeah, "},{"startTime":240.32,"endTime":248.48,"body":"that makes sense. Yeah. And we there was one group  "},{"startTime":248.48,"endTime":255.12,"body":"there was there was no intervention. We just had "},{"startTime":248.48,"endTime":255.12,"body":"someone introducing a distraction. She was my she  "},{"startTime":255.12,"endTime":260.16,"body":"played a nurse that was like my little chatty "},{"startTime":255.12,"endTime":260.16,"body":"Kathy and she just I didn't realize the person  "},{"startTime":260.16,"endTime":266.64,"body":"could talk so much. She was a wonderful actress "},{"startTime":260.16,"endTime":266.64,"body":"and she just would talk. However, the interaction  "},{"startTime":266.64,"endTime":273.84,"body":"with that type of distraction was entirely "},{"startTime":266.64,"endTime":273.84,"body":"different than what transpired when we saw those  "},{"startTime":273.84,"endTime":280.32,"body":"that were actually experiencing some bullying "},{"startTime":273.84,"endTime":280.32,"body":"behaviors. Yeah. Well, though there were no  "},{"startTime":280.32,"endTime":286.16,"body":"significant findings between the three groups as "},{"startTime":280.32,"endTime":286.16,"body":"far as the distractions or the bullying behavior,  "},{"startTime":286.16,"endTime":292.8,"body":"what was interesting finding that I thought was "},{"startTime":286.16,"endTime":292.8,"body":"that the exposed group to bullying distractions  "},{"startTime":292.8,"endTime":297.12,"body":"finished their medication administration in a "},{"startTime":292.8,"endTime":297.12,"body":"much shorter time than the other groups. What did  "},{"startTime":297.12,"endTime":303.12,"body":"your team attribute this finding to? Well, that "},{"startTime":297.12,"endTime":303.12,"body":"one it was kind of sad and it's just like, oh,  "},{"startTime":303.12,"endTime":308.16,"body":"it's almost like that fear anxiety. It's like, "},{"startTime":303.12,"endTime":308.16,"body":"well, let's hurry up. let's get out of here,  "},{"startTime":308.16,"endTime":316.08,"body":"right? That fight or flight. And it's like, oh "},{"startTime":308.16,"endTime":316.08,"body":"gosh, it's more of a a flight. And that's where  "},{"startTime":316.08,"endTime":322.8,"body":"looking at it now and looking at it a little more "},{"startTime":316.08,"endTime":322.8,"body":"in depth, it's like, wow, that could be dangerous,  "},{"startTime":322.8,"endTime":328.16,"body":"you know? Yeah. Oh, for sure. Yeah. I mean, you're "},{"startTime":322.8,"endTime":328.16,"body":"rushing through a medication administration,  "},{"startTime":328.16,"endTime":336.56,"body":"something as quote unquote simple as administering "},{"startTime":328.16,"endTime":336.56,"body":"insulin. Insulin's not simple. Giving too much  "},{"startTime":336.56,"endTime":342.96,"body":"insulin, you could actually harm a patient. "},{"startTime":336.56,"endTime":342.96,"body":"Yeah. You could kill a patient. I mean, so yeah,  "},{"startTime":342.96,"endTime":347.76,"body":"rushing through a certain task just because it's "},{"startTime":342.96,"endTime":347.76,"body":"like, oh goodness, this person's hovering over  "},{"startTime":347.76,"endTime":353.6,"body":"me. Or they're just like, you're taking so "},{"startTime":347.76,"endTime":353.6,"body":"long. You don't know what you're doing. And  "},{"startTime":353.6,"endTime":360.0,"body":"I even have one one of the participants say, I've "},{"startTime":353.6,"endTime":360.0,"body":"done this before. It's like, but I just couldn't  "},{"startTime":360.0,"endTime":364.96,"body":"think. Right? You lose focus and concentration, "},{"startTime":360.0,"endTime":364.96,"body":"especially if you feel you're being intimidated,  "},{"startTime":364.96,"endTime":370.32,"body":"right? Exactly. With the distractions. So "},{"startTime":364.96,"endTime":370.32,"body":"although you didn't find that the distraction  "},{"startTime":370.32,"endTime":376.16,"body":"led to a medication error, you did find that "},{"startTime":370.32,"endTime":376.16,"body":"those who were in the bullying behaviors,  "},{"startTime":376.16,"endTime":382.16,"body":"I'm just reiterating finished in a significantly "},{"startTime":376.16,"endTime":382.16,"body":"shorter amount of time than the other two arms  "},{"startTime":382.16,"endTime":386.64,"body":"of the study. And it was a small sample size. So "},{"startTime":382.16,"endTime":386.64,"body":"obviously you probably didn't have enough power  "},{"startTime":386.64,"endTime":391.2,"body":"to capture something with that small. But that's "},{"startTime":386.64,"endTime":391.2,"body":"an that's something interesting to take further  "},{"startTime":391.2,"endTime":399.2,"body":"with a larger group of of students in multiple "},{"startTime":391.2,"endTime":399.2,"body":"settings you know and see if that shows up again  "},{"startTime":399.2,"endTime":404.08,"body":"which what those findings were. I would be really "},{"startTime":399.2,"endTime":404.08,"body":"interested and I think many people would too. So  "},{"startTime":404.08,"endTime":409.92,"body":"that was a, that was a very interesting point I "},{"startTime":404.08,"endTime":409.92,"body":"thought when I was reading the article. Yeah. How  "},{"startTime":409.92,"endTime":415.04,"body":"would you suggest an instructor build a similar "},{"startTime":409.92,"endTime":415.04,"body":"scenario in their simulation lab? What would you  "},{"startTime":415.04,"endTime":420.56,"body":"change in the delivery of the distraction or did "},{"startTime":415.04,"endTime":420.56,"body":"you feel the distraction was distracting enough  "},{"startTime":420.56,"endTime":425.84,"body":"which you just kind of mentioned that the actor "},{"startTime":420.56,"endTime":425.84,"body":"did a really good job at being very chatty? Well,  "},{"startTime":425.84,"endTime":432.56,"body":"there in the health care setting there's so many "},{"startTime":425.84,"endTime":432.56,"body":"different distractions. It all depends on how you  "},{"startTime":432.56,"endTime":438.56,"body":"want to educate your population. If you're like, "},{"startTime":432.56,"endTime":438.56,"body":"well, on the low end, hey, this is how you deal  "},{"startTime":438.56,"endTime":443.76,"body":"with distractions in general. So, you can kind "},{"startTime":438.56,"endTime":443.76,"body":"of structure it that way. It's like, okay, yes,  "},{"startTime":443.76,"endTime":448.88,"body":"we have phones in the hospital. Well, you may need "},{"startTime":443.76,"endTime":448.88,"body":"to put that to the side, especially if you're a  "},{"startTime":448.88,"endTime":454.08,"body":"brand new nurse or if you're just a students "},{"startTime":448.88,"endTime":454.08,"body":"cannot have them in the in the clinical area,  "},{"startTime":454.08,"endTime":459.44,"body":"but sometimes all of a sudden you see this little "},{"startTime":454.08,"endTime":459.44,"body":"phone coming out, but training is like, hey,  "},{"startTime":459.44,"endTime":465.165,"body":"these things need to be put away for a reason, "},{"startTime":459.44,"endTime":465.165,"body":"not because we don't want you to have technology.  "},{"startTime":465.165,"endTime":472.96,"body":"It can also be structured where the bullying "},{"startTime":465.165,"endTime":472.96,"body":"the those that are performing the bullying. Oh  "},{"startTime":472.96,"endTime":479.6,"body":"goodness. You can have them just kind of be like a "},{"startTime":472.96,"endTime":479.6,"body":"little gang. One time I actually described someone  "},{"startTime":479.6,"endTime":485.92,"body":"as remember the movie Mean Girls. Doesn't "},{"startTime":479.6,"endTime":485.92,"body":"necessarily has to be women or men, but mean  "},{"startTime":485.92,"endTime":493.6,"body":"people where they're just grouping around kind of "},{"startTime":485.92,"endTime":493.6,"body":"gossiping. Just even just that chitter chatter.  "},{"startTime":493.6,"endTime":499.04,"body":"It's like are they talking about me and things "},{"startTime":493.6,"endTime":499.04,"body":"of that nature. So it can be introduced that way.  "},{"startTime":499.04,"endTime":506.16,"body":"I mean there are so many different ways you can "},{"startTime":499.04,"endTime":506.16,"body":"take this. What was the role of the actor playing  "},{"startTime":506.16,"endTime":512.8,"body":"the bully? Like what what bullying behaviors did "},{"startTime":506.16,"endTime":512.8,"body":"they manifest when they were interacting with the  "},{"startTime":512.8,"endTime":519.36,"body":"students? We had to keep it pretty low-key because "},{"startTime":512.8,"endTime":519.36,"body":"we did not want to cause I mean physical harm or  "},{"startTime":519.36,"endTime":525.44,"body":"anything of that nature. Of course. Of course. "},{"startTime":519.36,"endTime":525.44,"body":"Yeah. So what we did one time the gentleman he's  "},{"startTime":525.44,"endTime":530.56,"body":"like I described what we needed and he's like "},{"startTime":525.44,"endTime":530.56,"body":"I'll just be on the phone pretending that he's  "},{"startTime":530.56,"endTime":537.12,"body":"on the phone and he's just like oh yeah you know "},{"startTime":530.56,"endTime":537.12,"body":"how these students are they just take forever  "},{"startTime":537.12,"endTime":544.96,"body":"and ever this this one she know doesn't even know "},{"startTime":537.12,"endTime":544.96,"body":"what she's doing just those small little zingers,  "},{"startTime":544.96,"endTime":553.28,"body":"those... Right. ...and that's when it's like is this "},{"startTime":544.96,"endTime":553.28,"body":"really happening to me so that's how he introduced  "},{"startTime":553.28,"endTime":562.4,"body":"it. And there was actually one student who "},{"startTime":553.28,"endTime":562.4,"body":"pushed back. He also... Yeah. ...he had a different  "},{"startTime":562.4,"endTime":566.64,"body":"he had life experience. Let's just say life "},{"startTime":562.4,"endTime":566.64,"body":"experience. I remember. But he pushed back and  "},{"startTime":566.64,"endTime":574.16,"body":"it's like, \"Excuse me, you're supposed to be here "},{"startTime":566.64,"endTime":574.16,"body":"to help me.\" It's like, \"Oh, okay. Very good.\"  "},{"startTime":574.16,"endTime":580.32,"body":"Okay. So, so there was some built-in resiliency "},{"startTime":574.16,"endTime":580.32,"body":"potentially from already previous exposure or life  "},{"startTime":580.32,"endTime":589.28,"body":"experience that they seem to be a little bit more "},{"startTime":580.32,"endTime":589.28,"body":"equipped to handle the situation. Exactly. So, and  "},{"startTime":589.28,"endTime":598.16,"body":"this type of simulation I would love to see with "},{"startTime":589.28,"endTime":598.16,"body":"brand new grads. Yeah. due to the fact that okay  "},{"startTime":598.16,"endTime":603.92,"body":"they have this wealth of knowledge that they've "},{"startTime":598.16,"endTime":603.92,"body":"already gotten from school but how are they going  "},{"startTime":603.92,"endTime":611.44,"body":"to be in able to integrate in the real world with "},{"startTime":603.92,"endTime":611.44,"body":"what's really out there I mean it's fortunately  "},{"startTime":611.44,"endTime":617.28,"body":"right now where I'm at it's a wonderful place but "},{"startTime":611.44,"endTime":617.28,"body":"there are some places that are not so wonderful  "},{"startTime":617.28,"endTime":625.04,"body":"and you're these brand new grads are walking in "},{"startTime":617.28,"endTime":625.04,"body":"it's like, oh gosh, what have I gotten myself into?  "},{"startTime":625.04,"endTime":631.12,"body":"So. Yeah. Dr. Rutherford, how would you suggest "},{"startTime":625.04,"endTime":631.12,"body":"an instructor build a similar scenario in  "},{"startTime":631.12,"endTime":637.44,"body":"their simulation lab? And also, what would you "},{"startTime":631.12,"endTime":637.44,"body":"change in the delivery of the distraction or  "},{"startTime":637.44,"endTime":643.68,"body":"would you change anything in the delivery of the "},{"startTime":637.44,"endTime":643.68,"body":"distraction? Delivery of the distraction to keep  "},{"startTime":643.68,"endTime":651.2,"body":"it low-key and safe. I probably I personally would "},{"startTime":643.68,"endTime":651.2,"body":"not do any changes. They could if they wanted to  "},{"startTime":651.92,"endTime":663.84,"body":"have additional people. Okay. Instead of just one "},{"startTime":651.92,"endTime":663.84,"body":"because I only had one person who was introducing  "},{"startTime":663.84,"endTime":673.12,"body":"the distracting behavior slash bullying behavior "},{"startTime":663.84,"endTime":673.12,"body":"with one student. I I would love to also see,  "},{"startTime":673.12,"endTime":680.96,"body":"hey, maybe they could develop it where there is "},{"startTime":673.12,"endTime":680.96,"body":"just the instructor or someone who is doing a  "},{"startTime":680.96,"endTime":688.64,"body":"check off, but have another student like a pair, "},{"startTime":680.96,"endTime":688.64,"body":"a buddy with them while they're there because not  "},{"startTime":688.64,"endTime":696.56,"body":"everybody is outspoken. Maybe having two people "},{"startTime":688.64,"endTime":696.56,"body":"there will kind of protect protect each other and  "},{"startTime":696.56,"endTime":703.28,"body":"keep them on track. That's another way. and and "},{"startTime":696.56,"endTime":703.28,"body":"even if they want to do further research in this,  "},{"startTime":703.28,"endTime":708.56,"body":"would that make a difference? Especially if "},{"startTime":703.28,"endTime":708.56,"body":"they're a brand new new nurse or even  "},{"startTime":708.56,"endTime":716.16,"body":"just a student nurse, it's a buddy system. "},{"startTime":708.56,"endTime":716.16,"body":"I assume there's education around this topic  "},{"startTime":716.16,"endTime":722.16,"body":"then for these students. It's not an isolated "},{"startTime":716.16,"endTime":722.16,"body":"situation where they go into this simulation lab  "},{"startTime":722.16,"endTime":729.76,"body":"and experience this, but there is education around "},{"startTime":722.16,"endTime":729.76,"body":"it. Correct. Those that had the intervention that  "},{"startTime":729.76,"endTime":740.0,"body":"was the intervention for those that were in that "},{"startTime":729.76,"endTime":740.0,"body":"particular arm of the the right yes yes but I was  "},{"startTime":740.0,"endTime":744.72,"body":"wondering if these students would also get that "},{"startTime":740.0,"endTime":744.72,"body":"same type of education after the fact and be  "},{"startTime":744.72,"endTime":750.48,"body":"exposed to the same strategies for dealing with "},{"startTime":744.72,"endTime":750.48,"body":"those type of behaviors. I personally think that  "},{"startTime":750.48,"endTime":760.32,"body":"would be ideal. And I also think that this is this "},{"startTime":750.48,"endTime":760.32,"body":"type of education needs to be kind of woven into  "},{"startTime":760.32,"endTime":768.32,"body":"the curriculum so they have that additional "},{"startTime":760.32,"endTime":768.32,"body":"additional information to to kind of armor  "},{"startTime":768.32,"endTime":778.48,"body":"themselves have a toolbox of of things to go from "},{"startTime":768.32,"endTime":778.48,"body":"point A to point B. Right. So, well, well, I want  "},{"startTime":778.48,"endTime":783.68,"body":"to thank you so much for joining us today in this "},{"startTime":778.48,"endTime":783.68,"body":"conversation. I really appreciate your time and  "},{"startTime":783.68,"endTime":788.8,"body":"your expertise in broadening our understanding "},{"startTime":783.68,"endTime":788.8,"body":"of this work and how we can begin to introduce  "},{"startTime":788.8,"endTime":794.24,"body":"some of these strategies in our own institutions "},{"startTime":788.8,"endTime":794.24,"body":"and programs. To our listeners, if you have not  "},{"startTime":794.24,"endTime":800.0,"body":"already had the opportunity, please take a look at "},{"startTime":794.24,"endTime":800.0,"body":"the author's work, Bullying Behaviors in Clinical  "},{"startTime":800.0,"endTime":805.92,"body":"Settings Potentially Harmful Distractions. "},{"startTime":800.0,"endTime":805.92,"body":"And the article can be found in the July-August  "},{"startTime":805.92,"endTime":810.88,"body":"issue. And Dr. Rutherford, again, thank you so "},{"startTime":805.92,"endTime":810.88,"body":"much. Thank you for joining us from Ketchikan,  "},{"startTime":810.88,"endTime":820.16,"body":"Alaska. Appreciate your time. Thank you so "},{"startTime":810.88,"endTime":820.16,"body":"much, sir. You have a great day. You, too."}]}