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  • Kelly Willis, MSN, MBA-HM

How I Used the Negative Behavior Checklist to Improve My Unit

The Beginning

In 2015, during my first formal leadership position, I was sitting in my living room skimming through a Nursing Management magazine. One article, in particular, caught my eye, entitled The Cure for Workplace Bullying by John Olmstead, MBA, RN, CNOR, FACHE. I wondered, was there really a cure for workplace bullying? After reading it, I was convinced. I immediately made plans to adopt his suggested practices into my ICU.


How Was the Checklist Created?

Olmstead created a form called The Negative Behavior Checklist to identify unacceptable verbal and non-verbal workplace behaviors. He also clearly outlined the repercussions for such conduct. He disseminated this information to his surgical unit and reinforced the anti-bullying policy by following up on reported negative behaviors. This, Olmstead found, lessened nursing turnover, resulted in fewer absences, and improved staff morale.

How I adopted the Negative Behavior Checklist

I copied the Negative Behavior Checklist out of the magazine and adapted it to fit the needs of my team.


Before distributing it widely, I shared it with my immediate ICU crew over the course of a couple of meetings. The checklist was clear and concise and gave black and white examples of unacceptable behavior. The staff talked about it. Some reacted negatively to the new policy, but I was glad to know that it was being discussed.


I emailed the checklist to all ICU staff and posted it in the report room and nursing station. After giving the ICU staff some time to see and consider the checklist, I brought my idea up the chain. I emailed it to other hospital leaders, who expressed widespread interest; even senior management and HR jumped on board.


The checklist took shape, and with input from upper management, changes were made, including the removal of ‘Negative’ from the title.


With HR, communications, and senior management satisfied, it was time to distribute the final draft. The checklist was sent out to everyone in the organization, and several units provided the checklist for new hires to review and sign during onboarding.


The Evolution of the Checklist

Six months after introducing the behavior checklist, I began sending out a monthly bulletin of healthy work environment topics. These included gossip, negative sarcasm, stirring the pot, and creating tension in the workplace.


After sending out the first of these topics, I immediately received referrals from my staff about an incident within the unit. Thanks to quick action and awareness, I dealt with the events as they came to me.


One year after implementation, I gave two 45-minute Healthy Work Environment in-services to 150 of my colleagues and leaders. I proudly presented my work on the behavior checklist.

A year after that, I gave 15-minute in-services on the behavior checklist to the medical and surgical units during the annual skills days. By that time, the checklist was adopted throughout the organization.


Results of the Behavior Checklist

Ultimately, this implementation pitted the unit’s small bullying clique against staffers that used the behavior checklist to report uncivil behavior. This division resulted in several petty reports in an attempt to exclude staffers that didn’t ‘fit in,’ but most didn’t match the guidelines of the checklist.


Here, discernment on my part was vital. I carefully sifted through all the information before making a conclusion.


At the end of the day, I realized that staff who’d felt unheard in the past saw the behavior checklist as a huge boon. They felt that the checklist narrowed in on many of the issues they were experiencing in the unit, and all were appreciative that I took it seriously.

The behavior checklist gave us a tool that firmly stated, in no uncertain terms, which verbal and non-verbal behaviors were unacceptable. There was no guessing as to the definition of ‘bullying behaviors’ in our organization. Referrals for perceived negative behaviors that were sent to my office were dealt with fairly and compassionately, and I ensured that both sides of the story were acknowledged and understood.


To obtain the Behavior checklist please click here



(Behavior Checklist PDF: https://a955c3eb-ced9-4a60-9a21-efde401ff8eb.usrfiles.com/ugd/a955c3_2fcbf4009c7a4cbb8a39986575439cd4.pdf

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