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All staff should unite to stop bullying in the NHS

One in five NHS employees have experienced bullying in the last year, said yet another survey into the difficulties of working in the NHS. Our first reaction to this is to wonder if two in five are too scared to respond honestly to the survey while the other two didn’t hear the question properly.

Bullying has always confused us, hasn’t it? That an organisation that exists to deliver health and wellbeing can construct such destructive relationships among its staff.

It can make them feel threatened, disempowered and even afraid. And being a health service it often does it with a smile. The psychic equivalent of giving you a head massage before hitting you with a cricket bat.

We know bullying comes in many forms. From the aggressive healthcare support worker who takes a dislike to alternate students, to the inadequate consultant who treats everyone like they are his butler. And we know staff can feel bullied regardless of their position and that it is insidious. It damages services and dehumanises us all.

‘Bullying in an organisation that exists to deliver wellbeing is the psychic equivalent of giving you a head massage before hitting you with a cricket bat’

So it is helpful to be reminded by various reports that bullying happens and it should not be tolerated. However, don’t we also need to be aware of how the NHS creates the perfect circumstances for institutional bullying? Because it’s not just about people being unkind or careless and it’s not just about the nature and intensity of the work. It is often about politics, pressure and the threat to jobs and services, and it would be hypocritical not to acknowledge that.

At a time when political parties are preparing us for spending cuts, those who work in public services are left bracing themselves for anything from near impossible working conditions to redundancy. That generates insecurity and defensiveness. What sort of culture is it that offers a choice of working in near impossible conditions or risk losing your job? Where nervous senior managers manage the demands that come from above them rather than the needs of those they oversee? It is a bullying culture. One that leaves nurses and others exposed to the machinations of managerialism and the nonsense that is the internal market.

Everyone - regardless of grade or banding - is going to feel under pressure over the next couple of years. Nurses, doctors, managers, cleaners - all will be expected to make savings or sacrifices. They may even have to make choices that feel uncomfortable for a “greater good”, which has for too long been defined by politicians we neither respect nor trust. That is a bullying culture. The only way we can do anything about it is to begin to realise and articulate the fact we are all - doctors, nurses, cleaners and managers - bound not by the restraints of public spending but by our responsibility to best practice, innovation, high standards and professionalism.

Maybe it’s time to forget the false divides of banding, profession or job title and unite around a willingness to defend services together? The best way to stop a bullying and corrosive culture must surely be to help each other do the right thing?

Readers' comments (37)

  • From above

    It seems rather sad that the NHS have to take responsibility for the behaviour of their professional staff. One would have thought that nurses and managers were professional and responsible adults or is iit that the NHS make bad choices on recruitment. I expected much more from my colleagues and feel bitterly let down.

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  • Do people get some satisfaction out of exhibiting bullying behaviour?

    Those who demonstrate this type of attitude or behaviour should be taken quietly aside and told that it is not acceptable.

    Nobody has to put up with disrepect from others.

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  • Perhaps I should add to the above that bullying is not counterproductive and does not get any work done effectively, let alone caring for patients in a bad psychopathological atmosphere.

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  • Apologies, my second comment above is very badly written and doesn't make much sense. It was written just before I was rushing out!

    Please ignore it and read instead, bullying is counterproductive. It contributes to an unhealthy psychopathological working environment which is not conducive to effective patient care, team work or any other related tasks on the ward other departments.

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  • Hello,

    I'm a very mature nursing student in Canada. If I had known about the abuse in nursing before I had started on this endeavour, I never would have signed up. I've never felt so disrespected or demoralized in my whole life, (well, at least not since high school). In a few months I will begin my final focus/practicum, and I literally pray every day to get a placement where I can actually learn something and fit in. And, at my age it is really hard to fit in.

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  • older students usually have the flexibility to try and fit in and one would imagine that the team would make every effort to make you feel welcome. in my last job where there was a huge cultural gap I was bullied out of my job after five months and a serious skiing accident necessitating three months sick leave and then told by the director that I had not been accepted by the team and asked to leave.

