That’s a bully for you

In order to combat the large and growing problem of power abuse, organisations must understand its many forms. 

For more than 30 years, Melanie Stephens has worked as a nurse. She has moved around Australia working in different hospitals and medical facilities.

Stephens, whose name is changed here, has enjoyed the responsibility of a being a nurse. It wasn’t until she was injured on the job, not once but twice, that she ever experienced any kind of bullying.

“When I was able to complete my full duties I didn’t notice any bullying but as soon as I was unable to … the other nurses made me feel uncomfortable,” she says. “They made it incredibly difficult for you because I couldn’t lift a patient. It is not that I didn’t want to, it was just that I didn’t have the strength or the ability to because of my injuries.”

Stephens suffered both injuries whilst on shift and was subsequently allocated administrative duties.

“The first injury I suffered was when I slipped and tore cartilage in the right knee,” she says.  “That took a while to recover and a few years later I fell again and seriously injured my left shoulder.

“Eighteen years later, I still have serious issues with my left shoulder and I undergo radiofrequency neuro ablation to try and ease the pain. When you have an administrative job and you need time off to have treatment, which is all arranged beforehand, I found a lot of nurses [don’t] believe your injuries and they just assume you wanted to get out of work, which was never the case,” Stephens says.

“But I do believe a strong senior registered nurse can put an end to the gossip and bullying. I was made to feel very uncomfortable wherever I worked when I couldn’t complete the normal duties of a nurse, despite my chronic injuries. I don’t believe anyone should have to put up with bullying in the workplace.”

Lisa Fitzpatrick, secretary for the Victorian branch of the Australian Nursing & Midwifery Federation, believes bullying is growing across the whole healthcare sector and that a long battle is ahead to try to stop it.

“It is a huge problem and continues to grow,” Fitzpatrick says. “In our Victorian branch we have put on additional staff just to keep up with the growing number of complaints.

“I think now that there is increased awareness of bullying and people know their rights, we are seeing more people speak up about it. What is concerning is that it is not restricted to a particular area of the healthcare sector but widespread across it.

“It comes in many forms – from doctors to nurses and nurses to nurses, to patients and relatives bullying nurses.”

Fitzpatrick believes one of the reasons bullying by patients and relatives has increased is quick turnover. Gone are the days when patients would arrive the day before surgery and a nurse could get to know them and their background. Often now patients are in and out on the same day, frequently only an hour or two after surgery.

“As a consequence, patients are more demanding, putting nurses under more pressure,” Fitzpatrick says. “I believe the whole healthcare approach needs to be addressed. A lot of bullying issues don’t get resolved and the issue escalates until it is too late.

“Very rarely do you have a positive resolution at the end because neither party is happy and neither wants to move on. It is very difficult to re-build relationships with people.”

Bullying is most often defined as having four components: the intent to cause harm; repeated acts; one individual or a group attacking another individual or group; and a power imbalance, says Sue Anderson, coach, trainer, co-founder of Good2gr8 and author of the book Unbullyable.  “Serious bullying may also include conduct or behaviour that is intended to, or could reasonably be expected to, cause the victim of the bullying to engage in suicidal thoughts or thoughts or actions that involve self-harm.”

The ANMF now runs regular Prevention of Workplace Bullying seminars across the country. These address concerns for nurses, midwives and personal care workers, providing strategies for preventing and dealing with incidents of bullying and harassment. The focus is on workplace policies and procedures, addressing the needs of employers and employees.

The ANMF has also put out a document, Workplace Bullying: A guide to assist members.

“We need to make inroads into bullying,” Fitzpatrick says. “It is a hard slog but I believe that if organisations have clear workplace policies and procedures in place that are transparent, and staff are made aware of them, it will help.”

Bridgette Wheeler has worked in hospitals in Australia and England. She has done ward duty, worked in emergency in public hospitals and worked in private facilities. She believes that due to the stress and nature of the job, bullying does occur.

“I can’t say I have experienced it myself but I have witnessed it,” Thompson says. “The bullying varies from organisation to organisation, depending on who is in charge and how it is run. A lot of old school nurses believe in the approach of ‘It’s my way or the highway’ and this can cause conflict.”

Wheeler thinks a re-examination of what constitutes bullying may be necessary – starting at university.

“The other issue to consider is actually what is bullying?” she asks. “I mean when you are working in emergency and other stressful situations there isn’t time for debate. Things need to be done and they need to be done quickly. How you deliver that message can be entirely dependent upon the stress you are under.

“Perhaps it is time for the university courses to alter what they teach and focus on more dealing with stress under conflict for nurses when they enter the profession.”

