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15th AnnualNursing Leadership Conference Bullying and Burnout:Renee Thompson, DNP, RN, CMSRNUSI.edu/healthWednesday, April 4, 2018 8 a.m.4 p.m. (CDT) University of Evansville Ridgeway University Center Joint
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To fill out a bullying form:
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Start by stating your personal information, including your name, contact details, and any relevant identification numbers.
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Provide details about the incident, including the date, time, and location of the bullying event.
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Describe the individuals involved, including their names, positions, and any other identifying information.
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Explain the nature of the bullying incident, including the specific behaviors, actions, or remarks that took place.
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Mention any witnesses or evidence that can support your claim.
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Describe the impact the bullying incident has had on you, both emotionally and professionally.
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Include any additional information or attachments that you believe are relevant to the case.
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Sign and date the form, confirming the accuracy of the information provided.
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To fill out a burnout form:
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Begin by providing your personal details, such as name, contact information, and job position.
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Mention the date or period during which you experienced burnout.
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Explain the symptoms you have been experiencing, such as fatigue, detachment, insomnia, and reduced productivity.
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Describe the potential causes of your burnout, such as excessive workload, lack of support, or work-related stressors.
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Explain any actions you have taken to address the burnout, such as seeking professional help or discussing the issue with a supervisor.
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Mention any suggestions or requests you have for your employer to help prevent burnout in the future, such as implementing work-life balance policies or stress management programs.
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Provide any additional information or supporting documents that may be relevant to your burnout case.
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Sign and date the form to certify the accuracy of the information provided.

Who needs bullying and burnout?

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Bullying and burnout support and resources are needed by individuals who:
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- Have been victims of bullying in any environment, such as schools, workplaces, or communities.
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- Are currently experiencing burnout or displaying symptoms of burnout due to excessive stress and workload.
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- Want to raise awareness about the harmful effects of bullying and the importance of addressing it.
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- Seek guidance and assistance in dealing with bullying incidents or preventing them from happening.
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- Wish to understand the signs and symptoms of burnout and learn effective coping mechanisms.
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- Require organizational support and strategies to prevent burnout and foster a healthy work environment.
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Bullying refers to repeated aggressive behavior that can harm another individual, while burnout is a state of emotional, physical, and mental exhaustion caused by prolonged stress, often in a work environment.
Typically, employers, educational institutions, or organizations are required to file reports on cases of bullying and burnout involving their employees or students.
To fill out bullying and burnout reports, one should gather all relevant information, complete the designated forms with details of the incidents or observations, and submit them to the appropriate authority within the organization.
The purpose of addressing bullying and burnout is to identify and mitigate harmful behaviors and stressors in the workplace or educational settings, ensuring a safe and healthy environment for individuals.
Information that must be reported includes the nature of the incident, dates, individuals involved, witnesses, the impact on the victim, and any actions taken to address the situation.
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