Workplace Bullying in the Health Care Setting
September 11, 2014
The College of Nursing
and Health Professions is pleased to introduce a series of articles authored by
Paul Thomas Clements, who will share his expertise on topics such as
workplace bullying, stalking, child assessment of abuse, victim assessment, and
workplace violence in healthcare.
By Paul Thomas
APRN-BC, CGS, DF-IAFN, Associate
Clinical Professor and Coordinator of Drexel’s Forensic Trends and Issues in
Forensic Healthcare Certificate Online.
Bullying in the workplace has become a significant focus in
the contemporary era of healthcare. The implications of bullying are
far-reaching for employees and employers and need to be actively addressed.
Workplace bullying has been defined as any type of repetitive abuse in which
the victim of the bullying behavior suffers verbal abuse, threats, humiliating
or intimidating behaviors, or behaviors by the perpetrator that interfere with
his or her job performance and are meant to place at risk the health and safety
of the victim (Murray, 2009).
It is estimated that 1 in 7 employees are bullied at work
There are four generally accepted categories of bullying:
verbal bullying is characterized by
threats, insults, and name-calling.
relational bullying is characterized
by exclusionary behavior and rumor spreading.
- Cyber-bullying, which is the newest form of bullying, uses electronic
methods for inflicting emotional distress on the target. This can include
texting, e-mail, and various forms of social media (Facebook, Twitter, etc.).
Retaliation is a type of bullying that uses psychological and
social behaviors to cause harm. One example is conceptualized by the adage
“Once they stop talking to you, they begin talking about you.” This can result from the target being
perceived as “ratting out” another employee, causing someone to “get in
trouble,” being blamed for being “passed over” for a promotion, etc.
Why does an
The bully has an extreme need to have complete control over
an individual or an environment. Additionally, the bully may have personality
flaws such as an exaggerated sense of self (Murray, 2009).
does the individual bully?
This usually occurs via a systematic mistreatment of the target. The bully:
- Sabotages the victim(s) work
- Uses verbal abuse
- Employs public humiliation (often in front of
- Excludes or ignores the target
The following examples may help
healthcare employees recognize if they are being bullied:
- Despite attempts
to learn a new procedure or complete a task, the supervisor is never pleased.
- Being called to
unplanned meetings with the supervisor (and perhaps others who are witness or
participants) where only further degradation occurs.
- The workplace
bully continually undermines and torments an employee who is trying simply to
do his or her job.
spreading of rumors or negative comments about an employee’s personal
appearance, beliefs, or performance with patients.
- Making it clear
that the employee is not considered
“part of the team.”
- When an employee
asks an organizational leader for help, he or she is told to “get
a tougher skin” or “work out your differences.”
- Co-workers and
senior leaders share the employee’s concern that the bully is a problem but
they take no action to address the concern in the workplace (Murray, 2009).
Impact of bullying in
Bullying encompasses many levels of impact for healthcare
employees and agencies. Research has shown that bullying decreases job
satisfaction among employees, decreases employee productivity and increases
employee absence from work. Additionally, bullying increases job turnover; one
report notes that 64% of bullying victims leave their jobs (Tarkan, 2013). The
financial impact of replacing large numbers of vacancies with the associated
costs of orienting new personnel can be staggering to employers. One study
reports that the cost incurred from bullying in the work place can be as much
as $4 billion dollars a year (Murray, 2009).
Bullying should be identified as an “abusive work environment.”
From a risk management standpoint, such a policy and practice stance can limit
employers from secondary liability risk when such behaviors are documented,
impact is assessed, and actions are taken. Such an approach can include
termination of the bullying employee. Zero tolerance for violence policies that
include bullying as a facet holds both the employees and employer accountable
for bullying in the workplace. Employers should clearly indicate that bullying
will not be tolerated and that cases of reported bullying will be investigated.
When an employee
believes they are being bullied
It is important to examine the healthcare agency’s policy on
workplace violence and bullying. This will increase the ability to recognize
when bullying is occurring. If the policy is unclear, an employee should seek
information from the Office of Human Resources for guidance. Anti-bullying
actions are a “culture” change on the part of all employees, management, Human
Resources and Administration.
Employees should document all incidences of workplace
bullying –specifically including date, time, occurrence, and witnesses. It is
also important that employees report if they witness another employee being
bullied. In either situation, this includes bringing the incident to the attention
of the manager immediately (and repeatedly if there are subsequent events) and
“document, document, document” (Murray, 2009). Additionally, employees can
familiarize themselves regarding state and federal rights on workplace bullying
Bullying in the workplace is a significant issue in the
contemporary era of healthcare. It has both measurable and immeasurable costs
for employees and employers. The prevention of workplace bullying will occur
when there is an increase in recognition, reporting, and response from the
continuum of those working at the bedside, to management, Human Resources, and
Administration in each healthcare facility nationwide. This requires a clear
stance that workplace bullying is not
acceptable and is not tolerated.
(2009). Workplace Bullying in Nursing: A Problem That Can’t Be Ignored. MEDSURG Nursing, 18 (5), pp. 273-276.
Tarkan, L. (2013).
How to cope with bullying in the workplace. Retrieved from: http://www.foxnews.com/health/2013/04/25/how-to-cope-with-bullying-in-workplace/