Self-awareness and honest feedback can help you make a change.
- Bullying and incivility are prevalent in the nursing profession, so we each need to determine if and how we contribute to the problem.
- If you’ve recognized your behaviors may be considered bullying, make a commitment to yourself and your coworkers to get the help you need to adapt your behavior.
IF NURSES around the world are talking about nurse bullies, we have to ask ourselves, “Who are the bullies?” The answer is that we are. We, nurses, are the bullies, or at least we have to consider that we might be.
Nurses are known for being compassionate, caring, dedicated, competent, selfless, and committed to their patients. These same nurses also can be cruel, uncaring, uncivil, and brutal to their colleagues. Within each of us lie good, bad, and sometimes ugly behaviors that show up in the workplace. Some behaviors—such as eye rolling or not being overtly friendly—elicit less damaging effects. Other behaviors—such as withholding information, ignoring requests for help, and setting someone up to fail—disrupt the work environment and threaten the safety and quality of patient care. When caring and compassionate nurses resort to the silent treatment, make unfair assignments to nurses they don’t like, or openly criticize colleagues in front of others, patient care is compromised. (See Scope of the problem.)
“I’m the bully”
Connie (not her real name) was invited to a leadership workshop to discuss bullying and incivility. She’d been a nurse for more than 30 years and was working as the operating room director. About halfway through the workshop, Connie stood up and proclaimed in front of her colleagues, “I’m the bully.” Her assistant manager and charge nurse, who were sitting next to her, quickly jumped to her defense, “No, you’re not. You’re just a bit intense.” Connie again proclaimed,“I’m telling you, I’m the bully. That’s me up there [referring to the list of bullying behaviors on the screen].” However, her colleagues defended her innocence until finally, they both said, “Okay. You are the bully, but we’ve been too afraid to tell you!”
Why was Connie able to recognize her behavior based on the material presented during that workshop, but not before? Couldn’t she see how her repeated patterns of overt yelling, targeting employees she thought were weak, and barking demands were characteristics of bullying? Connie said that although she knew she could come across as abrasive, she justified her behaviors as “for the good of the patient.” For 30 years, Connie was known as a bully, but it wasn’t until she was able to self-reflect and recognize her behaviors during the workshop that she made the decision to change her behavior.
If we’re going to finally put an end to the rampant incidents of bullying and incivility within the nursing profession, we each need to take a hard look in the mirror.
Bullying vs. incivility
Not all disruptive behaviors can be labeled as bullying, so nurses need to understand what bullying is and what it isn’t. But keep in mind that all acts of disruptive behavior in healthcare settings—whether it’s bullying or incivility—aren’t acceptable and should be addressed.
Although a legal definition of bullying doesn’t exist in the United States, the general definition is “repeated patterns of disruptive behaviors with the conscious or unconscious attempt to do harm.”
For a behavior to be considered bullying, you need a target, the behavior must be harmful in some way, and it must be repeated over time. For example, suppose that an experienced nurse, for whatever reason, doesn’t like a newly hired nurse. She openly criticizes her, refuses to help her or take report from her, and withholds information during shift report. The experienced nurse treats all of the other new nurses as professional colleagues. This is bullying.
Incivility includes being rude, inconsiderate, and disrespectful. It shows up as gossip, condescending body language, helping the people you like, and not helping the people you don’t like. It’s the eye rolling, mocking, and clique-like behavior too often seen in workplaces. Although bullying is typically addressed through workplace policy and codes of conduct, incivility is addressed through culture change.
Begin with self-awareness
As I work with healthcare leaders to cultivate a healthy, professional, and supportive workforce by addressing workplace bullying and incivility, I’ve learned that the bullies can’t be “everyone else.” If over 90% of new nurses report witnessing or experiencing bullying behavior, we all have to look in the mirror and determine if we might be the bullies or at least, in some way, contribute to an uncivil work culture.
Start by taking an introspective look at your behaviors using a self-assessment tool, like the one I created.(See What if the bully is you?) Complete the assessment honestly and identify areas where you may be contributing to an unprofessional work environment. This assessment tool hasn’t been validated, but it provides a quick and easy opportunity to self-reflect. For a validated, more comprehensive assessment, consider Dr. Cynthia Clark’s Workplace Civility Index (bit.ly/2Tu2k3k).
Answering “sometimes” or “frequently” to many of the questions on the “What if the bully is you?” assessment may indicate a pattern of disruptive behaviors that could be defined as bullying. This may come as a shock, or you may already know that some of your behaviors are unprofessional. Remember that there are levels of disruptive behavior; if you answered “frequently” to some of the questions, you may be exhibiting low-level (incivility) behaviors. Whatever the level of your behavior, you need to make a change. And recognizing the need to change is usually the toughest part.
After you complete the assessment and identify that you’ve behaved unprofessionally, regardless of the reason, you now have an opportunity to step up and choose to conduct yourself professionally.
I read this story a few years ago about a man who was curious about who the “mean guy” was in the neighborhood: People were always talking about this mean guy who lived on our block. I decided to go see for myself. I went to his door, but he said he wasn’t the mean guy; the mean guy lived in the house over there. “No, you stupid idiot,” I said, “that’s my house.” It may be difficult and uncomfortable to open yourself up for scrutiny and awareness of your own behaviors, but such openness is a quality of maturity and professionalism.
Ask for honest feedback
Admit to your coworkers that you recognize you haven’t always treated them professionally and that you intend to change. Ask them to be honest and direct with you if they see you behaving unprofessionally or uncivilly. Tell your coworkers, “If I ever come across as_________, please let me know because I really want to improve.” The key here is that when someone does call you out on your behavior, you need to be open to it and refrain from being defensive. Reacting defensively to the feedback will reinforce a culture of silence.
Ask your supervisor for honest feedback, too. Don’t assume that just because your supervisor hasn’t talked to you about your behavior that your coworkers’ complaints are unwarranted. Many managers and supervisors struggle to have difficult conversations with staff. Bringing it up yourself may be just the opening your supervisor needs to have an honest discussion with you.
If you recognize bullying behavior in yourself, avoid spending excess energy on guilt and self-deprecation. Nurses who bully don’t always make a conscious decision to treat their coworkers poorly. Sometimes they adopt bullying behaviors to cope with the demands of the job, protect themselves from others, or because they have personal issues that are spilling over into work.
To that end, don’t be afraid to seek professional help to achieve the changes you’re striving for. Most healthcare organizations offer some type of employee assistance program, which may be no or low cost. You also can find a trusted mentor, someone who will give you honest feedback and offer you suggestions about how to adapt your behavior.
Do your part
There’s no shame in realizing you’ve been behaving asa bully; the shame lies in realizing you’re a bully and doing nothing about it. If you’ve openly criticized co workers or made fun of another’s mistake, make a vow that you won’t behave that way again.
When Connie admitted she was the bully and her assistant manager and charge nurse finally had the courage to agree, she cried, they cried, we all cried.
The entire room of 75 people applauded her, not because she was the bully, of course, but because she was able to finally see herself through other people’s eyes. She vowed, in front of everyone, that she would do everything she could to change her behavior. And she did.
You can’t fix something if you don’t even know it’s broken. We’re losing great nurses to bullying and incivility. Everyone has to do his or her part to stop the cycle of nurse bullying—even the bullies.
Renee Thompson is the CEO and founder of the Healthy Workforce Institute in Pittsburgh Pennsylvania (email: firstname.lastname@example.org). She’s also the author of the book “Do No Harm” Applies to Nurses Too!
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