Disrespect among the health and behavioral health workforce has reached a crisis point. Escalating incidents of workforce bullying and harassment touch every practice setting. I receive weekly emails that provide stories of belittling among professionals that are so atrocious my heart aches. Those who approach me following my presentations to disclose their experiences display powerful emotions and raw wounds, independent of whether the situation happened decades ago or the past week. The data presents concerning implications for all industry stakeholders:
· 68% of executives identify bullying as a serious problem in their organizations, though only 5.5 % actively do anything about it.
· 30% of the 90,000 charges received by the EEOC included an allegation of workplace harassment.
· Workplace mobbing (bullying by group) occurs 37% of the time in organizations.
· 48% of employees deliberately reduce their efforts when faced with disrespectful colleagues.
There is momentum and expertise being devoted to shift the workplace bullying tide, from organizational and workforce education to advocacy and therapy. Some entities focus on research and public education while others promote legislation like the Healthy Workplace Bill. Yet despite the efforts targeting the devaluing and harassment of persons across every workforce sector, bullying continues to escalate, particularly in health care. Some experts challenge that bullying is an occupational hazard of any workplace culture today. Others say organizational cultures directly promote it.
Organizational Culture as a Factor
Many professionals view bullying as an extension of a more pervasive organizational culture, one that seeks to enable disruptive behaviors more than negate them. While it can be a simple cop out to blame oppressive behavior on someone or something else, there is credence to the argument. Prior articles and blogs discuss the impact of power and hierarchical leadership cultures on bullying. Employers marked by climates that reflect fear, insecurity, and disbelief tend to have a higher incidence of bullying. Corporate cultures play a significant role in encouraging a workplace atmosphere that enables bullying and mobbing behaviors. Companies may explicitly reward assertive, if not aggressive behavior by promoting these individuals. As far as the C-suite is concerned, these persons get the job done. They can achieve the most successful outcomes, such as lowest length of stay or the highest prices for negotiated rates with insurers.
In health care organizations where team members often vie for limited resources, antagonism can easily become the norm. Workplace relationships become fraught with dysfunctional dynamics, marked by hostile and oppressive behaviors. An implicit message like ‘length of stay is too high’, or ‘return on investment isn’t demonstrated’ perpetuates abuse by encouraging ruthless competition among staff. Bullying behaviors becomes reframed as ‘do anything necessary to get the job done’. This mandate makes it acceptable to have verbal confrontations with colleagues as opposed to respectful professional communication. In a work atmosphere of these types of toxic behaviors, even the best employees can become drawn into negative interactions; their alignment akin to following the path of least resistance. At the end of the day over 72% of organizations continue to dismiss, deny, or discount bullying behaviors. Over 60% of organizations have no policies in place to manage these situations. Let’s face it; most frankly don’t want to deal with it.
Poor management further fuels the fire. Often the concerns that staff have about bullying extend to the quality of client care. Staff are put in the untenable position of wanting to speak out about their concerns, but feeling unable to do so for fear of retribution. This type of workplace has a toxic culture to its core! In the case of the Liverpool National Health Service, many are still reeling from the impact of a toxic culture of this type on patient safety and workforce trauma. Why must these situations reach the point of client harm and/or professional trauma and often suicide before any action takes place?
Which Cultures Live in Your Organization?
A number of workplace cultures can live in an organization. Any one or more of them can influence bullying prevelence positively or negatively within the workspace:
- Dictatorial Culture: relies on power and control, with high levels of secrecy and jealousy among staff. There is little room for positive relationships to be built among and by employees.
- Disjointed Culture: lacks core values, and checks and balances on power. This workspace can appear hierarchical and bureaucratic, with little consistent enforcement and emotional reactions common to handle conflicts.
- Stable Culture: provides clear goals, rules, and values for employees, along with clear communication patterns (HINT: This is what you are striving for!).
The type of organizational culture can influence how readily an entity can respond to and prevent bullying. Defining the type of culture in the workplace is only part of the fix. An organization must first acknowledge bullying exists at all. Only then can shared interprofessional commitment create, implement, and enforce anti-bullying and harassment policies. Consensus will contribute to collaborative efforts, which build workable prevention programs that can minimize bullying episodes and occurrences. Staff retention is also known to be greater in these environments.
What Can You Do To Shift the Culture?
Several years ago I became irate when I uncovered data that attributed poor team communications from bullying to increased medical errors, plus deaths of clients and professionals. A culture of bullying is antithetical to the professional standards and ethical codes that underlie each discipline on the interprofessional team. How can an industry that grounds practice by assuring respect for inherent dignity and human rights for all individuals have the highest incidence of bullying? How can those persons tasked to protect clients from non-maleficence, in turn treat colleagues with such malice that they commit suicide? From my lens, we have reached that place where organizations must be held as accountable as their individual employees for how they promote a bullying culture. Of course, it must be stated that organizational cultures are not known for quick fixes. They are however prone to steady, progressive, and enduring changes.
1. Intervene early: Confront the person or persons involved.
2. Use Human Resources: Most don’t want to involve HR, but should you seek legal action, you must show you went through appropriate channels (as ineffective as those channels may be).
3. Don’t become isolated: You’ll want to retreat, but stay engaged with colleagues and friends to support you.
4. Do a self-check: Most often than not, it’s not you! It’s still good to check.
5. Document, Document, Document: The old mantra remains!
6. Don’t react to the bully: Reacting is exactly what bullies want you to do; instead stop, breathe, process.
7. You’re stronger than you realize: Remember bullies go after those who threaten them most!
8. Seek independent legal consultation: Use those in the know vs. those you simply know.
9. Obtain an independent mental health consultation: Seek objective support from a professional.
10. When nothing works, get out of there!: Recognizing you’ve hit a wall is not a weakness but a strength.
Want more on this topic? Watch for the article, The New Age of Managing Workplace Bullying and Violence in Health Care: Part 4, Organizational Culture and Beyond in Professional Case Management come November 2018.
Until next time...Stay Resilient