How to Identify and Respond to Bullying and Incivility

[Damion Jenkins]

According to the American Nurses Association (ANA), bullying is a major barrier to enhancing the nursing profession. The ANA and other nursing organizations have provided several resources to empower nurses in ending workplace bullying and incivility in the workplace.

According to Dr. Renee Thompson - an expert on the subject, uncivil behaviors include:

• Condescending body language
• Texting or talking during someone else's presentation
• Mocking a co-worker
• Jamming the copier
• Gossiping
• Treating someone like a child

Dr. Renee Thompson continues by saying that bullying is defined as repeated patterns of uncivil behavior with the conscious or unconscious attempt to do harm. This harm is typically directed at an individual or a group and is typically coming from the same person, or groups of people. It is important to understand that bullying is targeted, and repetitive.

Dr. Thompson also says that you should ask yourself the following questions to help in identifying bullying behaviors, or whether you've simply experienced some isolated incivility:

• Do they behave this way frequently?
• Do they only behave this way towards select people (maybe you and not anyone else)?
• Is there an underlying intent to do harm (remember, conscious/deliberate or unconscious/unaware)?

5 Easy Ways To Respond To Bullying:

STEP 1: Remain Confident

By remaining confident in your abilities, you can avoid being a target of bullying behaviors. Just remind yourself that you are a nurse and have met the minimum requirements by your school, your state and the NCLEX (National Council Licensure Examination) to practice as a nurse. You've earned your spot alongside the other nurses and should be treated with respect and dignity. With that being said, it is also your responsibility to know your knowledge limits and seek out additional assistance, guidance and training where appropriate. By demonstrating confidence in your ability to learn and practice as a new nurse, you will surely keep bullies from picking on you.

STEP 2: Remain Professional

It's easy for someone who is being bullied to demonstrate unprofessional behaviors such as arguing, yelling, screaming, using aggressive body language, using profane language or creating a disturbance within operational flow. It is crucial to your success that you remain calm, collected and professional in all of your responses to a bullying individual. Avoid any behaviors or actions that can come back to negatively reflect your level of professionalism.

STEP 3: Confront the Bully

Often times bullying behaviors are not recognized as such by the perpetrator. Regardless of whether bullying behaviors are intentional or not, it is important that you share your concerns with the individual who you feel is bullying you. This is best done after a shift and in an informal matter (i.e. pulling the person to the side, away from other colleagues). This will provide an opportunity for you to be open and honest with the individual. Please note that it is important for you to allow for the person to respond and that you fully listen before making any further judgment. In most cases, the person who demonstrated bullying behaviors will apologize and your working relationship will improve afterward. If this does not stop the bullying behaviors then it is time to report it to the nursing management, which is included in the next step.

STEP 4: Report the Bullying Behaviors

No one wants to get to the point of having to bring someone to the manager's office to be counseled, especially when it's you! Unfortunately, sometimes it is absolutely necessary to involve nursing management when bullying occurs. If the bullying behaviors continue after you confronted the individual(s), then it is imperative that you notify your nursing manager/supervisor immediately. Make sure you provide detailed information regarding the behaviors demonstrated, what your actions were to try to establish resolve, and how these behaviors are affecting you at work. Your manager will then follow through with a plan that will best address the situation.

STEP 5: Advocate for Peer Accountability

Creating a culture of peer accountability should come easy since most nurses come into the profession later in life and have gained a plethora of interpersonal skills, management skills, and have been in some form of supervisory position in previous positions. Even those of you who are entering into nursing as your very first job, you too can hold your peers accountable for their behaviors. By holding everyone on the team equally accountable for their behaviors, bullying behaviors decrease and work morale increases. Always practice by the standards of - if you see something, say something.

Of course, there is always the potential for meeting resistance in all of these steps provided. Just remember one thing - your determination to provide a positive impact will eventually overshadow the negativity that others may create. With consistent positive role modeling by following the above steps, you will surely help to create a healthy workplace environment!

[RTConnections]

Interesting but somewhat concerning conversation. Although we are all entitled to our opinion, it's how we communicate our opinion that matters most. Nursing is a profession and as a profession, we are expected to conduct ourselves at the highest level of professionalism. I have not seen that here. And although I'm not one to defend my work...to be clear...for a behavior to be considered bullying, there must be a target, the behavior has to be harmful, and has to be repeated over time. This isn't about being thick or thinned skinned...this is about the evidence that shows that disruptive behaviors (bullying or incivility), impacts patients in a negative way. If any of our moms, dads, sisters, brother, etc. were patients on our units, behavior would matter.

