How to Deal with Bullying in Hospital Environments

Vince Scopelliti - Wednesday, June 06, 2018

Hospitals - very few people like them, yet many of us will be a resident at one time or another. Even though hospitals can be sources of great joy, places where babies are born, miracles happen and lives are saved, they also represent sickness, injury, death, and some pretty ordinary food! 

The people who work in them - the doctors, surgeons, nurses, aides, assistants, administrators and catering staff - perform difficult work in an extremely stressful environment. Imagine the potential consequences when the added stressor of workplace bullying is added to the mix.

Factors which facilitate bullying in this environment 

Hospitals and the healthcare sector remain a particularly hierarchical environment - carers need to get sign-off from nurses before passing out certain medications, nurses confirm recommended treatments with doctors, doctors and surgeons rely on their own pecking order. 

This hierarchy, and the importance of culture and following rules, automatically puts certain workers in a subordinate position relative to others.

Lateral violence, verbal, physical and psychological bullying among peers, can also be an issue in the health services. 

Combined with the stress of having to deal with time-critical emergencies, becoming involved in physically and mentally straining situations and dealing with the trauma of patients suffering, hospitals are the perfect breeding ground for hostility, anger and frustration.

Prevalence of bullying

Bullying in the healthcare sector is an under-recognised but pervasive problem. Hospitals often have scant or limited resources and staff are under significant pressure, which may contribute to the prevalence of workplace bullying.

The Australasian College for Emergency Medicine surveyed its members in 2017 and found 34% had experienced bullying, 16.1% had experienced harassment and just over six percent had been victims of sexual harassment. A landmark 2015 report commissioned by the Royal Australasian College of Surgeons showed that almost half of all surgeons had experienced bullying, discrimination or sexual harassment. 

The Victorian Auditor General Office, in its 2016 report to the Victorian Parliament, 'Bullying and Harassment in the Health Sector', stated 

"The Health Sector is unable to demonstrate that it has effective controls in place to prevent or reduce inappropriate behaviour, including bullying and harassment. Key controls that would effectively reduce this risk to employee health and safety are either inadequately implemented, missing or poorly coordinated." 

However, by its very nature, bullying in this type of workplace can be particularly difficult to detect and manage. 

Consequences of bullying

The potential consequences of bullying are significant. In addition to litigation arising from the bullying and costs associated with worker's compensation or other payouts, a number of issues can arise. These include:

  • High turnover amongst dissatisfied staff
  • Presenteeism - where staff turn up at work, but are unhappy or stressed and perform inadequately, which is particularly dangerous in a hospital environment. 
  • Increased absenteeism
  • A poorly functioning team environment that can adversely affect staff and patients.      

are there solutions to bullying in high-stress environments?  

Key strategies to help solve the problem include:

  • A focus on workplace culture, including by conducting regular cultural audits. 
  • Encouraging a 'mentor' or 'buddy' system (in consultation with unions where appropriate), or otherwise provide a supportive environment whereby staff are encouraged to vent or ask for assistance with any matters they are struggling with. 
  • Facilitating easy access for staff to obtain confidential counselling, or advice services. 
  • Fostering an environment where staff feel comfortable raising concerns and complaints with their peers and management.
  • Having clear zero tolerance policies regarding workplace bullying and harassment, which are easily accessible to all staff
  • Ensure that this zero tolerance policy, is demonstrated by senior management, so there is a top down recognition of adherence to the policy from all staff. 
  • Staff need to be regularly reminded of the consequences of any poor behaviour in the workplace and this should be reinforced during staff meetings.  

Bullying or harassment - in any workplace - is simply unacceptable. Many incidents of bullying or harassment may be unreported for fear of reprisals. All staff should be encouraged to report any incident. 

If your organisation needs any assistance in this area please contact WISE to arrange a no-obligation appointment or otherwise contact us to discuss how we may assist you. Our services include investigation, training, provision of a whistleblower facility (which can be tailored to suit your reporting needs), and review of policies

Aged Care Investigations: A Guide for Reportable Assaults

Vince Scopelliti - Wednesday, April 18, 2018

The thought that some of the most vulnerable in our society - the elderly - might be at risk of harm in residential aged care facilities is abhorrent. But even with the best of intentions and the proper guidelines in place, there is still potential for abuse and assault to occur. 

Abuse allegations in an aged care setting are highly emotional and challenging for all involved, especially the victims and their families. 

