Bullying in Healthcare: The Truth that Lurks in the Shadows

By Noel Belton

In the corridors of healthcare facilities across America, where lives are saved and miracles take place every day, a dark force lurks in the shadows. Bullying, a problem that has long plagued various industries, seems to have found a particularly toxic home in the healthcare profession, with nurses bearing the brunt of its wrath. Okay, sorry about the dramatic start to today’s blog, but it just felt right…

Beyond the cold statistics lie real stories of nurses enduring the demeaning treatment of their peers, who often unknowingly extinguish the passion that led them to the nursing profession. In today’s post, we’ll discuss the reality of bullying in healthcare and include real-life accounts that bring the issue to life.

The American Nurses Association’s description of bullying resonates deeply: “repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient.” A 2018 study in the Journal of Nursing Management revealed that a startling 60% of nurse managers, directors, and executives bore witness to bullying within the walls of their workplaces. Of this distressing group, an alarming 26% endured the brunt of severe bullying, creating an atmosphere of fear and frustration in an environment that is already rated among the most stressful workplaces.

Recognizing Our Real Life Heroes

First, it’s so important to give credit where it’s due. There are countless nurses out there who are the embodiment of kindness, compassion, and care. They truly are the heart and soul of the nursing profession, spreading warmth and bearing the brunt of the majority of frontline patient care. We’re lucky to have them! This is why I thought it was important to address this important topic.

Over the last three years, we all watched in amazement the number of healthcare workers who bravely stood at the frontlines and faced the pandemic head on. Despite their own health concerns, at-risk family members, and long shifts, our healthcare workers rose to the occasion and took on COVID-19 one very sick patient at a time.

But like any workplace, sometimes, we run into communication and relationship challenges with our colleagues. You know, those moments when someone throws a cutting or passive-aggressive (or just aggressive) comment your way, and you’re like, “What just happened?”

In some cases, it’s even worse. We’re talking about outright animosity and bullying. It’s tough to imagine and sometimes even harder to talk about, but today we’ll address this issue. We can’t just sweep it under the rug.

The Alarming Statistics

A recent study from the University of Indiana looked at how many new nurses decide to leave their jobs. They found that in the first year, anywhere from 17% to 30% of newly licensed nurses leave, and by the second year, it’s even higher at 30% to 57%! Another study discovered something really surprising. They found out that a whopping 78% of nursing students experienced bullying within just six months of being in school. It doesn’t stop there.

So, we really need to pay attention to this issue and figure out how to make things better. Studies have shown that a lot of nurses, like 34% of them, have thought about leaving the profession because of bullying. This bullying stuff ends up costing hospitals and healthcare organizations $11,581 per nurse per year.

Most Common Types of Bullying

Within the realm of bullying, there are six distinct categories, each harboring its own unique traits and implications. Let’s delve into these categories to gain a comprehensive understanding of the forms bullying can assume:

Physical Bullying: This type of bullying leaves visible marks, both physical and emotional. It involves direct acts of aggression, such as hitting, kicking, pushing, or even stealing personal belongings. Physical bullying is often more overt and easier to identify, as it leaves tangible evidence of the harm inflicted upon the victim.
Verbal Bullying: As a weapon of choice, words can be equally destructive. Verbal bullying encompasses hurtful language, name-calling, insults, and derogatory remarks aimed at belittling and demeaning the target. This form of bullying can leave deep emotional scars, as its effects extend beyond the spoken moment.
Relational Bullying: Often subtler but no less insidious, relational bullying operates through manipulation and the deliberate exclusion of the victim from social circles. Gossip, spreading rumors, and forming cliques designed to ostracize individuals are tactics employed in relational bullying. It inflicts emotional distress by exploiting the victim’s desire for belonging and acceptance.
Sexual Bullying: This particularly distressing form of bullying involves unwelcome sexual advances, comments, or harassment, targeting the victim based on their gender or perceived sexual orientation. Sexual bullying violates personal boundaries and can create an environment of fear and discomfort for the victim.
Prejudicial Bullying: Prejudicial bullying stems from biases related to race, ethnicity, religion, disability, or any other characteristic perceived as different. This form of bullying perpetuates discrimination and perpetuates harmful stereotypes, inflicting emotional harm and undermining the victim’s sense of self-worth.
Cyberbullying: In the digital age, bullying has found new avenues through the internet and social media platforms. Cyberbullying encompasses the use of electronic communication to harass, intimidate, or spread harmful content about the victim. The online anonymity can make this form of bullying especially pervasive and difficult to trace.

The First Step

We can start by acknowledging that this stuff exists and having an open conversation about it. Empathy and understanding go a long way, and I would imagine as with any other troublesome behavior, they are often the only symptoms of other underlying issues. By acknowledging these difficulties, we take the first step towards fostering an atmosphere of open dialogue and empathy.

Unmasking the Numbers: A Grim Reality

The figures surrounding bullying in healthcare paint a somber picture. The American Nurses Association (ANA) reports that 18% to 31% of nurses have been bullied by colleagues ranging from subtle intimidation to outright verbal abuse. These numbers not only reveal the gravity of the issue but also call for immediate action to safeguard the sanctity of healthcare environments. Members of the healthcare community refer to it as “eating our young.”

Real-Life Chronicles: Echoes of Pain and Resilience

Behind these statistics are stories of resilience and tragedy that deserve to be heard. Tanya’s tale, for instance, brings to light the devastating consequences of unchecked bullying. Tonya, a dedicated nurse, found herself in the crosshairs of a seasoned colleague’s relentless ridicule. Daily barrages of derogatory remarks, dumping of undesirable shift responsibilities, and belittling comments eroded her self-esteem, not only affecting her professional performance but also compromising patient care. Despite her attempts to voice her torment, her complaints fell on deaf ears, leaving her feeling abandoned and voiceless. Sadly, Tanya’s story is more common than you might think.