Respectfully,

Renee

[meanmaryjean, DNP, RN]

Damion Jenkins said:

Thank you meanmaryjean for your insightful contribution to this discussion. It appears that you are also an expert on the subject. Adding derogatory terms such as "twitsville" to your professional vocabulary is exemplary of nursing excellence. You are a stellar role model for our future nurses.

Best,

Damion

And how exactly is YOUR post not bullying then?

[RNNPICU, BSN, RN]

Damion:

I do not agree with major parts of your article. I do not think that texting or other things on a phone during a presentation is bullying. I have given many presentations and attended national conferences where this occurs. I have never felt that anyone was rtying to intimidate me by texting during a presentation. I have been at conferences where people are texting, responding to emails, etc. I think it is just a refelction of how much we are dependent on technology rather than bullying. As for jamming the copier - I have no idea how any one could purposefully jam a copier so much that it would amount to bullying.

I have had people give eye rolls during some interactions. Most of the occasions it is not directed to me rather the frustration of the context of the conferensation. I never once felt that someone was trying to put me down.

Gossping COULD BE if the intent is to maliciously harm someone's credibility, etc. Random gossip occurs because maybe people generally care about someone and are wanting to help.

Treating someone like a child could be easily misinterpreted. I have seen were someone made a comment that a nurse needed to be more efficient at tasks. The new nurse responded that she felt things were moving to fast and she needed time to think it through. The other person, slowed things down, went step by step explaining the details. The new nurse felt it was treating her like a child. I thought the other person was just being helpful and providing detailed guidance, alas it was misinterpreted.

The core may be related to more efficient communication. If someone is unaware that their actions could be construed as bullying, let them know, it could be that it is not true and the person feeling bullied is misinterpreting and misrepresting the actual actions.

I think your article while interesting is not a true attestament to bullying. It has the potential to alienate those who have been bullied as many of the areas of discussion you outlined sound more like a bad day or suboptimal behavior.

[Damion Jenkins, MSN, RN]

Thank you RNNPICU, BSN, RN for your contribution to this discussion. I appreciate the opportunity to discuss this further. Let me begin by clarifying that it was never said that texting during a presentation was defined as bullying. However, according to Dr. Renee Thompson, this behavior falls into the category of uncivil behavior.

In the article, bullying is defined as repeated patterns of uncivil behavior with the conscious or unconscious attempt to do harm. This harm is typically directed at an individual or a group and is typically coming from the same person, or groups of people. It is important to understand that bullying is targeted, repetitive, and most often disruptive behavior. Therefore, I would agree with you that texting during a presentation by itself on an isolated incident does not fall under the definition of bullying used here.

The focus here is repetitive and targeted uncivil behaviors that define bullying. An occasional eye roll does not fall under the definition of bullying. However when another nurse rolls their eyes every time you interact with them, or walk by them, or when you are recognized for your hard work by the manager, then this would meet the criteria of bullying behavior as well as its unprofessional and demonstrates negative body language.

Regarding gossip - it's never acceptable to exclude others from the conversation. If you are truly concerned for the well-being of others, you should include them in the conversation, regardless of helpful intentions or not. This leads to more misunderstandings than any other of the above listed issues mentioned thus far.

I agree that sometimes things may get misinterpreted, but we are all able to pick up on tone, negative body language, and the attitude of others despite how careful others think they are being with their communication and actions. Perhaps the nurse training the new nurse did in fact treat her a certain way that made her feel like she was being treated like a child. I can say that I've experienced this on many occasions when others do not listen to what is being said when I ask questions. Instead of actively listening to my learning need, they assume I do not know anything and start from the very beginning, making snide remarks along the way such as "I guess you didn't learn anything in nursing school.", etc. Unless you were the nurse training the new nurse, or you were observing 100% of their interactions, perhaps the new nurse had a valid concern. I personally would have explored the situation further to see if perhaps the nurse training the new nurse was fit to precept, because training new staff takes more than proficiency in unit policy and procedure.

I 100% agree that ineffective communication is one of the leading contributing factors to workplace conflict. Sometimes misunderstandings lead to targeted and repetitive uncivil behaviors, which then blooms into full on bullying. That is why I included the step of confronting the person whom you feel is demonstrating bullying behavior so that you can attempt to clear any misunderstandings. We must always speak up when we feel we are not being treated professionally.

Finally, I thank you for your opinion - I hope that this has provided clarification. I'd be interested in reading your definition of workplace bullying, and how you'd support those nurses who feel that they are being bullied by others.

