No time for nice? Exploring the nature and influence of workplace incivility and bullying in long-term residential care

Residential care aides (RCAs) provide the majority of hands-on care for individuals in long-term residential care (LTRC). Yet, as they are situated at the bottom of the workplace hierarchy, they receive little respect or recognition for their work. In BC, LTRC workers (mainly RCAs) have the highest rates of on-the-job injury; four times higher than the provincial average and twice as high as acute care workers, due primarily to overexertion and violent or aggressive acts from residents. 
Little is known about RCAs’ experiences of peer workplace incivility and bullying, also known as horizontal violence. This is a significant gap, as staff turnover and absenteeism (factors which negatively impact residents’ quality of care and quality of life) are more correlated to exposure to workplace incivility and bullying than to patient threats and violence. 

Quality person-centred care depends on respectful and collaborative relationships among RCAs; however, workplace incivility and bullying have the potential to significantly disrupt such relationships. For example, faced with workplace incivility and bullying, RCAs may lift or ambulate immobile residents alone rather than asking for help, putting themselves and residents at risk.

Using a critical ethnographic approach, this novel study will examine workplace incivility and bullying among RCAs in LTRC and its effect on care provision. Dr. Cooke’s findings will generate practice and policy recommendations for improving staff relationships that will, in turn, help improve residents’ quality of care and quality of life.

A Community Advisory Committee will provide input throughout the research process. Forums will be held periodically at each study site to share emergent findings, and a publicly-accessible, study-specific website will be created. Findings will also be shared with a variety of knowledge user groups (e.g., health authority residential care quality committees, UBC Centre for Research on Personhood in Dementia’s colloquium series, and the Patient Voices Network) to encourage dialogue and exchange. This will provide an opportunity to stimulate transformation in LTRC beyond the scope of the study sites and influence policy and practice across BC and potentially beyond.