Outside of nursing, most people believe bullies are native only to playgrounds and high school locker rooms. Unfortunately, bullies also frequent hospital units, ambulatory care centers, clinics, and even emergency departments. Their targets? Their own colleagues and peers. Most practitioners know that the old adage “nurses eat their young” is alive and well in the 21st century. This conflict saps energy, destroys teamwork, and hinders motivation. Worst of all, it can decrease the quality of patient care. This fully updated new edition, What to Do When Nurses Hurt Nurses, tackles topics ranging from social media and crucial communications to resiliency and stress management. It provides tools to help nurses create safer, more respectful workplaces and combat the ongoing cycle of bullying. Cheryl Dellasega, author of the groundbreaking Surviving Ophelia, explores relational aggression and the nature of nurseon- nurse violence while establishing an action plan for the future.

Nursing has a not-so-secret problem. The profession is prone to—some would say thrives on—workplace conflict, incivility, bullying, and meanness. And while nurses observe and experience this conflict daily, too few have been trained in its resolution. Toxic Nursing aims to change that with strategies, tools, and techniques to help nurse leaders, managers, and administrators defuse conflict, turn around toxic situations, and create positive, healthy work environments. Written by Cheryl Dellasega—author of the groundbreaking books Surviving Ophelia and Mean Girls Grown Up—Toxic Nursing explores the reasons behind toxic behavior and its impact on not just the workplace but patient safety. TABLE OF CONTENTS Part 1: The Relational Nurse Manager Chapter 1: Incivility Chapter 2: The Newbie: Mistreatment of New Nurses Chapter 3: The Know-It-All/Criticism Queen Chapter 4: Gossip and Trash Talk Chapter 5: Cliques, Campaigns, and High School Drama Chapter 6: Competition and Credit Chapter 7: Nurse Managers as the Problem Part 2: Working Together Chapter 8: Men in White Chapter 9: Better Than You Chapter 10: Generations at Work Chapter 11: Competent and Caring Leaders? Chapter 12: Social Media, Electronic Communication, and Professionalism Part 3: Navigating Toxic Systems Chapter 13: Politics and CYA Chapter 14: Patients as Victims Chapter 15: On the Battlefield: Nurses Under Attack Chapter 16: Toxic Culture/Environment Chapter 17: Conclusion Appendix A: Is Your Management Style Causing Conflict? Appendix B: Conflict Case Scenario Appendix C: Organizational Cynicism Self-Assessment Appendix D: When It’s Time to Seek Outside Counsel Appendix E: Compassion Fatigue ABOUT THE AUTHOR CHERYL DELLASEGA, PhD, RN, CRNP, is a Professor in the Department of Humanities at Penn State College of Medicine. An award-winning author, speaker, and researcher—and founder of Club and Camp Ophelia—she has spent much of her career helping women and girls confront and overcome bullying and relational aggression. She has worked clini­cally as a nurse practitioner and is an international expert on family relationships.

“Dr. Todaro-Franceschi calls us to look with open eyes, open hearts, and open minds at the good, the bad, the ugly, and the ugliest in health care so that together we can cultivate a healthcare world in which compassion prevails and our shared humanity is embraced... It is up to all of us to hold and safeguard each other in this sacred work. Dr. Todaro-Franceschi helps us in this mission through this extraordinary book.” Mary Koloroutis, RN, MSN CEO Creative Health Care Management, Minneapolis, Minnesota Co-Creator of the Relationship-Based Care Model In this second edition of her seminal text, Dr. Todaro-Franceschi offers new insights on professional quality of life, incorporating current practice, research literature, and examples to show how contentment and happiness of the nursing workforce is related to quality of care. The book provides practical strategies for dealing with a myriad of issues, including compassion fatigue, burnout, moral distress, caring for the dying, PTSD, and workplace violence. This resource will help empower nurses so they can create a more compassionate work environment. Written by an acknowledged expert in end of life education, professional quality of life, and clinical leadership, the text addresses the complex nature of well-being in the nursing workforce. Supported by research but written from a holistic and personal perspective, the text includes case studies and exercises that will help the reader to identify negative patterns and explore ways to find purpose in one’s life. New to the Second Edition: Expanded emphasis on how workforce well-being contributes to care quality Updated resources and information on national nursing initiatives related to professional quality of life New chapter on workplace violence (incivility, bullying and mobbing) New chapter on education related to improving PQOL and work environment Provides a Nurse Leaders Resource Toolkit to guide staff education Key Features: Articulates an ethic of care developed from a transdisciplinary perspective Increases nurse awareness of issues that might be hindering their PQOL Provides strategies for enhancing staff contentment and productivity, thereby promoting a healthy work environment Includes real-life examples from critical care, end-of-life care, hospice, oncology, and more Assists nurses with grief healing

Named a 2013 Doody's Core Title! Nursing practice is a complex and varied field that requires precision, dedication, care, and expertise. Clinicians must have both the skills and the tools to attend to changes in patients' responses, recognize trends, and understand the nature of their patients' conditions over time. This book clearly delineates the skills needed to become an expert nurse. In this new edition, the editors present a report of a six-year study of over 130 hospital nurses working in critical care. Expanding upon the study conducted in the previous edition, this new book documents and analyzes hundreds of new clinical narratives that track the development of clinical skill acquisition, including caring, clinical judgment, workplace ethics, and more. Highlights of this book: Includes transitional guidance for nurses new to the field Discusses the primacy of caring and the importance of good clinical judgment Includes new practice models, including the Dreyfus Model of Skill Acquisition Provides guidelines for strengthening the nurse-patient relationship Presents implications for nursing education and patient safety Ultimately, this work defines expertise in nursing practice. The book serves as a valuable resource that will enable nurses to expand their knowledge base, cultivate their clinical skills, and become successful experts in nursing practice.