When investigating these allegations, it is essential that procedural fairness and objectivity are paramount.

the two types of reportable assaults

The Aged Care Act 1997 (Cth) sets out the requirements for when approved providers of residential aged care must report matters involving their residents to the police. 

Section 63-1AA of the Act defines 'reportable assaults' as either unlawful sexual contact with or the unreasonable use of force on a resident of an aged care facility. 

Unlawful sexual contact considers situations where the resident does not or is unable to provide consent. In cases where residents have cognitive impairment, it is particularly important to ensure that all allegations are properly investigated.

Unreasonable force is intended to cover situations where elderly residents are treated roughly, causing physical injuries. Given the manual nature of handling aged care residents, it is accepted that occasionally 'innocent' or accidental injuries do occur - however, any physical injuries should be adequately reported.

wHO TO REPORT TO, AND WHEN

The Department of Health oversees aged care facilities generally. The Australian Aged Care Quality Agency (AACQA) is required to assess aged care facilities for ongoing compliance with accreditation standards and reporting responsibilities. 

The aged care provider is required to notify the federal government's Department of Health, either by completing a form or calling the hotline, within 24 hours of a suspected reportable assault. The police must be contacted within the same timeframe. A failure to comply with these reporting requirements may result in sanctions being imposed by the Department of Health. 

Given the serious nature of elder assault, even in circumstances where it is unlikely that a suspicion will be proven to be correct, an aged care provider must undertake the necessary reporting within the required timeframe. 

Staff members who notify their employers of potential assaults are protected in accordance with the Act. This means that their anonymity must be maintained and they are protected from potential reprisals by colleagues. 

the role of the aged care complaints commissioner

Complaints relating to the quality of aged care can also be directed to the Aged Care Complaints Commissioner. 

The Commissioner is tasked with resolving complaints, taking action on issues raised in complaints and helping to improve the quality of aged care. 

Making a complaint to the Commissioner may be a more appropriate avenue for individuals who do not work in an aged care facility, but who wish to report suspect behaviour, such as family members or other concerned residents. 

Other responsibilities for providers

Additional responsibilities imposed on aged care providers include:

  • Requiring staff to notify suspect assaults -  In practice, this means ensuring that staff have sufficient information available to understand their obligations to report, and the methods by which they can inform their employer (or the Department of Health directly if they are concerned about protecting their jobs). They must also ensure staff understand the potential consequences of providing false or misleading information. 
  • Record keeping - Aged care providers are required to keep detailed records relating to all suspected incidents involving reportable assaults. Specific details which need to be noted include the date the allegation was made, the circumstances giving rise to the allegation, and more information surrounding the notification. The records must be available for viewing by the Department of Health or the Quality Agency, if requested. 
  • Privacy - Aged care providers are required to balance their obligations under the Act with all requirements imposed by privacy legislation, including protecting the identities of their staff and residents. 

When is an assault not reportable?

In certain circumstances, assaults need not be reported. These are set out in the Federal Aged Care Act. Broadly speaking, an assault is not reportable if:

  • The alleged person who has committed the assault is a resident who suffers from cognitive or mental impairments (such as dementia, depression or similar conditions) which are likely to have contributed to the assault, and appropriate arrangements are put in place immediately to deal with that behaviour. 
  • The same incidents have already been reported. 

If you or your organisation is responsible for safeguarding the aged, WISE Workplace's Investigating Abuse in Care skills-based short course will assist you in investigating claims of abuse and reportable conduct, in line with the legislation applicable in your state.

Is Child Protection a Priority in Your Volunteer Organisation?

- Wednesday, January 25, 2017


Volunteer organisations have a special place in the heart of every community. The vital work that they carry out most often involves providing assistance to those who are in need. Issues of poverty, homelessness, abuse, infirmity and mental illness are just some of the challenging aspects within the day-to-day operations of many volunteer groups.

Volunteering and our kids

Children and young people can often have a strong connection to one or more volunteer organisations in the community. This might be as a recipient of food parcels, being minded while parents sort out finances, or assisted to find accommodation. On the other side of the equation, children are increasingly involved in volunteer activities themselves as parents encourage their children to do their bit. Whether planting seedlings in waterways, helping to sort second hand clothes or lending a hand at the local pet shelter – children are involved members of many volunteer organisations throughout Australia.

It is sobering to say the least to necessarily consider child safety concerns within volunteer organisations. Education and training are essential for any adult volunteers working with children, as is a police check and Blue Card or Working with Children Check.

But it goes beyond this. Continuous improvement of policies and procedures relevant to child safety will be the hallmarks of a truly safe volunteer organisation.

