An article I wrote for the BJN in 2012 stated:
‘It is likely that many nurses have come into contact with bullying at some point in their careers, either as victims or as perpetrators.’
This claim was taken from an article on the deliberate use of bullying as a management tool by nurses engaged in either clinical practice or management roles, or both, and I believe that the time is right to re-visit and update the original article. The specific intention here is to discover whether attitudes and practices that could be termed ‘bullying’, ‘harassing’ or ‘discriminatory’ still exist, whether anything has changed in the intervening years and if not, why not.
The Royal College of Nursing (RCN) (2018) stated that the NHS in all four countries of the UK has significant levels of bullying behaviour. In 2021 it updated its guidelines on bullying and harassment in the workplace (RCN, 2021). Although the term ‘bullying’ is value laden and subjective, the RCN defines bullying as the misuse of power or position that undermines a person's ability, or leaves them feeling hurt, frightened, angry, or powerless (RCN, 2005: 11). Bullying can also be defined as being:
‘Offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power through means intended to undermine, humiliate, denigrate or injure the recipient.’
In my original article I presented examples of behaviours that can be seen as bullying, suggesting that bullying affects the individual nurse, the bully, the work environment, and the wider organisational culture, along with the financial, health and social costs of bullying. Most of these have not changed. Kline and Lewis (2019) suggested that the financial cost of bullying to the taxpayer with regard to staff health, sickness absence costs to the employer, employee turnover, diminished productivity, sickness presenteeism, compensation, litigation and industrial relations costs, amounts to £2.281 billion a year. Back in 2007 the amount was £682.5 million—a more than a threefold increase over the intervening 11 years, which is likely to increase in the years to come (Kline and Lewis, 2019). This is just the financial cost and does not take into account the purely human cost—to both the victim and the perpetrator.
Kline and Lewis (2019) suggested that staff surveys fail to capture the types of behaviours often attributable to bullying and this should be a focus in designing future anti-bullying interventions. Bystander/witness experiences are undocumented, as are workplace incivilities and staff satisfaction with policy and procedures for tackling bullying. Policy change is vital for capturing the financial and human costs of bullying and to use these as mechanisms to manage organisations that fail to address bullying.
A number of issues arise from the above figures:
- Far from declining, workplace bullying as a ‘legitimate’ management tool and style has increased since the original article was written in 2012 and is set to increase still further
- The reasons for this continuation and increase in the use of bullying are unknown but will be multifactorial
- Nurses are at the forefront of bullying as victims, guilty bystanders, and perpetrators
- There is a huge financial and human price tag associated with and resulting from bullying, which cannot be sustained and is ethically and morally wrong and indefensible
- As health professionals, we must not allow this to continue as to do so reflects poorly on each one of us. If I as a nurse allow bullying to continue, what does that say about me? Anyone who defends the use of bullying should be ashamed of themselves!
Bullying, be it as a management tool or not, has no place in contemporary nursing and must be stamped out. Who is with me on this?