Best,

Damion

[Damion Jenkins, MSN, RN]

Hi Leader25,

Thank you for your contribution to this discussion. If your manager and their supervisors are not supportive of creating a professional environment, then I recommend that you follow the chain of command and report these behaviors to HR. If that does not resolve the issue, then I would recommend leaving that position and finding a place to work that does not condone such unprofessional behavior.

Best,

Damion

[RNNPICU, BSN, RN]

Damion:

Each of us have our own personal characteristics that make us unique. SOme of us use humor, sarcasm, devils advocate, while others are more sincere, quiet, reserved, and some of us are a mixture of all of these. (I am sure I have not added all characteristics) Difficulties arise when some ideas are miscommunicated.

There are a few people who are aggressive, and others who are overly aggresive in their approach to comunication. Here is where bullying begins.

Before going down a bullying line, first determine, is this just a personality clash and am I reading in to things, for example someone who relies on sarcasms as their go to for things. Sometimes okay, other times, too much, if you compare this to someone who is more reserved, like me, I don't always get sarcasm. I just go with it. I could not be paired with someone who always has a sarcastic comment, as well as I hear that I am too serious. It is a balance.

A workplace needs a great mixture of personalities and backgrounds. You will have leaders, doers, followers, listeners, planners, etc.

Note how intimidation, maliciously and intently out to get someone are left out. These characteristics, as well as others, can lead to true bullying.

A workplace does not have to have everyone like each other, but you have to work as a team, put differences aside. I can get along with most personalities, I just go with the flow. There are always a small number of individuals that cannot do this.

To better address these concerns in a work place, have everyone recognize the individuals we are and how we are also similar. Have units/ workplaces create behavior guidelines of accpetable and unacceptable behaviors. Have this posted. Guidelines developed by those that have to live by them have a higher chance of being adhered to. Outline consequences for actions.

[Here.I.Stand, BSN, RN]

Damion, your sarcastic responses to dissenting opinions are bordering on ad hominem attacks. Maybe not quite TO that point... but rude enough that I do think some self-reflection may be a good idea for you.

[Damion Jenkins, MSN, RN]

Thank you RNNPICU for your thoughtful contribution to the discussion, this is good advice for all of us to consider.

Best,

Damion

[Damion Jenkins, MSN, RN]

Thank you Here.I.Stand for sharing your thoughts and for contributing to this discussion.

Best,

Damion

[Wuzzie]

Damion Jenkins said:

Thank you meanmaryjean for your insightful contribution to this discussion. It appears that you are also an expert on the subject. Adding derogatory terms such as "twitsville" to your professional vocabulary is exemplary of nursing excellence. You are a stellar role model for our future nurses.

Best,

Damion

In your own words "mocking others and using dismissive language is what meets criteria for defining bullying behaviors." Pot meet kettle.

As someone who was actually bullied you are only damaging the cause by acting this way. Please stop and reconsider what the goal is. Open discussion, including dissenting opinions, are the only way for us to learn how to recognize and put a stop to this behavior. Thinly-veiled sneering is not helpful and serves only to shut down true, thoughtful discussion. Victims of bullying behavior don't need your kind of "educating".

[Damion Jenkins, MSN, RN]

Thank you Wuzzie for your contribution to this discussion. I appreciate your feedback, though I disagree with you regarding my "educating". This forum is for nursing students. The original comments by those whom I've responded sarcastically offered no additional insight or constructive criticism. Instead, they diminished the importance and value of the work that was done to arm new nurses with basic strategies on how to identify and respond to bullying and incivility.

All of my responses were carefully calculated, and although they are heavy with sarcastic tone, I do not feel they were inappropriate. Nurses with their level of experience should be contributing to the betterment of the profession - not creating negative discourse because they think that a couple of the behaviors used as an example by Dr. Renee Thompson to reflect uncivil behavior are laughable.

This was not a simple disagreement, and even if it was, this language did nothing to help nursing students or new nurses. It only exacerbates the problem.

I do appreciate you sharing your experience and adding that my reactions do not improve the situation - this is excellent advice that I wish everyone would take into consideration.

Finally, "my kind of educating" cannot be defined by this sarcastic banter initiated by professional nurses on a nursing student forum. Rather, I thank everyone who has contributed on this entire thread as it only helps students and new nurses better understand the forces they are up against.

Best,

Damion

[heron, ASN, RN]

OP, your last post is a prime example of the double standard in this whole bullying discussion:

If I hurt your feelings or offend your sensibilities, I'm a bully. When you do the same to me, it's justified because you were addressing nursing students. Or something. The only thing missing is "where's the compassion!"

So ... to reiterate my question, what differentiates bullying from incivility?