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Unifying our approach to bullying, incivility, and violence

Snakes at the nursing station

By: Judith Briles, MBA, DBA

Let’s face facts: Some nurses aren’t kind to their colleagues. Some get their kicks by playing the saboteur or bully, committing acts of treachery and betrayal ranging from damaging or destroying others’ property to spreading lies about colleagues with the goal of destroying their reputations or getting them fired. If these behaviors are tolerated, the workplace becomes toxic.

How do you confront the offender—the “staboteur” as I like to call the backstabbing variety—without setting yourself up for further attack? How do you convert the saboteur or bully into an ally, or at least a nonaggressor? And how do you deal with pit bulls who delight in intimidating coworkers?

Over the past year, I’ve received dozens of requests from nursing candidates asking permission to use the Sabotage Savvy Questionnaire I created to measure the amount of undermining in the workplace. Why all the interest in sabotage and bullying? Because, sadly, such behavior is common. Pit bulls, scorpions, and snakes create conflict in an effort to feel powerful. They get their fix by undermining colleagues. Their behavior lowers morale, magnifies stress, reduces productivity, and increases turnover. Collectively, it costs employers millions of dollars annually. Unless the perpetrators are dealt with, some victims quit while others stay but detach themselves emotionally from the workplace.

The gender factor

The healthcare workplace is overwhelmingly female. In the eight national studies I’ve done on workplace conflict (both within healthcare and in general), I’ve consistently found female saboteurs are more likely to target other females, whereas males show no gender preference. Also, women are more inclined to sabotage in a covert way while men are more overt.

In these surveys, I asked, “Have you ever been treated unethically by a man or a woman?” Respondents who answered “yes” were instructed to indicate whether the treatment came from a man, woman, or both. Another question concerned gender work preferences: “If you had a choice, would you prefer to work with men, women, either, or neither?” In all eight studies, about one-third of female respondents said they preferred not to work with other women.

In the two studies I conducted for my book Zapping Conflict in the Health Care Workplace, 34% of female respondents said the same thing. In the first study, respondents from both management and staff said workplace conflict had increased in the past 5 years.

I created the second survey after an internal report by a nonprofit healthcare provider alliance concluded that the nursing shortage stemmed primarily from abusive physicians. I had my doubts, and decided to conduct my own survey into why healthcare professionals had left their jobs. Of my 1,338 respondents, 830 were nurses, 375 were managers or administrators, and the remainder held other positions. When asked if they’d left because of abusive behavior, 45% said yes; when asked if the behavior was bullying, sabotage, harassment, other, or all of the above, 48% answered “all of the above.” When asked who’d generated the abuse, 47% said a manager, 17% said a co­worker, and 31% said a combination. Only 5% attributed abusive behavior to a physician.

Stopping the sabotage, disarming the bullies

Can workplace sabotage and bullying be stopped? Yes, if you have the right attitude and use the right tactics.

First, call things what they are. Many women are reluctant to label undermining activities as sabotage. But that’s exactly what backstabbing, gossiping, taking another’s credit, and not passing on vital information are.

Being aware that conflict and sabotage exist in the workplace increases your confidence. Saboteurs and bullies choose their victims carefully, constantly scanning the environment for timid, insecure, unassertive types. If you exude confidence, you remove yourself as a target; you’re simply too much work to bring down.

Confronting the perpetrator

A toxic workplace is bad for everyone—but confronting a bully or saboteur is no picnic, either. Most of us would rather not risk making a fool of ourselves by confronting a tormentor, so we end up getting stuck in a conspiracy of silence. From an early age, females are socialized to avoid conflict and confrontation. We don’t speak up—at least not to the right person. We’re more inclined to confide in a best friend, spouse, or relative than confront the person who’s making us miserable.

But confrontation is exactly what’s needed to eliminate the bad behavior. And the sooner you do it, the better. In the thousands of interviews I’ve done over the years, virtually every respondent who’d been a victim of sabotage said she wished she’d confronted the perpetrator.

If you stay silent, you’re condoning the behavior. Your silence is saying, “Keep doing it—to me, to anyone. It’s OK.” That’s exactly the wrong impression to convey. If you confront this person instead, you’re sending a much different type of message: “Back off. I’m not easy prey.”