The Provoking Factors: A Cauldron of Hostility

Bullying is common in healthcare due to a combination of factors that create a perfect storm for such behavior to thrive. Understanding these factors can help us address the issue more effectively:

High-Stress Environment: Healthcare settings are notorious for their high-stress nature. Long hours, demanding workloads, life-and-death decisions, and emotional intensity can cause tension and frustration among healthcare professionals. Some individuals may resort to bullying as a maladaptive way to cope with their stress or perceived powerlessness.
Hierarchical Structure: Healthcare facilities typically have a clear hierarchical structure, with varying levels of authority. This hierarchy can create power imbalances, where individuals in higher positions may exploit their authority to mistreat those below them. In such cases, bullying can be a means for some to exert control and dominance over their colleagues.
Intense Emotions: Healthcare professionals frequently deal with emotionally charged situations, witnessing suffering, loss, and trauma on a regular basis. These intense emotions can sometimes spill over into interpersonal interactions, leading to conflicts and bullying.
Job Insecurity: In some healthcare settings, job insecurity is prevalent due to factors like budget constraints or fluctuations in patient numbers. The fear of losing one’s job can contribute to a toxic work environment where colleagues might engage in bullying to secure their position or protect themselves from potential threats.
Lack of Awareness and Training: Many healthcare professionals, especially those in leadership roles, may not be adequately educated about recognizing and addressing bullying behavior. This lack of awareness can perpetuate a culture where bullying goes unchecked and unchallenged.
Organizational Culture: The culture within a healthcare organization plays a significant role in shaping behavior. A culture that tolerates or ignores bullying can inadvertently encourage its prevalence. On the other hand, a culture that prioritizes respect, collaboration, and open communication can act as a powerful deterrent against bullying.
Impact of Burnout: Burnout is a prevalent issue among healthcare professionals, leading to emotional exhaustion and decreased job satisfaction. Burned-out individuals might be more prone to engaging in bullying behaviors as they struggle to cope with their own emotional turmoil.

To combat bullying in healthcare, it is crucial for organizations to address these underlying factors. Implementing comprehensive training programs, fostering a culture of respect and open communication, and providing support for healthcare professionals’ mental well-being are essential steps toward creating a healthier and more compassionate work environment for all.

A Silver Lining: Illuminating the Path to Change

While the issue of bullying in healthcare casts a long shadow, there is hope for change. But it will require organizations to take decisive action to get rid of bullying and cultivate a culture of respect, empathy, and collaboration. The following strategies can pave the way for a brighter future:

Zero Tolerance, Absolute Resolve: Healthcare organizations must establish and vigorously enforce a zero-tolerance policy against bullying, leaving no room for ambiguity.
Empowerment through Education: Regular training sessions, workshops, and discussions can equip healthcare professionals with the tools to recognize and combat bullying.
Safe Spaces and Open Ears: Encouraging reporting mechanisms that guarantee confidentiality and protection against retaliation empowers victims to speak out.
Fostering a Garden of Respect: Nurturing a culture that values every individual’s contribution, regardless of their position, fosters a sense of unity and camaraderie.

Onboarding: Getting Off on the Right Foot

Onboarding nurses in a way that emphasizes a supportive and respectful environment can be instrumental in preventing bullying. Here are some essential steps to consider:

Comprehensive Orientation Program: Develop a well-structured orientation program for new nurses that covers not only job-related skills but also emphasizes the organization’s values, policies, and code of conduct. This ensures that new nurses are aware of the importance of respect and kindness in the workplace.
Anti-Bullying Training: Incorporate anti-bullying training into the onboarding process. Educate new nurses about what bullying looks like, its impact, and how to address and report bullying incidents. Provide them with tools and resources to handle such situations effectively.
Mentorship and Support: Pair new nurses with experienced mentors who exemplify a respectful and supportive attitude. Mentors can provide guidance, act as role models, and help new nurses navigate the challenges they may face.
Open Communication: Foster a culture of open communication from day one. Encourage new nurses to share their experiences and concerns without fear of reprisal. Let them know that their voices are heard and valued.
Encourage Team Building: Organize team-building activities to promote camaraderie among nurses. Building strong relationships from the beginning helps create a positive and cohesive work environment.
Set Clear Expectations: Clearly communicate expectations for behavior and professionalism. Make it known that bullying is not tolerated and that everyone is responsible for upholding a respectful workplace.
Anonymous Reporting System: Implement an anonymous reporting system where nurses can report bullying incidents without fear of retaliation. This encourages reporting and ensures that issues are addressed promptly.
Regular Check-ins: Schedule regular check-ins with new nurses to gauge their experience and address any concerns they may have. This shows that their well-being is a priority and helps identify and resolve potential issues early on.
Celebrate Diversity: Emphasize the value of diversity and inclusion in the workplace. Celebrate the unique strengths and perspectives each nurse brings to the team.
Lead by Example: Leadership plays a crucial role in setting the tone for the organization. Ensure that leaders exemplify respectful behavior and address any instances of bullying promptly and effectively.

Conclusion

Bullying in healthcare serves as a stark reminder that even in the most noble of professions, toxic behaviors can sneak in if left unchecked. The numbers may shock us, and the stories may break our hearts, but they also galvanize us to action. By acknowledging the problem, taking proactive steps, empowering healthcare providers to stand up against bullies, and putting would-be bullies on notice, we can reduce bullying in healthcare. Acknowledging the problem is the first step towards creating a healthier and more supportive healthcare environment. But we can’t stop there. We must take proactive steps to address bullying head-on, not just as individuals, but as a united front.