Aggression at work can lead to ‘vicious circle’ of misconduct

New research led by the University of East Anglia (UEA) reveals that frequently being the target of workplace aggression not only affects the victim’s health but can also cause them to behave badly towards others.

Workplace aggression is a significant issue particularly in the healthcare sector, where nurses can be targeted by both their colleagues and co-workers through bullying, and by patients and their relatives through ‘third-party’ aggression.

While workplace aggression has been examined in relation to the health-related consequences for victims, less is known about the possible negative impact it may have on their own behaviour at work.

The findings of this study suggest that the experience of anger and fear associated with being the target of aggression at work could lead some nurses to translate the emotions that are triggered into misconduct, possibly disregarding professional and ethical codes.

Published in the journal Frontiers in Psychology, the study was led by Dr Roberta Fida from UEA, working with colleagues from Coventry University, and universities in Italy and the US.

It involved 855 nurses, who were asked about their experiences of aggression, negative emotions and health symptoms. They were also asked how often they engaged in a range of counterproductive work behaviours, from insulting a colleague and stealing something belonging to an employer, to clinical misbehaviour related to restraining patients and modifying prescriptions without consulting doctors.

The results have implications for designing programmes aimed at increasing employees’ well-being, the quality of the interactions with patients and staff, and the quality of care.

Dr Fida, a lecturer in organisational behaviour at UEA’s Norwich Business School, said: “Our findings provide further evidence that being a target of aggression represents a frustrating situation in which victims experience anger that may prompt a ‘hot’ and impulsive aggressive response, with likely impact on the quality of care provided to patients.

“Little research has been conducted in the healthcare sector on this type of behaviour, despite the potential importance of the issue in this setting. There are consequences, not only for the direct victim, but also for the entire organizational system, in which it is possible to envision the trigger of vicious circles leading to broader and more diffuse forms of workplace aggression.”

This is the first study to examine the specific role of frequent mistreatments at work in triggering misconduct and the emotions of anger, fear, and sadness separately. These emotions were studied because they are those most regularly experienced by targets of aggression, but are different in terms of mechanisms, consequences and strategies for managing them.

The authors also investigated the role of moral disengagement, namely a set of cognitive mechanisms that temporarily silence people’s moral standards, allowing them to freely engage in conduct they would generally consider wrong.

Dr Fida said: “This research provides the first evidence of fear being an important discrete emotion associated with misconduct through moral disengagement. Since individuals experiencing fear are more alert and attentive to picking up potential external threats, and tend to perceive the environment as highly dangerous and threatening, they are more likely to engage in any form of behaviour, including aggression, which may potentially help them to defend themselves and comply with their need for protection.”

The findings confirm that sadness is not associated with engaging in misconduct but is exclusively associated with health symptoms. Fear and anger are also associated with health symptoms, with the authors concluding that the emotional experience associated with being target of aggression, be it bullying or third party aggression, is associated with a range of health symptoms affecting nurses’ well-being and their behaviour at work.

The authors suggest that training should focus on emotions and in particular on the specificity of the emotional experience. For example, it should help employees to gain awareness about the different possible emotional responses associated with the experience of aggression at work that may potentially lead to different dysfunctional paths for themselves and others.

In relation to the relevance of moral disengagement, it is also important to design and implement interventions aimed at promoting an ethical culture and providing examples of strategies to deal with threatening and hostile interactions.

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