Workplace bullying in pharmacy - a study on prevalence, impacts and barriers to reporting.

PURPOSE: The study aims to estimate the prevalence of workplace bullying, personal and work-related impacts, reporting practices for bullying, and the reasons for not reporting bullying incidents in the New Zealand pharmacy sector. DESIGN/METHODOLOGY/APPROACH: An online survey was conducted among registered pharmacists and pharmacist interns in New Zealand from June to August 2020. The questionnaire comprises both close-ended and semi-structured free-text questions. Goldberg's 12-item General Health Questionnaire (GHQ-12) assessed the respondents' general psychological health status, and a 22-item Negative Acts Questionnaire-Revised (NAQ-R) was used to estimate bullying prevalence together with the self-rated/self-labeled questions. The qualitative information obtained from the free-text responses was used to support and elaborate on the quantitative results. FINDINGS: The self-labeled prevalence of workplace bullying was 36.9%, with almost 10% reporting it occurring almost daily to several times per week. The 54.7% prevalence based on the NAQ-R assessment compares well with the prevalence of witnessing the incidents (58.5%). Psychological distress symptoms were experienced by 37.1% in pre-COVID and 45.3% during COVID-year 1. Supervisors or direct managers were the commonest perpetrators (32.7%). Only 28.8% of those who experienced bullying had reported the incidents formally. RESEARCH LIMITATIONS/IMPLICATIONS: This study is cross-sectional, and the relationships indicated are bi-directional. The consistency of the results is reassuring, however inferring causality of effect is challenging. Future studies and analyses should focus on this. This study suggests that in the pharmacy environment bullying from the top is reasonably prevalent, is not commonly reported and requires the design and implementation of prevention and management strategies that take into account and mitigate these bullying factors. Professional pharmacy leadership organizations, National Health Authority and Pharmacy regulators could play a significant role in awareness and training to reduce bullying with the development and promotion of strategies to curb it and improve reporting. ORIGINALITY/VALUE: This is the first paper to describe the prevalence and impact of workplace bullying, and the practices of reporting bullying incidents in the New Zealand pharmacy sector. Based on empirical evidence, pharmacists represent a small share of total healthcare workforce, yet the overall prevalence of bullying is consistent with professions with much larger numbers such as medicine and nursing.

The pharmacist as entrepreneur: Whether, how, and when to educate?

INTRODUCTION: Policy and funding changes are transforming how community pharmacists deliver services, with a level of entrepreneurship required to fulfil their dual roles as retailers and health care professionals. This study explored pharmacists' own entrepreneurship skill development, their views on the need for entrepreneurship training, and how and when this should be delivered. METHODS: Qualitative, semi-structured interviews were conducted with 21 New Zealand practising community pharmacists and key pharmacy sector stakeholders known for having an entrepreneurial mindset. RESULTS: Thematic analysis revealed five broad themes in relation to the study aim. Pharmacists had gained skills in entrepreneurship via training and education in a range of settings, including 'on the job'. While views were divided regarding the feasibility of training individuals to be entrepreneurs, most felt that some form of training was required to address shortfalls in the current workforce. There was support for this being delivered as part of the undergraduate pharmacy degree, although some felt that clinical learning should remain the core focus at this level. There were also mixed views regarding the timing of education in entrepreneurship. CONCLUSIONS: This study adds to the literature addressing the pharmacists view of when and by whom education in entrepreneurship should be delivered. The divergence of opinion has implications for educational leaders, policymakers and practitioners. Findings highlight the important role of education and training in developing pharmacists with entrepreneurship skills. However, the format of this in terms of delivery, timing, appropriate training providers, and training content, needs to be better understood.

The need to integrate in primary healthcare: nurse identity constructions of pharmacists as entrepreneurs.