Constant evaluation of child safety initiatives

Due to constraints upon virtually all resources within a volunteer organisation, it is perhaps inevitable that some tasks are put on the ‘back burner’. Administrative duties can be the first to be overlooked in the face of relentless service demand from clients. Yet if one area of volunteering must be continuously examined and improved for possible flaws, it is the organisation’s child safety strategy. Laws, criminological knowledge and technology are constantly changing. Volunteer management staff must be vigilant when it comes to assessing and reassessing their internal policies around children. 

As the Royal Commission into Institutional Responses into Child Sexual Abuse has demonstrated, there are some recognisable patterns to the behaviour of adults who seek to cause harm to children. Specific procedures are necessary for example around the prevention of grooming behaviours by perpetrators, as well as the creation of opportunities for abuse. 

Yet the commission emphasises that there is no one set of looks or behaviours that mark out a child abuser. This is a complex and ever-changing area and expert advice and auditing services are at times required to ensure that volunteer organisations remain up-to-date with their child safety obligations.

The broader child safety equation

The Australian Human Rights Commission developed its Child Safe Institutions Report in 2013, as part of a response to the ongoing royal commission. Importantly, child safety is seen to entail a broad notion of the potential dangers faced by children within organisations – educational, religious, volunteer, sporting or otherwise.
When we consider hazards such as the availability of inappropriate computer or television content at volunteer sites, physical and emotional damage from clientele interaction, bullying from other volunteers, accidents, or the potential for sexual abuse where inadequate supervision exists, it becomes clear that child safety within volunteer organisations should be much more broadly conceptualised that it perhaps is currently.

Child-safe systems and culture

We understand that operators of volunteer organisations are pulled in all directions. However, child safety is simply one of those ‘non-negotiables’ within 21st century organisational contexts. This is a growing and changing field of workplace knowledge, and involves the variables of procedural systems, workplace culture, legal compliance and training. All these skills are a key component of our specialy tailored investigations course to provide you with the skills necessary to investigate abuse in care complaints whether you work in a volunteer agency, not for profit or government agency. 

Offering courses in Sydney and Melbourne this year our Investigating Abuse in Care course will include investigating grooming behaviours, markers of a pedophile, conducting interviews, drafting allegations, dealing with respondents, risk assessment and weighing evidence to make sound decisions. 

Register for your place online and receive an information pack on what to do next. Book now for 2017 courses.



Nepotism and Bias in Volunteer Organisations: A Thorny Issue

- Wednesday, January 18, 2017


Managers within volunteer organisations are renowned for their ability to run operations with incredibly limited resources. Working with both paid staff and volunteers, there is a sense of needing ‘all hands on deck’ within busy community and charity groups. 
We explore today some of the hidden dangers of unconscious bias and nepotism that can arise in volunteer organisations, particularly when time is stretched and personnel decisions need to quickly be made.

The easy decision

It is perhaps not surprising then that particular workers– paid or otherwise – are more likely to receive preferential treatment. With an eye to quality service provision and being as efficient as possible, management might unwittingly be biased towards promoting the ‘easy going’ people – those with the same thoughts, ideas and humour as themselves.  And if the volunteer organisation is all about saving time, money and energy, then surely there is no necessity to run through a long and bureaucratic recruitment process? 

Problems with the ‘in group’?

Yet this is a dangerous way to think about differential treatment of paid and voluntary staff. What is occurring in these situations is the phenomenon known as ‘in-group bias’ or alternatively unconscious bias. Volunteer managers might unconsciously favour certain people or groups within the organisation – and these become the ‘in-group’, being given opportunities that the corresponding ‘out-group’ cannot access. 

The changes can be slow to build – for example, official recruitment processes can be short cut once a favourite is chosen, and information on transfers and training opportunities might only become known by a chosen few.  But what is the actual problem with this scenario?

Favouritism causes fractures

The idea of one person being more deserving than another will inevitably cause serious fractures to appear within the organisation. 

If objective merit is overlooked within volunteer organisations, then the unfortunate consequences are rather predictable. 

Accusations of nepotism and bias within management can begin as a whisper on the organisation’s shop floor – but then soon occupy much of the energy of both paid and unpaid workers. 

While everybody is on the same side when it comes to helping others, it can become acutely demoralising to be left out of management’s favoured group. Clients can also suffer as the outflow of acrimony from paid and unpaid staff begins to affect the very quality of the organisation’s good work.

