Changing attitudes towards bullying

There is no doubt that bullying exists in the NHS and even flourishes in some clinical environments. Although healthcare workers may realise they are being bullied, it can be difficult for them to articulate what is happening, simply because their line of work is supposed to embody the values of caring and empathy. This situation is further exacerbated by the fact that there is a lack of consensus about how bullying should be defined. A recent publication from the Association for Perioperative Practice (AfPP), Challenging Behaviours in the Perioperative Environment, directly addresses this issue by providing a comprehensive guide about what constitutes bullying and how it differs from discrimination, racism and harassment. Undesirable behaviour – including bullying, harassment, horizontal violence and discrimination – is damaging to the individual and the organisation if left unchecked. Recent surveys have shown that managers and colleagues bully staff, yet the Government and the NHS had, until recently, given low priority to addressing such behaviour. According to Kennedy 2009,1 “Bullying is one of the biggest untalked about problems, in the delivery of good care to patients.” Moreover, the problem is said to be caused by the NHS’s hierarchical culture, and occurs across all staff groups. With its latest publication, AfPP intends to:

• Raise awareness about the incidence of workplace violence, harassment and bullying.
• Increase knowledge and understanding of why and how people bully, harass or commit acts of violence, and against whom. • Aid recognition of those who bully and are being bullied.
• Provide practical advice and guidance.
• Outline current legislation that regulates such behaviour and discuss the responsibility of individuals faced with such situations.
• Encourage a culture within the perioperative environment where everybody treats colleagues with dignity and respect.

 Bullied workers are effectively stripped of the resources required for them to work effectively. It is normal for bullying victims to feel isolated and vulnerable, and to believe that, somehow, they have done something wrong. Guidance has now shifted towards an organisational approach which acknowledges that certain environments can minimise or accelerate bullying behaviour. With this in mind, it is important to consider how can we change broader attitudes to bullying and move away from the mistaken belief that “it just happens” and the consequences will simply “go away”.