PURPOSE: This study explores nurses' views as to whether they see community pharmacists as "entrepreneurial" and what this might mean for working together in primary care. Pharmacists are expected to fully integrate with their colleagues - particularly nurses - under the New Zealand health policy. Yet, there is scarce literature that examines multidisciplinary teamwork and integration through an entrepreneurial identity lens. This is particularly important since around the world, including New Zealand, community pharmacies are small businesses. DESIGN/METHODOLOGY/APPROACH: This was an exploratory qualitative study. A total of 18 semi-structured interviews were conducted with nurses from primary care, nursing professional bodies and academics from nursing schools. Interviews were audio recorded and transcribed verbatim. Coding was undertaken through general inductive thematic analysis. FINDINGS: In total three key themes emerged through analysis: the entrepreneurial profile of the community pharmacist, the lack of entrepreneurship across the profession, and the role identity and value that community pharmacists hold, as viewed by nurses. There appeared to be pockets of entrepreneurship in community pharmacy; nurses did not express a blanket label of entrepreneurship across the whole sector. Nurses also discussed several forms of entrepreneurship including commercial-oriented, clinical and social entrepreneurship. The social entrepreneurship identity of community pharmacists sat most comfortably with nurse participants. Overall, nurses appeared to value community pharmacists but felt that they did not fully understand the roles that this profession took on. RESEARCH LIMITATIONS/IMPLICATIONS: This paper contributes to the academic literature by identifying three domains of entrepreneurship relevant to community pharmacy as well as multi-level barriers that will need to be jointly tackled by professional bodies and policy-makers. Improving nurses' and other healthcare professionals' knowledge of community pharmacists' role and expertise is also likely to facilitate better inter-professional integration. ORIGINALITY/VALUE: There is scarce literature that attempts to understand how entrepreneurial identity plays out in health organisation and management. This study adds to the knowledge base of factors influencing integration in healthcare.

Conceptualizing workplace cyberbullying: Toward a definition for research and practice in nursing.

AIMS: To explore nurses' understandings and perceptions of workplace cyberbullying, in order to develop a relevant and meaningful definition of the phenomenon for future research and practice. BACKGROUND: Although previous research places nurses at an elevated risk of exposure to traditional workplace bullying, there is a notable absence of research investigating workplace cyberbullying within this profession. Considering the detrimental outcomes experienced by the targets of workplace cyberbullying, this is an issue that warrants focus. METHODS: Utilizing relevant scenarios as prompts, semi-structured interviews were conducted with 16 nurses (practising and in training) to explore their understanding of the concept and dynamics of workplace cyberbullying. RESULTS: Three high-level themes were identified and discussed: (1) cyber-specific features that make cyberbullying more damaging than traditional bullying; (2) the importance of context; and (3) the work environment factors that facilitate the occurrence of workplace cyberbullying. CONCLUSIONS: Our refined definition facilitates the investigation of a broader and more inclusive range of behaviours that targets may experience as workplace cyberbullying, and our findings in general highlight potential antecedents in common with traditional workplace bullying. IMPLICATIONS FOR NURSING MANAGEMENT: Given the work environment and the challenges faced by the nursing profession, a system-wide approach to intervention and management is recommended, along with utilizing a nursing-specific definition.

Transition Needs of Adolescents With Sickle Cell Disease.

OBJECTIVE: This article describes how adolescents with sickle cell disease (SCD) perceive their ability to perform everyday tasks required for transition to adult health care and independent living. METHOD: The Adolescent Autonomy Checklist (AAC) was adapted to include skills associated with managing SCD (AAC-SCD) and was administered to adolescents during clinic visits. Participants indicated "can do already" or "needs practice" for 100 activities in 12 categories. RESULTS: Of 122 patients, the percentage of adolescents who needed practice was greatest in living arrangements (38.7%), money management (35.8%), vocational skills (29.6%), and health care skills (25.5%). We found a significant effect of age and of cerebrovascular injury on the percentage of those who reported "needs practice" in multiple categories. We found no effect of gender and limited effect of hemoglobin phenotype on any skill category. CONCLUSION: Findings support the need for educational intervention to improve transition skills in adolescents with SCD.