Raymond was one of the two male nurses working in an ICU in an inner-city hospital. The nurse manager always put him in charge of the ICU whenever he worked his twelve-hour shift. When Raymond was in charge, problems were handled quickly and without drama. His efficient demeanor during a code comforted families, staff nurses, and even the medical interns and residents. Attending physicians requested that Raymond care for their sickest patients as well as their family members. In addition, letters were often written to the hospital about his outstanding care and his attention to details. His exceptional customer service and outstanding patient care made Nordstrom's customer service department look bad!

However, if there was a question that needed an answer, Raymond knew it and wasn't shy about letting everyone else around him know it too. His self-assured behavior came across as overconfident and conceited. It didn't help him win any popularity contests as he was the only master's-prepared nurse on the unit; most of the nurses didn't even have their bachelor's degree. He tried to fit in with the other nurses by joking with them or giving the best assignments to the most popular nurses. Raymond didn't realize it, but the nurses in the most popular group were always putting him down and criticizing him behind his back. During morning rounds with physicians, the other nurses would challenge Raymond and try to embarrass him or roll their eyes whenever he spoke.

Raymond wanted to join the "in gang" and so started to share some personal information with the other nurses about his deteriorating relationship with his wife. She was unable to work due to a chronic medical condition and was becoming increasingly needy with repeated hospitalizations. The other nurses rallied around him pretending to offer support when they were actually scheming to teach him a lesson since he was a "know it all." One nurse got his personal e-mail, while the other nurse planned the prank.

A few weeks later, Raymond started receiving e-mails from a secret admirer named Terry. Their e-mail relationship lasted several months before he told his coworkers about it. He shared stories with his interested coworkers about the admirer and told them that he was actually thinking about leaving his wife for her. Later, Raymond found out that not only did the entire staff in the ICU know about this prank but his e-mail conversations were distributed to the unit's nursing and support staff.

Tasks:Discussion Questions

• What are the facts of this case?
• What is the nature of the organizational behavior problem?
• Which theory or theories do you believe best explain the behavior of Raymond's coworkers?
• As the nurse leader, what interventions would be useful in dealing with workplace bullying?
• What types of workplace behaviors define bullying?
• Have you ever experienced or observed workplace bullying? Describe what happened and how it was managed.
• How does bullying impact the workplace morale? Productivity? Patient care? Can you think of the other effects of bullying in the workplace?
• How does the leadership or management team contribute to bullying?
• What types of ethical issues are identified in this case study?
• What kind of financial impact do you think the behavior of the nurses and their supervisor may have on the hospital?
• Provide your reflections and personal opinions as well as your recommendations for addressing this problem.