Research Explains Why Bullying Exists, Inspires Strategies for Change in Healthcare Settings

By Amanda Ghosh via Multibriefs

Anyone who has experienced bullying at work knows how mind-boggling it is to see professionals misbehave. Fortunately, we’ve learned why bullying exists, so we know how to design safer workplaces.

Bullying vs. Incivility

Not all uncivil behavior constitutes bullying. According to the American Nurses Association, bullying is “repeated, unwanted, harmful actions intended to humiliate, offend, and cause distress in the recipient.” Incivility is “one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them.”

Intrapersonal Sources of Bullying

Bullying, according to the Canadian Bureau of National Affairs, is a symptom of emotional distress. Intrapersonal sources of bullying, therefore, include mental illness, drug, or alcohol habits.

That’s not to say that every bully has a drug problem. It’s much more likely that they have a mental health problem.

Environmental Factors That Facilitate Bullying

Research published by Cooper and Swanson (2002) and Salin (2003) depict bullying as a symptom of environmental factors like poor lighting, lack of safety measures, and working with violent patients.

Understaffing, poor relationships with colleagues, changes in workgroups, lack of administrative support, increased workload, and organizational change also contribute to bullying.

Additional research describes bullying as a learned behavior. For example, Lewis (2006) argued that new nurses adopt bullying behavior to fit in, therein propagating bullying instead of ending it.

In some cases, a simple difference of opinion as to how to treat a patient can create conflict among healthcare workers, which can force caregivers to pick sides for acceptance and support. These informal organizational alliances make it easier for bullies to control their colleagues using inappropriate emotional and psychological tactics.

How Administrators Can Prevent and Reduce Instances of Bullying

Bullying encourages medical professionals to leave the profession, endangers patients, and negatively affects the mental and emotional health of employees. Eradicating bullying should be a top priority for healthcare administrators, and the following strategies may make it easier to prevent or reduce instances of bullying:

• Adopt a zero-tolerance policy for all bullying behavior and document all instances of bullying.
• Provide anti-bullying training for those demonstrating incivility.
• Make career and mental health coaching part of employee development plans for those cited with bullying or incivility. Make compliance with such a program a condition of continued employment.
• Observe group dynamics and alter workgroups as necessary to create safer environments.
• Keep a pulse on the culture developing amongst employees at all times.
• Say what you mean and do what you say. A reliable, fair, and consistent administrative presence can have a positive impact on workplace culture. Take employee concerns seriously, enforce a zero-tolerance bullying policy, and support the well-being of all team members.
• Design healthier mentorship programs for new nurses so they don’t have to choose between propagating bullying behavior and receiving acceptance or support — end bullying by preventing it from being adopted by new hires.
• Be mindful of staff workload and how workgroup changes impact staff. Go to bat for the addition of more team members to reduce workload and fight for efforts that support work-life balance.
• Find genuinely meaningful ways to support staff when you can’t give them what they want.

Be sure to check with your legal team before implementing any strategy to make sure your actions are compliant with the law.

The State of The Healthcare Work Environment

Management has a significant impact on work culture. Retaining medical professionals and preserving the mental and emotional health of professional caregivers is largely in the hands of those who have the power to change the culture of the work environment and facilitate the coaching of individual employees.

Amanda Ghosh, MS, BA, is a freelance writer pursuing her third degree, a BS in nursing. Previously she studied nutrition and journalism. She has worked as a Wellness Director and Adjunct Instructor. Amanda’s writing focuses on nursing and the healthcare industry.