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

'I Was Sent to Coventry' and Other Social Bullying Techniques

Vince Scopelliti - Wednesday, October 25, 2017

When we think of bullying, the clichés of schoolyard taunts might spring to mind. Yet as we learn more about the wide-ranging techniques of bullying, it is clear that this deeply complex phenomenon can be hard to pin down. 

For example, being ignored, or made an outcast in any situation - 'sent to Coventry' - can be highly distressing. This insidious brand of social bullying unfortunately arises in many workplaces, causing pain and anxiety for victims.

what is bullying? 

Bullying can be physical (including hitting or even destroying property), verbal, cyber (such as bullying on social media), and social. 

A person being 'Sent to Coventry' is a form of social bullying. 

So what do we mean by a person being 'Sent to Coventry'? Historically the phrase appears during the English Civil War when prisoners would be sent to the eponymous North-Western City for punishment, and experienced isolating treatment by locals. But how does this tend to manifest as workplace bullying? 

Picture this: on the surface, the workplace looks pleasant. There is occasional chatter and people seem content. But look closer - on Friday lunch excursions, one person appears to be ignored by the others as they leave. In meetings this person's colleagues seem to ignore their ideas, or quietly mock them when they have the courage to speak. They have also mysteriously been kept off the roster except for a few skeleton shifts... and so on. 

These are classic moves of ostracism as a weapon for workplace bullying. Left unmonitored, such behaviour can lead to severe stress and mental health problems for the outcast employee. 

The worker might originally have committed a 'sin' in the eyes of co-workers - perhaps told management about colleagues misconduct, or appears to be given special treatment. On some level, one or more workers have judged this as being unforgivable, leading to a long and toxic period of unrelenting silence, mockery and isolation.

bullying women, bullying men

What are the gender differences when it comes to social bullying? Unfortunately, this more covert behaviour seems to be a particular feature of female-to-female bullying

The phrase 'deafening silence' sums up the effect of this form of workplace bullying, where a worker is deliberately placed on the outside of a work group dynamic by one or more of their colleagues. 

The mechanisms are often subtle, and certainly challenging for management and workplace investigators to detect or prove. Yet by their very nature, stealthy and outwardly ambiguous bullying tactics in the form of ostracism and freezing-out can be painful and injurious for the victims of such attacks.

Men can also engage in subtle forms of social bullying, but are more likely to add overt actions as they bully a fellow worker. Particularly where rank or divisions enable such bullying, male offenders might sabotage the atmosphere and opportunities for targeted colleagues, later escalating to overt physical and verbal abuse. 

pulling rank - the hierarchical workplace

In the armed forces, emergency services and police, there is an opportunity for those in particular positions to 'close ranks' as a form of workplace bullying. For the victims of such behaviour, equipment can mysteriously go missing and vital operational information can 'somehow' bypass the bullied person. Aggressive taunts are also more likely in rank-based organisations.

questioning what is true

Most 'quiet' forms of workplace bullying seem to evaporate when management or a workplace investigator shows up. Also, consummate 'Coventry' bullies will sometimes alternate their attacks with neutral or even pleasant exchanges with the bullied worker. 

The victim is left on the back foot, unsure of what is real or imagined and often quickly becoming susceptible to both functional and mental decline as a result. Such 'gas lighting' attacks often cause the most long-term harm to a worker. 

Investigators must be vigilant in exploring alleged workplace bullying of this type. Common mistakes in the field can be when those investigating warm to often-extroverted perpetrators; bullies are masters of manipulation and can at times seem charming.

Conversely, the worker claiming bullying might appear nervy and unclear in their communication - perhaps even a little 'odd' compared to other workers. Rather than using this as a basis for dismissing the allegations, the history and behaviours behind all interviews must be carefully collated and compared with utmost objectivity. Indeed, the unusual presentation of a worker might in fact indicate a reaction to the effects of a covert system of workplace bullying.

Gathering evidence from multiple witnesses will often assist in identifying if there have been any patterns of behaviour from the perpetrators. 

When it comes to claims that a worker has been 'Sent to Coventry' and subjected to social workplace bullying, it is important to approach the ensuing workplace investigation with care. 

WISE Workplace is happy to assist you with any queries you might have regarding the right way to investigate any alleged workplace bullying incident. We offer unbiased, professional investigation services, carried out by a qualified and experienced team.

