7 healthcare leaders share best ways to combat nurse bullying

Bullying remains an issue for nurses in today's healthcare environment. Bullying occurs between nurses, and nurses have also reported being bullied by physicians or even hospital managers or administrators. But there are things organizations can do to address the issue.

Becker's Hospital Review asked healthcare leaders to share the best ways to combat nurse bullying. Read their responses below.

Floyd Chasse
Vice President of Human Resources at Erlanger Health System (Chattanooga, Tenn.)

"Erlanger Health System has put in place a number of protocols for employees to report harassment and/or bullying in the workplace. These include providing our employees with the opportunity to report a concern anonymously by using our company hotline, contacting human resources directly to discuss with an employee relations representative, as well as providing bullying/harassment training for our staff throughout our health system. We have discovered that many employees are not aware that bullying and harassment have unique identifiers and can also lead to an unlawful act.

"It has been our goal to educate Erlanger's workforce on the signs of bullying and harassment and provide our staff with mechanisms in which they can report on behalf of themselves or inappropriate actions they may have witnessed. We always encourage employees to keep copies of all emails, text messages and/or letters they may have received from an alleged harasser, as well as maintain a time-stamped diary of all events since this can be of significant value during an investigation.

"Bullying/harassment is not something Erlanger takes lightly. We feel very strongly about confronting workplace bullying and harassment, knowing the significant impact and damage to employees, our patients and our organization."

Maggie Fowler, RN, BSN
CNO of SSM Health (St. Louis)

"Unfortunately, bullies exist in all aspects of our lives, including the healthcare setting. I've always felt the best way to address bad behavior in the workplace is to begin by defining good behavior, including setting expectations on how we treat each other using common core values that embrace respect. The message also needs to include how to handle those who do not live up to the team's expected standards. The best success is when there's support from other team members who physically stand with the one being bullied as he/she addresses the unacceptable behavior. This show of support, by physical presence, reinforces that this type of behavior is unacceptable and that the rest of the team is united against the abuse. This works well with all team members, including nurses and physicians, and when practiced correctly, will help everyone gain confidence in standing up for what's right in the workplace."

Carolyn Green, RN, BSN
CNO of the Presbyterian Delivery System, Presbyterian Healthcare Services (Albuquerque, N.M.)

"Nursing leaders must strive to foster an environment that prevents bullying before it starts. Nursing leaders have a unique opportunity to serve as role models for all nursing staff by demonstrating acceptable behavior while also identifying inappropriate behavior and enforcing processes that mitigate it. Educating the entire care team about the impact bullying has on absenteeism, turnover and patient outcomes as well as modelling collaborative, respectful conversations is critical for patient safety and productive communication."

Karen Grimley, PhD, RN, BSN
Chief Nursing Executive for UCLA Health (Los Angeles)

"Create an environment that empowers people to act. That involves multiple levels of administrative commitment. For starters, you build teamwork and camaraderie among the groups with whom you work so that they take care of one another. Equally important, you show leadership presence from the top down, even on days when nothing is wrong. That means being physically present, rounding on the floors, showing interest, asking questions, being available. At UCLA Health, our CiCARE rounds are an excellent example of an institutional commitment to urge people to communicate about issues that affect them. It creates an environment of trust so that someone who may have been bullied feels comfortable stepping forward. It also encourages other people to step forward on their behalf.

"Further, the culture itself should be one of accountability in which leaders have an opportunity and an obligation to help. That includes having zero tolerance for bullying. That's not as easy as it sounds, of course, because it means being aware of the nuances of bullying, the nuances of a threatening environment. But when you're aware of the nuances, you can't simply dismiss bullying incidents or brush them aside. To learn these nuances, you have to learn the subcultures within your institution so that you become aware of the potential issues.

"Finally, it's about rewarding good behavior. As an administrator, you can't simply notice people for doing negative things, although of course you absolutely must do that. But you also need to support positive behavior. If you focus your attention and expectations on positive behavior, the negative behavior doesn't simply become less noticeable, it actually diminishes.  

"One quote sums it up for me: 'Be a better bystander.' As an administrator, that's what I try to do — and that's what I urge others to do."

Kathy Howell, RN
Chief Nursing Executive for UCHealth and CNO of University of Colorado Hospital (Aurora)

"The most impactful way to address nurse bullying is to role model and educate all team members on what bullying is and what is not bullying. I believe it is important to not utilize terms such as civility, respect, etc., but to call it out overtly as bullying. It is just as important to educate teams on what is not bullying, such as constructive feedback and progressive performance planning. Bullying is often not overtly seen but is practiced through exclusion, not informing of important notices or changes, and not being included in social settings within the department. Leaders play a key role in reinforcing a culture that does not tolerate bullying."

Melissa Kline, DNP, RN
Vice President of Patient Care Services and CNO of MetroHealth (Cleveland)

"MetroHealth has an inclusive culture, and bullying of any form is not tolerated. Two of our core values as an organization are respect and inclusion and diversity. We empower our staff to report and step in to stop any unacceptable behavior, and we have policies in place that support a nonbullying environment."  

Cathy Townsend, RN, MSN-L
CNO of Banner – University Medical Center Tucson and South campuses (Tucson, Ariz.)

"Banner Health has several core behaviors that we deeply believe in that encompass how nurses and all employees treat each other. We seek to maintain a team focus and role model servant leadership.

"Nursing professionals have an opportunity while they are students to work on our hospital units and integrate with the staff. This Banner Health nurse residency program helps the students and professionals get to know each other and understand each other’s needs prior to and during employment. We have found that this program decreases the incidents of unprofessional behavior and promotes a safe and compassionate environment for nurses.

"In addition, leaders in Banner Health understand that a welcoming environment translates into safer patient care. Leaders hold themselves and their teams accountable for creating a positive and professional orientation for nurses.

"Healthcare work environments are complex and the combination of education, orientation, compassion and accountability goes a long way to decreasing the incidents of bullying for nurses."

 

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