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Praise for the First Edition: “Where was this book when I was a new nurse just learning the ropes of labor and delivery? This is a true gem of a book—a must for any new grad going into labor and delivery. I recommend this book for every labor and delivery floor." -Cindy Curtis, RNC, IBCLC, CCE Former Director, The Family Birth Center Culpeper Regional Hospital Lignum, VA "The best one-stop reference book for the experienced and novice Labor and Delivery RN....Finally an excellent Labor and Delivery book by RN's -- for RN's." -Garla DeWall, RNC Presbyterian Hospital in the Family Birthing Center Albuquerque, New Mexico The clinically oriented guide to nursing care during childbirth is distinguished by its strong focus on evidence-based practice as well as its engaging style and user-friendly format. It reviews the nursing process from admission to delivery focusing on proper surveillance and care, comprehensive data acquisition, interpretation, and teamwork. The second edition continues to help labor and delivery nurses make wise decisions in the delivery room, optimizing both maternal and fetal outcomes. It clearly explains the stages and phases of labor, delivery, and pain assessment and management—all supported by proven research. This text provides authoritative guidance on intervention options, creating patient-centered care plans, and improving communication with other members of the obstetrics team. New to the Second Edition: Proper analysis of the partograph to facilitate appropriate patient interventions Updated information about clinical pelvimetry New information on psyche, including the religious, spiritual, and cultural dimensions of care Setting priorities in triage and care related to postpartum hemorrhage Identification of “myths” related to childbirth Individualized patient care related to fetal distress and nonreassuring fetal status Oxytocin infusion and its relationship to permanent Erb’s palsy and autism Updated information on technology, including connectivity between smart IV pumps and the EMR How to distinguish functional from mechanical dystocia and intervene to enhance fetal and maternal safety Key Features: Applies to nursing care of childbearing clients world-wide Focuses on evidence-based practices Written in engaging, easy-to-understand style for new nurses, seasoned practitioners, and nurses seeking certification Enhances effective decision-making to optimize patient care and outcomes Replete with informative references, relevant graphics, and review questions Incorporates research to clearly explain concepts and best practices Provides orientation fundamentals, checklists, and log charts

First edition named a Doody's Core Title and winner of an AJN Book of the Year Award! "This is truly a contribution to the hands-on clinical literature....This book can serve as a resource for nurses working in inpatient psychiatry, nursing students, and nursing faculty who teach undergraduate psychiatric nursing."—Choice: Current Reviews for Academic Libraries "[A] great book for inpatient psychiatric nurses."—Doody's Medical Reviews Psychiatric nursing practice has changed dramatically to accommodate increasing patient acuity and an evolving healthcare landscape. In addition, the inter-relationship of medical illness and psychiatric symptoms can make treatment and care challenging for nurses regardless of where they practice. Inpatient Psychiatric Nursing: Clinical Strategies, Medical Considerations, and Practical Interventions reflects these factors by focusing on four particularly challenging aspects: keeping the patient safe, stabilizing symptoms, promoting engagement in treatment, and discharge planning. In a systematic, easy-to-access format, it offers evidence-based interventions and concrete strategies that can be used alleviate patient distress and effectively deliver care. This expanded and updated second edition is organized according to patient behaviors and interventions that nurses can employ to manage those behaviors. Each behavioral-focused chapter follows a consistent format so that readers can easily locate key information at point of care and concludes with a quick-reference table that summarizes goals, patient assessment, maintenance of safety, appropriate interventions, and next steps. The book also addresses a variety of medical conditions that may be complicated by psychiatric illness or have symptoms that may be erroneously attributed to mental illness. This symptomatic approach provides guidance for nurses and other healthcare professionals working with patients with behavioral disturbances—regardless of the cause or the practice setting. New to This Edition: Expanded coverage of the inter-relationship of medical illness and psychiatric symptoms Expanded coverage on the management of barriers to being therapeutic New chapter on key medical considerations for the psychiatric patient Key Features: Provides evidence-based interventions designed to modify and manage challenging and disruptive patient behavior in all practice settings Addresses psychiatric issues in medical settings and medical issues in psychiatric settings Features quick-reference tables that summarize goals, patient assessment, maintenance of safety, appropriate interventions, and next steps Demonstrates application to practice with real-life scenarios

The second edition of this popular introductory text explores the many sensitive issues of culture, race and ethnicity as they affect patient care, including: -health and illness beliefs, and their relationship to religious beliefs -mental health and culture -women's health in a multicultural society -caring for older people death and bereavement All chapters have been updated to present the latest theory and practice and new chapters on men's health and cultural care, and migration and asylum seekers have been added, along with updated case studies and reflective exercises to help the reader link theory to practice. This book is essential reading for all nursing students, as well as midwifery, allied health and health and social care students. It is also a useful reference for qualified nurses, midwives, health care assistants, assistant healthcare practitioners and allied health professionals.

"Bullying among nurses is a vexing and serious problem within the profession - a problem that has the potential to destroy a nurse's morale, interfere with the ability to trust colleagues and erode quality of care. When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Nurse Bullying confronts this problem by examining the causes and providing ways to diffuse a confrontational situation. ... Dellasega delves into the history of nurse bullying, provides theories about its causes and offers sample dialogues to diffuse violent situations as well as ways to create a positive work environment. "--Publisher.