The nursing profession exemplifies caring and compassion to the public. Yet bullying may exist in all areas where nursing is practiced, from student nurses to more experienced nurses.
Bullying, sabotaging and scapegoating nurse colleagues is a serious problem that jeopardises staff morale and can compromise patient safety.
Bullying creates a toxic work environment with serious consequences for victims, institutions and, ultimately, patients.
Victims feel isolated from other team members. They may dread going to work. Their self-esteem decreases and their self-doubt suppresses their initiative and innovation. Eventually, they become impaired psychologically and occupationally. Many new nurses lack confidence to begin with and require positive feedback about their performance; bullying makes them feel invisible, incompetent and inferior.
Two years ago, the University of Durham surveyed 3,000 staff at seven trusts and concluded that trusts need to develop cultures whereby barriers are recognised and addressed, policies are seen as effective and each report of bullying is treated seriously.
It highlighted cultural barriers that stop people reporting bullying: 14% of staff said they did not want to be seen as a troublemaker, while 11% were concerned that this would make the situation worse. A similar proportion of staff said nothing would change and that they would not report a bully who was more senior than them.
There have been various reports of bullying happening within the NHS and we need to be aware of how the NHS creates the perfect circumstances for this. It’s not just about people being unkind or careless. Often it is often about politics, time constraints and the threat to services, it would be hypocritical not to mention that.
With greater time constraints and expectations, senior hospital managers do not always have the time or resources to deal with complex complaints.
The Freedom to Speak Out Review highlights the shocking fact that NHS staff are still afraid to speak up about poor care and dangerous practices. Furthermore, those who do speak up are often ignored, bullied and even dismissed from their jobs for doing so.
Helene Donnelly, Staffordshire and Stoke-on-Trent Partnership Trust’s ambassador for cultural change, has spoken out to encourage every trust to appoint an ambassador for cultural change to work alongside frontline staff. This is so that people who want to raise concerns can do so without the fear of being judged or victimised. This is an important role that should be considered by hospital management. Each time someone is deterred from speaking up, an opportunity is lost to improve patient safety.
The implementation of a cultural change ambassador would allow for greater emphasis to be placed on people gaining confidence to speak out to the right person at the right time.
The challenge for the NHS is build a cultural shift into transition planning to ensure that the NHS of the future is doing all it can to protect and support its most valuable resource - its staff. If the staff are happy this will result in a happy ward where patients are cared for with respect, dignity and compassion.
James Merrell is a registered nurse working at Musgrove Park Hospital, Taunton. He is also a NursingTimes Speak Out Safely Ambassador.