Bullying in High Stress Workplaces: Can an Investigation Help?

Vince Scopelliti - Wednesday, August 30, 2017

A disproportionately high number of allegations of bullying in emergency services and other high stress environments have led to a referral to the NSW parliament for an inquiry in May 2017, looking at the policy response to bullying, harassment, and discrimination in certain emergency services. A review is also being conducted by the Victorian Equal Opportunity and Human Rights Commission of allegations of bullying and harassment into the MFB and CFA. 

The very nature of the tasks undertaken in these workplaces understandably provokes a variety of extreme responses in both senior and lower-level staff. A combination of observed trauma, time-critical demands and associated spikes in adrenaline for individual professionals can lead to tense communication and decision-making.

It is essential that Human Resource (HR) managers take an objective approach towards all issues raised by the parties when allegations of bullying in emergency services arise. 

In many cases, a well-planned workplace investigation will mark the difference between costly repercussions and an efficient resolution of issues within these high stress environments. 

Alarming workplace reports

Incidents of workplace bullying are on rise across Australian emergency contexts. A 2017 report on emergency departments highlighted the deplorable extent of workplace bullying reported amongst emergency doctors. Shaming, verbal abuse and sexual harassment were just some of the parlous behaviours reported by 1/3 of survey participants.

Similarly, NSW has announced that the extent of workplace bullying within emergency services now requires a dedicated investigation. There are indications that the hierarchical nature of these services leads to the depersonalised treatment of personnel involved. 

Submissions for the NSW Parliament inquiry closed in July, with hearings scheduled for September - October 2017. During the inquiry, police, ambulance and fire services will each be scrutinised in relation to allegations of bullying and the troubling aftershocks that can accompany such incidents. 

Workplace bullying and hr responses

The importance of HR departments in recognising and dealing promptly with allegations of workplace bullying in emergency services cannot be overstated. 

As part of this focus, it is essential that any workplace investigation into alleged bullying be carried out in a professional and objective manner. Moreover, important decisions need to be made about an organisation's capacity to conduct an investigation that complies with the demands of procedural fairness. 

In some matters that are likely to prove particularly complex or sensitive it might be preferable to source the expertise of a trained workplace investigator. 

If HR managers can find prompt and accurate answers to these questions, any future costs of workplace disputes are likely to be mitigated. 

THE good and the bad of workplace investigations

Unfortunately, even a workplace investigation, if carried out without careful preparation and execution can be entirely unproductive - or even a costly blow to the organisation. At times, employers can underestimate their own lack of objectivity during investigations of workplace bullying. Unlike many workplace procedures, knowing the people involved can actually prove a hindrance to workplace investigations. The ability to see things in a truly fresh and clear manner is crucial to investigations; and sometimes hard to muster if preconceptions exist. 

Some employers are fortunate enough to have within their ranks staff that are fully trained in the nuances of workplace bullying allegations and the right way to conduct workplace investigations. When carried out correctly, an in-house investigation can do all that is necessary to produce a fair and accurate investigation report. 

Yet if any doubt remains about the potential bias, pre-judgement or lack of resources within the organisation, then an external workplace investigation will pay dividends. If an investigation has fatal flaws that are later picked up in official proceedings, then employers will find themselves in an unenviable position.  

investigation woes: a case in point

In a recent Federal Court matter, Justice North made a piercing analysis of the deficiencies in one organisation's methods of investigation. Victoria's Royal Women's Hospital conducted a workplace investigation into the alleged contribution made by a neonatologist to the deaths of two infants. His Honour explained that the deficiencies within the investigation report were significant. Vague allegations against the worker and the lack of specifics concerning event, time and place led to a report that was devilled by 'apparent holes' as well as 'pollution' from fraught relationships. 

The case highlights the importance of gaining true objectivity from the situation whenever a workplace investigation is undertaken.

Care at every turn

Employers understand that when allegations of workplace bullying arise it becomes essential to keep the elements of procedural fairness front-and-centre. HR and senior management must make fast and accurate decisions about how and when to activate a workplace investigation. 

Considering the disproportionately high number of allegations of workplace bullying in emergency services, it is hoped that good decisions are made around the best way to investigate these troubling situations. 

Should you or your organisation be seeking clarity on the best way to conduct a workplace investigation, please get in touch with us.