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Practice comment

Trusts must tackle all forms of negative behaviour between staff


Focusing on bullying alone means many different kinds of negative behaviour in the workplace are tolerated and not dealt with, argues Rachael Pope


Negative behaviour between staff continues to be a destructive problem in the NHS, according to literature, survey data and academic research. This is despite various policies, reports, initiatives and directives over many years.

People are still being emotionally and psychologically damaged by the behaviour of managers/team leaders and colleagues. Of course the damage does not just affect them, but also affects the community around them.

In a recent article (Santry, 2009), Sir Ian Kennedy, on retiring from the Healthcare Commission, is reported as giving “a sombre warning about the ‘corrosive’ impact of bullying among NHS staff”, saying it was “permeating the delivery of care”. Santry (2009) posed the question: “But why is bullying so widespread in an institution devoted to caring?”

That is an extremely good question and has been asked on a number of occasions in literature. The behaviour that is rightly expected for patients is in sharp contrast to what is often tolerated for staff.

The broader term of negative behaviour covers any behaviour that is disrespectful and undermines or violates the value and dignity of an individual. In the workplace it is behaviour that damages individuals and organisations. Within that term we could use words such as incivility, aggression or abuse, but more commonly we use the words bullying and harassment. We could also use the words unkind, unpleasant or nasty behaviour.

Our research report in this issue shows that all negative behaviour, however defined, is damaging and has implications for patient care. Incivility that is not defined as bullying has very similar effects as incivility also classed as bullying.

“There needs to be a huge change in attitude so that staff welfare is given utmost priority at the most senior levels of the NHS and in individual organisations”

From observation and experience, the narrowness of focus on using words such as bullying and harassment is causing some practical workplace problems. It seems that organisations and managers will go to extreme lengths to avoid defining any behaviour as bullying.

It is almost as though if it is not called bullying, then it does not count, and no-one has to do anything about it. It seems to produce a generalised paralysis and lack of action. We do indeed need to think broader than bullying.

Whatever term is used, the problems of dysfunctional teams and workplaces still need to be resolved. Relatively minor behavioural problems can cause difficulties for years due to lack of trust.

Research shows that organisations with happier staff have better patient outcomes and satisfaction ratings. However, the NHS seems to have high tolerance towards unkind and sometimes nasty behaviour.

There needs to be a huge change in attitude so that staff welfare is given utmost priority at the most senior levels of the NHS and in individual organisations. The biggest need is for honesty and individual and organisational self-assessment.  

There also needs to be a clear expectation of positive behaviour throughout the organisation.  All staff - but particularly leaders – need to be assessed on the basis of personal qualities and behaviour as well as competencies.

We need to develop organisations where there is “dignity at work within a caring supportive culture” (The UK National Work-stress Network, 2009).

Professor Michael West, speaking at the 2005 HR in the NHS conference, said we need to create communities that are kind, and that leaders should be kind.

These are essential objectives and we all need to play our part for the benefit of staff and patients.

RACHAEL POPE is physiotherapy clinical specialist in women’s health, Bridport Community Hospital, Dorset.




Readers' comments (2)

  • I qualified in 2000 and another friend also, we worked on same ward. We were bullied so much, and it is mainly off the cuff comments, little digs and then someone will laugh to cover up fact they were bullying you. It was awful. We went to manager about it but nothing was done. My friend eventually left and the manager admitted she knew all along she was being bullied but didn't do anything. Most of senior nurses and HCA's that had been there along time were doing it. The manager was friends with them all. Alot of them were so unhappy and miserable. So rude to the patients also and rough.
    I hated it and left , but some people stay. Another nurse left due to depression.
    I went back to NHS a year ago and not much had changed except i wasn't picked on as much cos i have clinical nurse specialist role and senior position. I still found a lot of staff moaning, hating their job, and still being horrible to other staff, trying to put the new ones down to hide there own insecurities. The morale and emotional tone of staff ws very low.
    I am still a nice nurse to this day and still treat all staff , junior and senior the same but i'm glad i never ever have to go back there again.

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  • I was sacked by my employers. They sent me a letter in the post terminating my employment from 21 November 09. This is what the letter said. "My employment at the hospital is not proving successful as there are constant tension between me and other staff. We have tried to resolve these issues with you over the last few months, however, unfortunately many of the issues remain ongoing dispite our best endeavours to resolve them. We fully support all staff who seek our support and assistance but in these particular circumstances, we consider that it is in both our best interests not to continue with your contract of employment at the hospital".
    I am so shocked, I did not see this coming. It all started in Jan 09 when I 1st started on the ward I sensed that there was already tension there. By the 3rd month of my employment I had voiced my complaint to the Matron about the behaviour of the Sister to me. By June I had to raise a formal complaint about her behaviour. My complaint was up held and the Sister had to Apologize in writing to me. It did stop there and soon after that iI lodge a complaint about my colleagues negative behaviour towards me. Statements were exchanged and decisions came and went and for a while there was nothing. I offered a proposal to enable closure, this was rejected by my colleague. A decision was made and my complaint was not up held. I made an appeal against the decision made, two weeks ago. I received the letter dated 23th November terminating my employment.
    I can not believe this has happen to me, what did I do that was so wrong? Did I deserved to be sacked in the 11th month of my contract? No prior warning was given. When the issues were addressed, it did not take long for them to reappear. The contention was mainly due to staff taking unofficial breaks to have a quick smoke. The ward and hospital has a no smoking policy. It caused contention because whilst they had their smoke the rest were left to carry on with the work. As the coordinator when I saw this happening I duly reported this to the Matron. I was a fool if I had known that what I was doing would have left me vulnerable I would have turned a blind eye to it all. All I was doing was to model the code of standards expected from others.
    I am awake now, cant sleep, what am I going to do now? This is not the end just yet, the negative behaviour continues. I was offered a Great job. I found out on Friday 20th Nov that the matron had sent a bad reference to the perspective employer, the job offer was withdrawn. I am unemployable now. Is it because I am black? Why I have been treated so?
    Other than that I have not been involved in any other problems on the ward that I am aware of.
    Since the employers will not do anything that would have a lasting effect. Should I report The Matron and Sister for their negative behaviour to wards me?
    All I did was to model the NMC Code of Practice expected by others. The problem is I made one too many complaints about the Sister of the ward, regarding her conduct which upset the status Que and as a consequence I lost my job, they got rid of me.
    It is not what you know but who you know.
    The Matron the Sister and the other bullies have been running the ward for a long long time. The Trust does nothing accept sack those that dare speak up against them. I just cant believe that this has happened. I have not been a RGN for long but i so regret being a Nurse, I hate how nurses treat one another, so uncaring and nasty and vicious.

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