    I learned on my management course that it can take up to six months to learn a new job and become a full and useful member of an organisation but unfortunately many are not tolerant of intelligent enough to realise this. never mind, i feel it is there loss as much as mine as I had offered them my services as a nurse who was far more highly qualified and with broader hospital experience than any of the other staff.

    One instance that comes to mind was the plan for the delegation of work for the next morning which was the duty of the nurse who finished on the evening shift. I asked them to explain to me, do it with me and what their preferences were. it should have been done according to work load and we tried to stay for our series of shifts until days off with the same patients. no matter how i did it it was always changed the next morning and i the 'new girl' was always left to work on my own so that the others could work with their friends and chat together. there was little motivation in showing the 'new girl' the ropes or making her feel useful or welcome. there is a lot to learn and it is hard to take everything in at once, especially if you are only told once and then expected to remember everything. i did question two things about their practice like dripping some type of wax sticks burnt with a match into a patient's ear and using the thickest calibre urinary catethers for incontinent patients and did in fact refuse to recatheterise a patient with one of these over 20-gage cathethers, which didn't gain me popularity but my patient had to come first and my evidence based theory, having recently taken a catheter course presented by a nurse from the manufacturers, was not acceptable to them.

    I could write reams about bullying but am limited at present by space and time.

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  • Anonymous | 31-Oct-2009 1:32 pm

    could you share some of your wisdom with the rest of us who are less savvy or successful in dealing with bullying. Maybe write a short article?

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  • I am interested to know what other nurses have done to find new posts when they have been victimised by bullying and been dismissed or had to leave their jobs as this often results in poor references and warnings to prospective employers.

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  • you find a suitable job but not ideal, as there is little choice and you do not wish to remain out of work. you spend a whole day shift there on the ward mostly observing others, reading the notes and helping out where you can. it seems fine, you get on with the staff and patients and the work and the ward organisation is very similar to what you are used to although probably rather less challenging and interesting as it is in a provincial hospital as opposed to the university hospital where you previously worked. however, you show enthusiasm as there is also experience to be gained in this setting which is not encountered in the latter which is one of the main reasons you wish to make this change. you study the job description and discover that its demands are very similar to those of your last job and well within your remit. you feel that you have the right knowledge and skills and are more than capable of doing the job. however, at the end of the day you are told that nursing has changed enormously and that you would not be able to cope, even though you explain your past experience and many years of working in the same specialty. there are no other jobs available in the area and the doors for a 50 year old are almost closed.
    What do you do?

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  • I have been subject to and have witnessed bullying in healthcare and it has come as a huge shock,one that never ceases to sadden me.On starting my present job a lovely senior staff nurse told how she'd been consistently bullied for 2.5 years.I actually thought she must have meant 2.5 months.I've been told that she has been unable to find work as a result of the effects of this on her health.A co-colleague on my banding has been bullied for 9 years and says she can't let the bullies win so keeps going to work.Others have 'left'.
    Things didn't start too well for me.My eagerness,willingness to work hard and pick the job up and do my best to care for the patients was soon knocked out of're too enthusiastic,too serious,calm down.Go with the flow or sink seems to be the motto.Toe the team line and you get to work certain shifts.There must be something wrong with a workplace when you can guess at those who aren't going to be given promotion by checking to see how often they're rota'd to work on a certain day each week on a late!
    Those that work well are there for the patients and that ultimately is why we choose to nurse.You can put up with daily harassment if it happens if you know you work well and for patients but over time it cannot but fail to affect you.Morale drops.It shouldn't have to be acceptable,'you know this is how it is,it's been going on for years'.
    Bullying tactics work and a bad employer knows this.Their reputation is much bigger than that of individual employees.Any hint of bad practice so huge,who would be brave enough to say anything.
    It is so sad to think that caring nurses have to feel scared,intimidated and perhaps leave healthcare.Patient care should be just that,'patient-centred' nothing more,nothing less.Employers in the health service should have someone to answer to too,not be law makers and breakers with impunity.

