Dr. Renee Thompson on Nurse Bullying

Dr-Renee-ThompsonDr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate bullying behavior.

What got you interested in workplace bullying?

When I worked as a nurse executive, I conducted a lot of focus groups and spent a lot of time talking with nurses about how to onboard new nurses and help them succeed. Many of the nurses shared horror stories of how they were treated by the other more experienced nurses. Student nurses and new nurses shared their stories about bullying. Their stories reminded me of my own experiences of being bullied when I was a new nurse and even as an experienced nurse.

This experience led me down the path to learn more about nurse-to-nurse bullying. What I found was that there was a lot of literature about what bullying looks like and why it occurs, but there wasn’t a lot about how to stop it. That’s when I decided to write the book and get more involved in working with individuals and organizations to eliminate workplace bullying.

Why does workplace bullying take place?

Workplace bullying takes place because it can. Firstly, we accept the behaviors as the norm and fail to recognize bullying behavior as a problem. We say things like, “that’s just the way it is in nursing.” Sometimes we say to others, “well, that’s just how she is. Don’t take it personally.” Secondly, when employees are bullied, they don’t speak up. 40% of all targets don’t tell anyone that they are being bullied. This silence occurs because of the fear of retaliation. Targets are afraid that if they speak up, the bully will find out and retaliate against them. Thirdly, leaders use silence as a strategy. Nobody teaches leaders how to address the bad behavior of their employees, yet 85% of a manager’s time is spent dealing with the behaviors of their employees. That is how the cycle of workplace bullying continues.

What are common types of bullying? When does the line cross from teasing to bullying?

Not everything is bullying. Sometimes it is teasing, being rude, or inconsiderate. For a behavior to be considered bullying it has to repeat. A common definition of bullying is the repeated pattern of destructive behavior with the conscious or unconscious attempt to do harm.

Some of the common behaviors include public criticism, threats, intimidation, sabotage and withholding information, gossip and rumor mongering, favoritism and exclusion, etc.

Does workplace bullying take place more publicly or privately?

Both. Some people who bully love an audience where they may yell, criticize, or treat someone in a condescending manner in front of others. We tend to refer to these behaviors as overt. However, there are a lot of covert bullies who either treat others poorly, but only in private, or can be so nice to your face but as soon as you turn around, they are stabbing you in the back!

Do you see this occurring in all workplaces or especially with nurses?

Bullying is destructive, pervasive, and exists in every industry. However, there is a high prevalence of bullying in the nursing profession for several reasons. One reason is because of the high stress environment nurses work in. When stressed, nurses tend to lash out at each other. A second reason is because of a general feeling of oppression. Nurses cannot say no to patient care and therefore, feel as though they don’t have a voice or control over their work. This also leads to high stress. In general, nurses are taught good coping mechanisms and may resort to releasing stress and frustration in unhealthy ways.

Nurse sitting in a corridor while holding her head in a hospital

How does bullying affect the workplace environment and work ethic?

We know that individuals pay the price for bullying with their physical, mental, emotional, and spiritual health. Organizations pay the price for bullying with their profits. Globally, organizations lose over 6 billion dollars per year due to bullying (in all industries). Ultimately, patients pay the price too. Studies show that organizations with a high prevalence of bullying have worse patient outcomes.

Is this something you see in most workplaces?

Yes. Bullying exists in all industries and represents a global issue. Nurses from all over the world reach out to me asking for help. Although bullying isn’t rampant in every department, every organization has some degree of bullying.

Once it is established that there is workplace bullying present, how do you approach the situation?

I first recommend getting very clear about the behavior and how it is impacting the work. So many people will just complain that someone is “bullying” them but it’s very difficult to address “bullying”. Getting clear on the behavior (called me an idiot in front of patients) can provide the opportunity to address specific behavior. I also recommend starting a documentation trail of bullying behavior. Dates, times, locations, incidents, witnesses, etc. Any time you can include verbatim comments, include them. Always link a behavior to a patient safety concern or strategic goal violation. Lastly, confront. I write a lot about confronting techniques in my book and my other various anti-bullying programs. There are simple ways to confront and more complex ways. The key is to stop using silence as a strategy.


Are these techniques applicable to other workplaces?

Of course! Bullying is a human issue. If you have humans working in your organization, you have the potential for a bullying problem. I specifically work with healthcare organizations and academic institutes to stop the cycle of bullying. However, the same principles apply to any industry.

Is there a way to prevent workplace bullying from happening before it is present?

Yes! Firstly, an organization has to set behavioral expectations immediately upon hire. This can’t just be to ask employees to sign a code of conduct or read the policy on behavior. Leaders have to engage employees in conversations about bullying versus professional behaviors. Secondly,  you have to provide skill development for your front line managers to teach them how to hold their employees accountable for behaviors. Thirdly, the organization has to provide the resources employees need to create professional workplaces (ongoing training and education, robust policies that address workplace bullying, and a surveillance system to monitor behaviors). Leaders need to hold everyone accountable for professional behavior. Even themselves.

We are hemorrhaging really good nurses due to bullying. That’s why I’ve devoted my career to this work. Through my online programs, consulting, products, and seminars, I am doing my part to stop the cycle of bullying in healthcare!

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About the Author: Sarah Lisovich

Sarah Lisovich is a Chicago based writer, editor, and content strategist at CIA Medical. The young author has published writing on multiple print and online publications and has received the Marion and David Stocking Prize for nonfiction writing. With creative writing, communications and marketing, and public relations experience, the up and coming creative thrives in multimedia publications and looks forward to applying her skills to learn, explore, and write about the wonderful world of medicine.