Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Nursing

Date of Defense

11-20-2024

Graduate Advisor

Julie Bertram

Co-Advisor

Wilma Calvert

Committee

Lisa Green

Phillip Waalkes

Abstract

Background: Disruptive clinician behaviors among healthcare staff are an increasing concern, negatively affecting patient safety. In 2015, 16% of nurses in the U.S. were foreign-born (Shaffer et al., 2022), and 25% of New York and California nurses were immigrants (Shaffer et al., 2021). Nurses' migration to the U.S. has been exploding. Non-native English-speaking nurses experience complications, problems, and discord in their workplace with coworkers.

Aim: The purpose of this qualitative descriptive study was to explore and understand non-native English-speaking nurses’ experiences with disruptive clinician behaviors in the U.S.

Specific aims were to 1) create a comprehensive description of the experiences of disruptive clinician behavior of non-native English-speaking nurses in the US, 2) identify responses of non-native English-speaking nurses toward disruptive clinician behavior, and 3) discover the impacts of disruptive clinician behavior on patient care activities.

Methods: Qualitative descriptive method was utilized to explore the status of experiences with disruptive clinician behavior for non-native English-speaking nurses.

Data collection: Semi-structured interviews were conducted as the primary data source.

Sampling: Purposive and snowball sample sampling were utilized to recruit twenty participants. Inclusion criteria were 1) age between 20 and 65, 2) working as non-native English-speaking licensed nurses (licensed practical/vocational or registered), 3) have experienced or seen disruptive clinician behavior at their clinical workplaces. Exclusion criteria were 1) age below 20 and over 65, 2) nurses working outside clinical settings (schools, industries, and community).

Analysis: This study utilized the phases of thematic analysis according to Braun and Clarke (2006) to gain a comprehensive understanding of disruptive clinician behavior and develop a nuanced interpretation of findings. The scholars analyzed transcripts using NVIVO software to find meaning units and themes. The study discovered sixty-five codes, which were then classified into eight themes and twelve sub-themes. This study explores the experiences of non-native English-speaking nurses dealing with disruptive clinician behavior, offering insight for native English-speaking clinicians. The study's findings can help healthcare organizations improve policies on workplace incivility. It can be a stepping stone for future research to develop education that promotes positive clinician behavior and fosters a more respectful work environment.

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