Unhealthy biases

Equally substantial are the possible repercussions for workplace health and safety. As with any organisation, volunteer groups have an obligation to ensure a safe workplace, wherein bullying and discrimination are not tolerated. Safe Work Australia notes that volunteer organisations have a duty to guard against the possibility of these damaging problems arising in the workplace. 

Importantly, having the organisation located within a common law state does not mean that these obligations can be avoided. Specific advice on the WH&S requirements for your actual volunteer organisation is a must-have. 

The merit-based volunteer organisation

Nepotism and bias can certainly creep up upon the culture of volunteer organisations. With such great work being done, it can be disheartening to see one group of people getting just that bit more of a ‘fair go’ than another. 
Attention to the details of recruitment, training and other opportunities becomes necessary, in order to ensure that all decisions are made with a clear view of individual merit. 

Unconscious bias and nepotism in decision-making can be difficult to see from our own vantage point. Most managers do not deliberately set out to recruit a work mate or nephew over other people. 

Yet, ensuring that all hiring decisions and opportunities are dealt with purely on the basis merit can sometimes require a fresh pair of eyes. Our professional workplace trainers, advisors and investigators can provide custom-made strategies and preventative measures for a truly fair volunteer-based workplace. When these elements are in place, the important work of the group can continue without any unnecessary internal challenges.

Keeping up with process and procedural fairness in the workplace can be challenging. That's why we have developed the Workplace Investigation Toolkit.   Provide best practice principles and keep your business out of the Fair Work Commission.   Get yours here today.

Liability for Volunteers: The Question of Workers Compensation

- Wednesday, December 21, 2016


Workers compensation is one of those central issues that necessarily impacts upon the thinking and planning of Australian employers. To use the old phrase – “accidents happen.” And indeed, it is this inevitability that leads to the simple, no-fault basis of most Australian statutory workers’ compensation schemes. 

Yet workers compensation is a variable beast, and not all issues are as simple as they might first appear. For example, the ongoing tension between the definition of ‘workers’ and ‘contractors’ is just one of the many complexities within the arena of work-related injuries. 

Add to this the many jurisdictional variances in applicable laws across Australia, and it becomes clear that claims for injuries sustained on work sites might well require some careful navigation. Volunteers can certainly add an interesting element to the liability equation.

The injured volunteer

One issue that can often be overlooked is the potential liability that attaches to volunteers who are injured in the course of their work for organisations. On first glance it might seem a simple answer – volunteers are, by definition, not workers – so workers compensation is clearly not payable. But is that strictly correct in every case? 
In unravelling the possibilities, it is necessary to examine the three interrelated issues of definitional challenges, the employer’s broader duty of care, and the complexity of state and federal differences in this arena.

Worker versus volunteer

We have pointed to the seemingly basic logic that volunteers are, by their very nature, not workers. And in many workers’ compensation schemes across Australia, volunteers will be specifically excluded from the workers compensation definition of worker, as well as from the matrix used by insurers to ascertain premium costs. But this is unlikely to be the end of the story. Complexities can arise for example where volunteers take on some paid duties from time to time, or are paid some form of honorarium. 
Will this make them ‘workers’ for the purposes of workers compensation? 
The answer will of course depend on a number of issues, beginning with the state or territory in which the injury occurs. 
From there, the issue of payment and questions of control over the person’s actions will assist in establishing whether the person is – for the purposes of the law – either a worker or a volunteer. 
If found to be workers for the purposes of the relevant workers compensation scheme, then the issue might well be cut-and-dried under existing legislation.

Volunteers and the employer’s duty of care

Yet even if an injured party is clearly a volunteer and outside of the workers compensation realm, the employer will almost certainly be liable for the costs and/ or damage associated with any injury that a volunteer sustains while engaged by the employer. 
We know that employers understand the over-arching duty of care that attaches to all persons who set foot upon a work site – and the volunteer work force is no exception. The duty stems from the legal need for Australian business owners to ensure the health and safety of all persons who are present at premises or sites of the organisation. Naturally, this includes volunteers. Managing the risks associated with the duty of care owed to volunteers, staff and others at work is a crucial and ongoing exercise for employers. It is vital that organisations are clear on the coverage of their insurance for these differing groups of individuals. 