Melanie Birks, professor of nursing, teaching and learning in the School of Nursing, Midwifery and Nutrition at James Cook University says the role of university courses for nurses is to ensure that critical skills are taught so people are ready for the workplace and can provide excellent care for the patient.

“Everyone knows the difference between good and bad practice in a workplace but unfortunately bullying is still predominant today,” she says.  “It is an ongoing issue, which a lot of people still don’t report. They just simply leave their jobs, which is sad.”

As this suggests, addressing bullying is not easy, as most people are conditioned to focus on their job first and worry about the personality clash later. Unfortunately, continual emotional conflicts at work affect our ability to perform our duties.

Sydney-based stress consultant Leo Willcocks believes part of the problem is that the person being bullied doesn’t believe in themselves and therefore accepts what is happening to them.

“Often those that are bullied do not have the skills to handle bullying. Some even feel deep down that they are not worthwhile,” Willcocks explains. “Many of my nursing friends and clients have said to me they have noticed that many nurses have come from backgrounds where they were treated as second rate.

“They were good and kind people, but had learned to put others before themselves to the extreme. They may have been bullied within their family or culture, and have always been afraid to stand up to bullies. That fear carries on into their adult life and makes being bullied as an adult particularly stressful. They still feel incapable of dealing with bullies.”

Willcocks makes the observation that often nurses work for low pay and in stressful conditions, making the situation even more intolerable.

So, where does the solution lie?

“Part of the solution is to hold people accountable for their behaviour, regardless of how it is perceived by the target,” Good2Gr8’s Anderson says. “Another way to confront bullies is to help bullies empower themselves so they don’t have to bully anymore.”

Willcocks argues that everyone in the organisation needs to be a part of the answer.

“To really tackle this issue, staff at all levels need to be part of the solution – from the CEOs to ENs and everything in between,” he says. “Higher management needs to see the value in resolving bullying, such as higher staff morale, better patient experience, staff being more able to give their all. Management need to act on bullying accusations objectively and not sweep bullying under the rug, much like how bullying from patients is not tolerated.

“Nurses who are vulnerable to being bullied can help build the courage to confront bullying. This often means being willing to overcome fears. It also means learning to see themselves as equally important and worthy and deserving of being treated well.”

Brodie’s Law

Victoria’s anti-bullying legislation, known as Brodie’s Law, commenced in June 2011. It made serious bullying a crime punishable by up to 10 years in jail. The law was introduced after the suicide of a young woman, Brodie Panlock, who was subjected to relentless bullying in her workplace.

Brodie’s Law makes serious bullying a criminal offence by extending the application of the stalking provisions in the Crimes Act 1958 to include behaviour that involves serious bullying.

Conduct that amounts to serious bullying carries a maximum penalty of 10 years’ imprisonment. The law applies to physical, psychological and verbal bullying, along with cyber-bullying. It covers actions occurring anywhere in the community and on the internet, including email or social networking sites such as Facebook and Twitter.

Upwards bullying in academia

Bullying is not just an issue in clinical practice, it is also prevalent in academic institutions around the country, professor Melanie Birks says. And she says in that environment, often it’s directed from the bottom up.

“You see upward bullying in academia,” Birks explains. “Lecturers are assigned subjects that they don’t want to teach so they complain to either human resources or to the union that they are being bullied, when in reality they are being asked to do their job, which they are being paid for. This can be an example of upwards bullying, which occurs when subordinates act against a supervisor.

“The question is who is being bullied? Is the person making the allegations bullying? Or is the person accused the bully?” Birks asks.

A professor of nursing, teaching and learning in the School of Nursing, Midwifery and Nutrition at James Cook University, Birks is also co-author of an article titled “Turning the Tables: the growth of upward bullying in nursing academia”.

The article, which appeared in the Journal of Advanced Nursing, states that the trend to impose legislation around workplace bullying has led to a significant increase in bullying claims. It states that whilst anti-bullying laws have good intentions, the claims can be destructive, particularly where managers are trying to ensure that employees handle reasonable workloads efficiently and effectively.

“Upward bullying thrives in organisations that are struggling to respond to change” and its behaviour “often takes the form of destructive, disruptive and passive behaviours”, the report, co-authored with Lea Budden, Lee Stewart and Ysanne Chapman, states.

“I have found that bullying often comes from middle managers who don’t want to do a job,” Birks says. “Bullying is often used against a senior manager and once an allegation is made, it is hard to shake. We really need to change the mindset at universities in Australia.”

Types of bullying

Vertical: This involves a supervisor bullying nurses under his/her management.

Horizontal: Can be described as bullying at a nurse-to-nurse level.

Upwards: Where supervisors are the target of bullying from nurses under their management.

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