Creating a Healthy Work Environment by Eliminating Bullying and Incivility

Here is an excerpt from a recent chat with Dr. Renee Thompson. Renee was the opening speaker at the 2016 Perinatal Leadership Forum. This year she is facilitating a pre-conference on creating a healthy work environment by communicating effectively.

As an international speaker and consultant, Dr. Renee Thompson tackles the professional challenges facing healthcare leaders today. With 26 years as a clinical nurse, nurse educator, and nurse executive, Dr. Thompson is an expert on workplace bullying and professional development. She hosts an award winning blog and is the author of several popular books on bullying and professional development. In order to fully appreciate the challenges facing leaders and their employees, Renee continues to practice as a bedside nurse.

Maureen: You will be speaking at one of the pre-conferences at the Perinatal Leadership Forum in November – addressing the need to communicate effectively in order to create a healthy work environment. As someone with an extensive background in nurse bullying, you have found that “85% of a manager’s time is spent dealing with the behavior of their employees – yet we don’t teach managers how to address behavioral issues.” This is a staggering statistic! Why do you think nurse bullying has become rampant and why hasn’t there been more done to address it?

Renee: Nurse bullying takes place because it can. First, we accept the behaviors as the norm and fail to recognize bullying behavior. 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.” Second, when employees are bullied, they don’t speak up. 40% of all targets don’t tell anyone 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. Third, leaders use silence as a strategy too. Nobody teaches leaders how to address the bad behavior of their employees yet as you say, 85% of a manager’s time is spent dealing with the behaviors of their employees! So, the cycle of workplace bullying continues. One of the reasons why more hasn’t been done to stop bullying is because of competing priorities. Healthcare leaders are overwhelmed by regulatory demands, decreased compensation for care by insurers, and increased public expectations for customer focused care. Dealing with disruptive behavior, because there is not a direct line to reimbursements, typically falls to the bottom of this list. However, smart leaders understand that although you might strive to ensure a culture of safe, high quality, and effective care, if you ignore your bullying problem , you will never achieve success.

Maureen: Have these behavioral issues between nurses taken a toll on the care their patients receive? What kinds of training and communication tools need to be implemented in order to combat this behavior? Or, have they already been implemented?

Renee: 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 for bullying with their outcomes. Studies show that organizations with a high prevalence of bullying have worse patient outcomes. Unfortunately, the majority of organizations do not include education and training on addressing bullying and incivility for their employees or their leaders. Organizations need to hardwire initial education and training for their employees and leaders upon hire, and incorporate ongoing training quarterly among the multi-disciplinary team.

Maureen: With over two decades experience as a clinical nurse, you’ve seen this behavior firsthand. Can you give some examples?

ReneeWhile so m e disruptive behaviors are sneaky and go undetected for weeks, months and even years (covert); other disruptive behaviors are easy to recognize (overt). Both are destructive and do not belong in a profession dedicated to caring and compassion.

Common overt behaviors:

  • Verbal criticism or name-calling
  • Intimidation
  • Blaming
  • Ethnic jokes or slurs
  • Finding fault
  • Threatening
  • Physical violence

Common covert behaviors:

  • Sabotage
  • Withholds information
  • Excludes others
  • Unfair assignments
  • Undermines
  • Downplays accomplishments

MaureenIt is said that the way we communicate with each other is everything. A simple facial expression, an eye roll, or vocal intonation can make or break a relationship. Can you give some examples of good and bad communication tools that you will be addressing in your speech?

Renee: I teach nursing leaders how to have “honest conversations” with their staff and each other. By engaging in honest conversations that are respectful (assertive communication), leaders can begin to change a culture to one that rejects bullying and incivility and promotes professionalism. It all starts with honest and respectful conversations.

Maureen:You were the Keynote speaker at last year’s conference where you also addressed communication. What will be different about this year’s seminar? What new questions will you be addressing?

Renee :This year I’ll be conducting a workshop specifically designed to provide leaders with the strategies and tactics to recognize and eliminate disruptive behaviors. We will do a deeper dive into how to set behavioral expectations, incorporate scripting techniques with employees, and how to create, hardwire and sustain a professional work environment. Everyone who attends will also receive a free copy of my book, “Do No Harm, Applies to Nurses Too .”

Maureen: You have dedicated a good portion of your career to this epidemic of nurse bullying. Since you have been so vocal and have played a vital role in providing tools to stop this behavior, have you seen any improvement?

Renee: Yes!! I’ve been working with organizations in a consultative manner and have seen significant improvements in the way staff communicate with each other and how managers handle complaints of bullying and incivility. Also, I’m helping nursing leaders to develop stronger partnerships with Human Resources so that there is a more expedited handling of disruptive behaviors. However, the greatest improvement I’ve seen is ho w individuals are becoming more aware of their own behaviors and are now the role models for professional practice

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About the Author

Maureen Gazda, a freelance writer and 2007 graduate of UMass Amherst, has contributed numerous articles and blogs to newspapers, magazines and websites on a local, regional and national scale. Covering topics from health to travel, she is currently a news and feature writer for New Mobility Magazine – a magazine for active wheelchair users. Paralyzed from the waist down at the age of 12 and open about her story, Maureen is launching her own blog where she will highlight her crazy adventures “rolling” through life. For writing/business inquiries please contact maureengazda@gmail.com.