Research shows hospital bullying cases rarely resolved

For her Ph.D. thesis, Dr Kate Blackwood completed a series of 34 in-depth interviews with nurses who had been targets of workplace bullying. She found only one of these cases was ever completely resolved.

The Massey University management lecturer, who graduates with her doctorate at the university's Auckland graduation next week, says she was initially surprised by the nurses' stories.

"I was shocked by the harmful, personal impact that bullying can have," she says. "The nurses were very emotional as they recalled their experiences. Sometimes bullying behaviours can seem petty in isolation but the impact builds up over time. It's very subjective and context-dependent, but the pain can be very real."

Dr Blackwood says the startling conclusion was that intervention in escalated cases of bullying is hardly ever effective.

"Some people never reported the bullying at all, then nearly half of those who did report it found that no action was taken," Dr Blackwood says. "When you look at the cases where some form of action was taken, those actions were only successful in stopping the bullying in one case. Many bullying targets simply end up leaving their jobs."

Dr Blackwood says hospital senior management, and the nursing profession as a whole, are aware just having a workplace bullying policy is not enough.

"Each of the three large public hospitals I worked with had a bullying and harrasment policy, yet so few experiences were resolved. Hospitals desperately want to do something about it, but simply do not know how."

She believes all workplaces need to create an environment where people understand what bullying is and ensure there is a culture where bullying isn't tolerated.

"Targets and managers dealing with complaints need to feel supported and it's crucial that bullying is identified and intervention takes place as early as possible," she says.

A culture where 'nurses eat their young'

But she acknowledges bullying is particularly prevalent in the nursing sector.

"There's a saying in the sector that 'nurses eat their young'. Young nurses go through a socialisation process – the sector is traditionally heirarchical and a culture exists that tolerates bullying.

"This means nursing faces a number of strong obstacles to effective intervention that require time and resources to overcome – both of which the profession has little of."

Her research also indicated differences in generational expectations were having an impact on whether actions were perceived as bullying and how any intervention was received.

"The senior nurses talked a lot about the politically-correct nature of society these days and how they felt junior nurses often react badly to criticism. These senior nurses learnt on the job and they thought classroom-trained nurses didn't have their emotional intelligence – a crucial part of nursing practice – tested until they were actually on the job."

But strong leadership that leads to a change in culture, can make a difference. Dr Blackwood says one of the three hospitals she researched had undergone a shift in culture that had been led by executive level leadership, which made it clear that bullying would no longer be tolerated.

"In this hospital reporting and intervention in bullying was encouraged due to the support of senior management. To break down the traditional heirarchies that exist within hospitals, good leadership is important at the nurse managers level as well. More leadership training needs to be provided, with nurse mangers recruited for their leadership skills, not just their clinical expertise."

As a member of Massey Univervisity's Healthy Work Group, a team of academics researching employee wellbeing and psychosocial hazards in the workplace, Dr Blackwood intends to build on her thesis findings. Her next phase of research will be to develop an intervention process for workplace bullying in hospitals and then evaluate its success.