Confrontation by carefronting

Carefronting (meaning caring enough to confront) is a communication model you can use to confront disrespectful behavior in a caring but assertive way. It’s based on a standard conflict resolution script that’s been around for ages. After tinkering with the specifics for the past 20 years, I’ve created my own script that includes seven key lines.

I recommend you try this technique. The more comfortable you become with it, the more successful you’ll be. After being carefronted, the bully or saboteur is likely to stop being aggressive with you. She may even become your ally, perceiving you as someone not to “mess with.”

Opting out of the perpetrator’s game

The final step in changing sabotaging or bullying behavior is to commit to not playing the perpetrator’s game—and then to implement your commitment. Don’t just talk about it. When someone does something unacceptable, call that person on it, to his or her face. Carefront it.

It takes courage, but it’s worth it. The workplace doesn’t have to be toxic. The choice is yours.

Judith Briles, MBA, DBA, is a full-time public speaker and author. She has written 25 books, including Zapping Conflict in the Health Care Workplace, The Confidence Factor, Stop Stabbing Yourself in the Back, and Money $marts: Personal Financial Success in 30 Days! Her next book, Is There a Staboteur in Your Midst?, will be available this winter. Her website is


  • Nena Denise Ram
    May 26, 2023 9:33 pm

    This is great information. Lots of productive tips to promote a healthy and productive work environment.

  • Jennifer Dawson
    March 8, 2023 11:47 pm

    To make work more pleasant to be there.
    To also help improve lack of management improvement.

  • Jennifer Dawson
    March 7, 2023 7:39 pm

    Good information to help make work a more positive environment.

  • Mackenzie Brown
    March 7, 2023 10:00 am

    Very Helpful always got to be in an professional manner.

  • Jasmine Johnson
    January 24, 2023 1:55 pm

    Totally helpful best thing is go to work do your job description. Just do your job don’t try to make friends it’s just business keep yo yourself be the best CNA you can. Win win situation no problems

  • kaaagbayjaren@gmail.com
    December 7, 2022 8:55 am

    this article very helpful to us just to be aware everyone

  • Shakira Harvey
    November 4, 2022 9:11 am

    I have came across a ignorant nurse and she would send me home on her shifts because I wouldn’t let her be rude to me. I think no matter what position you have respecting each other is top tier no matter what the situation may be.

  • Shakira M Harvey
    November 2, 2022 7:21 pm

    The ways I could confront a coworker, is politely asking to them without others being around. If I felt that my coworker hurt my feelings I would voice that to her, I would even apologize if I offended her and hold myself accountable. We would come to a “common ground” get passed it and go to work. Communication is a big factor in life so without it starts a lot of confusing.

  • Shakira M Harvey
    November 2, 2022 7:15 pm

    I agree to with this article. I have learned to go to work to work and dont focus on becoming friends with any coworkers. I tend to be cordial with everybody so I can do my job and head home afterwards.

  • Aleah Hollingsworth
    April 21, 2022 1:12 am

    Unfortunately there tends to be a bad apple in every bunch. However, I refuse to take a bite. Focus on your performance as a professional and the care patient/ residents. Your work will speak for itself and the enemy will be exposed. Also there are other ways to handle snakes… confront them with a superior and they will slither no more or less. Some people just can not help themeselves.

  • Leanne Robinson
    August 20, 2019 10:45 pm

    One of the big issues here is lack of management. In a facility that has lacking management, these bullies run amok, many times targeting people that are in positions of authority to them (i.e. the nurse’s aide who’s insubordinate to the nurse because she knows she can get away with it). I’m going through this now. I complained about an aide who decided for no reason that she doesn’t like me and in retaliation, refused to answer call lights or care for any of my patients. It got to the point that bed alarms were going off for 5 minutes while I was in another patients room; she’s putting my patients at risk of harm. I reported her twice and nothing happened. The third time, it was addressed, and she in turned lied to a manager the next morning and said one of my patients complained about me. I’ve been at the facility 6 months with no issues, no complaints, no disciplinary action, and I was fired without any investigation or anyone talking to any of my patients.

  • Virginia Albin
    July 19, 2019 12:29 pm

    I need to confront a backstabber next week who always tries to make me look stupid. Problems in the issue she goes to other people and tries to stir up trouble instead of talking to me about it. She’s accused me of stuff I haven’t done over three times, but never talks to me about it . Please wish me luck!

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