Around one in five doctors in the NHS say they have been bullied or harassed by managers or other staff in the past year.  Most incidents go unreported, often because staff believe nothing will happen or they are afraid to raise concerns. The General Medical Council (GMC) has said that “Bullying and undermining are completely unacceptable and can have a big impact on the safety of care given to patients.”

What is bullying and harassment?

Employers have a duty of care to employees and a duty to protect their health and safety at work, including protecting them from harmful acts like bullying.

  • Bullying is offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power through means that undermine, humiliate, denigrate or injure the recipient.
  • The effect of behaviour on the recipient is key to identifying whether bullying or harassment has taken place. This is why, when it comes to preventing bullying and harassment, it is important to reflect on how our behaviour is received by others.
  • The Equality Act 2010 defines harassment as unwanted conduct that is related to a protected characteristic (age, sex, disability, gender identity, race, religion or belief or sexual orientation) or unwanted conduct of a sexual nature. It has the purpose or the effect of violating someone’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for them. Harassment is unlawful.

Examples of bullying and harassment

Most organisations have measures in place to educate employees about this issue. As a result some forms of bullying are harder to detect or pin down, as those who perpetrate the behaviour can also use more subtle ways of undermining an individual. Harassment is generally focused on the protected characteristic of a person while bullying can take a wider form.

  • Physical or verbal abuse that directly attacks or ridicules a colleague.
  • Inappropriately criticising or humiliating a colleague in front of patients or colleagues.
  • Regularly ignoring a colleague and excluding them from meetings or events.
  • Making derogatory comments or offensive jokes about women, disabled people or people of a particular race or faith background, sexual orientation or age.
  • Inappropriate touching, sexualised comments or trying to elicit sexual favours through threats or promises.
  • Using low-level and obvious threats (e.g. about job security or patient care) to get someone to comply with work demands.
  • Deliberately using conflicting statements and requests to cause confusion, uncertainty and distress.
  • Setting someone up to fail by overloading them, giving inadequate support and blaming them for failure afterwards.
  • Constant criticism, excessive scrutiny and micro management of tasks.
  • Undermining a person; deliberately causing confusion and distress.
  • Changing tasks and job roles to sideline promotional prospects.

What is the impact of bullying and harassment on the individual?

We all have individual resilience levels which varies across time and the environment we find ourselves in. It can also be affected by what types of support network we have and whether we deal with other kinds of issues on a daily basis e.g. mental health, disability, problems at home.

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In general, the effects of bullying and harassment can include:

  • anxiety
  • feelings of shame, anger, humiliation and fear
  • difficulty sleeping
  • loss of appetite
  • inability to switch off from work
  • self-doubt, loss of confidence
  • feeling isolated, helpless and hopeless
  • rapid changes in mood due to distress
  • making more mistakes due to intense negative feelings and confusion
  • hyper-vigilance or a need to constantly double-check your work.

Why are people reluctant to report bullying and harassment in the workplace?

In general, studies show that people are reluctant to talk to managers or Human Resources (HR) when they are bullied and/or harassed. This is because the majority of people perpetrating bullying behaviour are senior staff. Those bullied tend to seek the help of a work colleague first or someone outside work for fear that raising a concern in the workplace will limit progression and cause job loss. While it is crucial for organisations to have regular training and induction sessions on bullying and harassment awareness for all employees, it is equally important to regularly audit the performance of senior managers to see if there are recurring problems, higher turnover rates in some departments and regular problems to pinpoint areas for targeted people management development and organisational change.

Main reasons people do not report bullying and harassment in the workplace:

  1. Won’t be taken seriously.
  2. Nothing will be done by management.
  3. The bully is a senior member of staff.
  4. Worried about career progression and future workplace opportunities.
  5. It might get worse.
  6. They will loose their job.

What are the wider organisational consequences?

  1. You are less likely to approach a colleague for clarification or help if they have shown bullying behaviour. This means patient care can be affected.
  2. If you are someone who witnesses bullying in the workplace and you see that nothing is being done, it has implications for your commitment to the organisation. Research shows that people who witnessed bullying in their workplace were more likely to want to resign, even though they themselves were not the target.
  3. If bullying behaviour is tolerated, excused or left unchecked it can quickly create a toxic environment across teams, departments and different layers of the organisation. When this happens it can become embedded in organisational culture and insinuate itself into different interactions between people in small and large ways, making it very difficult to root out.

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Practical steps

  1. If you are a line manager ensure you are alert to any changes in behaviour of those you manage.
  2. As an employee ensure you are familiar with policies such as dignity at work. If you are unable to approach your immediate superior contact external helplines.
  3. If as a line manager an employee tells you about an incident of bullying or harassment you are obliged to be respectful and take it seriously, listen and look into it. Ensure you provide the employee with the psychological support they need. Make sure you are aware of what your responsibilities as a manager are.
  4. After a report of bullying and harassment in the workplace ensure you run training and refresher sessions for all members of your team to reassure people that the organisation takes the issue seriously and to embed responsibility for behaviour with whole teams. Regular training also provides you with the opportunity to see if there are deeper, underlying toxic behaviours that need to be addressed.
  5. Ensure there are visible signs that bullying and harassment will not be tolerated. You can display items such as the bullying and harassment poster from the BMA
  6. Once you are aware of the situation ensure you keep a log of what has transpired.
  7. Make sure to regularly audit areas that have reported bullying and undermining behaviour.
  8. Ensure you investigate repeated patterns of behaviour – for example people leaving certain teams on a regular basis, changes in work commitment by previously dedicated employees.
  9. If senior management support bullying behaviour in teams and in the workplace they are liable for not providing a safe environment for staff to work in.

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References

BMA Workplace Bullying and Harassment

Bullying and harassment poster BMA

BMA Bullying and harassment of doctors: a review of recent research