State and federal differences

Once risk is analysed in relation to the volunteer presence of an organisation, employers may need to address the question of appropriate insurance coverage for injuries sustained by volunteers. States, territories and the Commonwealth can have subtle but important differences around the reach of their particular schemes. Are injured volunteers subsumed under workers compensation in this state? Does a common law duty of care apply in this territory, rather than statute? Do I need to organise coverage for volunteers beyond my general public liability cover? And so on.
The liability of employers for injuries sustained by volunteers will be a complex question to answer. We often hear that organisations are deeply grateful for the valuable work of their volunteers, and are motivated to ensure their health and safety during their endeavours. Preparation is necessarily central to meeting our obligations in this complex field. Whatever the jurisdiction in which your volunteers are engaged, seek expert advice on the question of liability, should a volunteer injury occur at the work site.

Keeping up with process and procedural fairness in the workplace can be challenging. That's why we have developed the Workplace Investigation Toolkit.   Provide best practice principles and keep your business out of the Fair Work Commission.   Get yours here today.

Conflict in Volunteer Organisations: Lessons from the CFA

- Wednesday, December 14, 2016

The CFA dispute between paid and unpaid volunteers has been a salutary tale for any Australian organisation with a mix of volunteers and paid workers. In many cases, these groups work together in relative harmony. After all, paid staff and volunteers tend to share similar values and goals in these workplaces.

But how, when and why do things tend to go awry for volunteer-dependent organisations?

We examine the particular ‘hot spots’ within this space, including the underlying cultural tensions that can balloon into all-out conflict in the volunteer-based workplace, and set out simple tips for diffusing tension within this important segment of the Australian workforce.

Roles and resourcing

Many small charities and non-profits begin operations on a few dollars, a band of passionate volunteers and a dream to ‘do good’ in the world. As service demand grows – very likely when free or low-cost community services are provided – executives within a charity can quickly find themselves scrabbling to deal with competing legal, accommodation, client, staffing, volunteer recruitment, cash flow and supplier issues.

It is perhaps no surprise that the task of addressing cultural issues can quite rapidly shift down the list of priorities in volunteer bodies. Take for example the common disparity between the numbers of paid and volunteer staff. Dollars are sparse and it can seem logical to invest in the recruitment of an unpaid force of volunteers. Yet large numbers and intermittent shifts for volunteers can leave paid staff feeling confused and undervalued, particularly if the role of paid staff is overlooked in the effort to make volunteers feel appreciated.

Perhaps unsurprisingly, paid workers might then draw information and resources closer to their chests in an effort to protect their positions in an uncertain work space.

The volunteer’s dilemma

On the other side of the issue, volunteers can feel as though the treatment from paid staff in unfriendly and unhelpful. Intent on carrying out a community service, volunteers can find themselves excluded from knowledge and decisions to which paid employees are privy. Before long, an ‘us versus them’ mentality begins to grow. Yet all of this might go undetected by management. With important work to carry out for the organisation, issues of culture and conflict can quite understandably become overlooked. However, we do so at our peril – as the CFA debacle has so clearly illustrated.

So protracted has the struggle been between paid and volunteer Victorian firefighters that the federal government has felt compelled to get involved with a controversial amendment to the Fair Work Act 2009. This demonstrates just how far worker/ volunteer animosity can go if left unaddressed by employers.

Solving the conflict

We cannot emphasise enough the importance of early action when clashes between paid staff and volunteer workers begin to surface. At the first sign of difficulty between these groups, consider conducting a thorough workplace investigation to establish the nature and extent of the cultural problems.

Internal investigations can be helpful, yet there are many factors to consider when collecting data. These include strict adherence to the requirements of fairness, impartiality, privacy and completeness when conducting the inquiry.

In many cases it can make sense to call upon the services of a workplace investigation professional to assist with or carry out the process. Unfortunately, when some employers attempt to look into general issues of workplace culture themselves, well-meaning mistakes can be made in trying to ‘get to the bottom of this’. And the detrimental consequences can be considerable – should bullying or discrimination issues arise, a flawed investigation can mean that future formal processes will be hard to successfully manage.

Being forewarned

In volunteer-based organisations, it is essential that core business is not made the only issue that is worthy of energy. After all, the noble endeavour of fighting fires for the Victorian community has now become a poor second to the relentless issue of conflict between paid staff and volunteer firefighters. There are many pro-active and positive methods for dispelling conflict between the people in such worthy organisations. The key is early action, involving a swift, professional and fair investigative process into any brewing cultural difficulties.

Keeping up with process and procedural fairness in the workplace can be challenging. That's why we have developed the Workplace Investigation Toolkit.   Provide best practice principles and keep your business out of the Fair Work Commission.   Get yours here today.