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  • As a student nurse in the 1990's, I reported the neglect and physical abuse of elderly patients on a Care of the Elderly ward. Instead of these patients being protected, my clinical mentor and the directorate manager tried to force me to retract my statement. I refused. However, because I had dared to report the abuse, I was made to continue working on the ward, and repeatedly bullied by every single member of ward staff. I was punished for simply revealing the truth. The staff, managers, and clinical nurse mentors allowed this kind of practice to continue for many years, until some forced resignations ensued. Even then, the individuals involved were allowed to walk away without fear of any real consequence. Over the years, I have seen bad and abusive behaviour covered up time and time again. And as a nurse, if you report it, you are either ignored or at increased risk of being bullied and abused yourself. The bullying and abuse of both patients and nurses will continue until managers choose to take a stand, and make it quite clear that abuse and bullying will not be tolerated. Unfortunately, far too many managers appear to be sociopathic bullies themselves, only interested in reaching their targets and promoting their own careers.

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  • Anonymous | 25-Aug-2011 6:31

    many tragic stories here of good nurses trying to protect their patients and themselves. what happens when one is accused of negligence for not reporting abuse towards patients or to any other human being and colleague for that matter? surely any sort of abuse must be illegal?

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  • George Kuchanny

    From the huge number of comments we can see that Mark Radcliffe's article is timely and important.
    I well remeber seeing one nurse telling another one off for being 'miss perfect' when all she did was indicate that a patient could hear!

    This is also bullying and should be trodden on very hard. Get bullying seen off and watch the culture change for the better.

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  • I practised for over 30 years and was never the subject of "bullying". I was, however, subjected to an accusation of "bullying" on one occasions:- the first occurrence involved a Staff Nurse who on a regular basis absented herself from work on the basis that she was "sick" - I spoke to her about her problem and arranged for her to see an Occupational Health doctor. The OH doctor found that this lady was basically fit but thought he social circumstance was responsible for most of of her periods of "sickness". Further discussion resulted in my offering this lady the opportunity of reducing her working hours - she accepted this offer. I never saw her again -------------- she went "sick" supported by her GP with medical certificates which alleged she was suffering "work induced stress".

    Six moths later she resigned and followed up with a solicitors letter in which she claimed constructive dismissal based on the "bullying" she had suffered from her supervisor. Her claim was pursued to Tribunal --------- where thanks to my meticulous records and witnesses who supported the fact that I had been extremely fair in my dealings with this lady her claim was denied. In announcing the tribunals findings the Chairman described this lady as being manipulative and undertaking what amounted to a "fishing trip".

    But that does not end the storey ------- she later wrote to ask me if I would give her a "good" reference"!

    You will have guessed that I assured her that I would provide an honest and factual reference --------

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  • JRT | 7-Jan-2012 8:07 am

    seems she may have had little insight into her own behaviour but what a lesson to be learned. Just shows how carefully one has to tread when dealing with others especially when there are problems which may be their own personal ones. Just proves the importance of clear documentation.

    There is also occasionally bullying online here in the comments. I believe those who use this platform for this type of behaviour must do it at work too, and at worst with their patients - or do they exercise double standards?
    Again they fail to acknowledge that their behaviour is inappropriate.

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  • 4 years qualified and now in my 2nd post and still being the target for frustrated nurses. I get blamed for things which happen even when its my day off. Ive voiced how terribly unhappy I am, how my confidence is shot, how emotionally I am shattered. I have never worked in such a bitchy atmosphere in my life.
    I have only been in this job 3 months and already looking elsewhere, its about time bullying in the work place was make illegal before it pushes somebody to the extreme limits. Caring profession??? dont make me laugh!

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  • once bully starts and somebody is being victimised it is hard to stop.

    includes bullying on line. somebody who bullies in the comments is likely to do it elsewhere as well such as to colleagues or patients.

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