Harassement and bullying in the Workplace

workplace violence

• An act or threat occurring at the workplace that can be include of the following: verbal, nonverbal, written or physical aggression; threatening, intimidating, harassing or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults or other behaviors of concern involving staff, practitioners, patients or visitors.

• Healthcare professionals are at high risk

definition of workplace bullying

• The repeated, health harming mistreatment by one or more employees of an employee; abusive conduct that takes the form of verbal abuse; or behaviors perceived as threatening, intimidating or humiliating; work sabotage; or in some combination of the above.

• Repeated is defined as 2x/week over 6 months (Leymann, 1980)

• Involves an imbalance of power between the victim and the bully

• According to the Institute it is more common than sexual harassment.

Forms of Bullying Behavior

• Constant and unfair criticism

• Social bantering and teasing

• Yelling, shouting and screaming

• Insults and behind-the-back put-downs

• Hostile glares and other intimidating gestures

• Malicious gossiping

• Monopolizing supplies and other resources

• Aggressive emails, texts or notes

• Having thoughts or feelings ignored

• Exclusion from activities or conversations

• Overt threats and aggression or violence

Why do employees bully?

• Control

• Insecurity

• Role and/or goal conflict

• Resentment

• Negative attitude

• Jealousy

• Aggression

• Personal challenges

Contributing Factors at the Organizational Level

• A culture that normalizes bullying by tacit encouragement or failure to adequately intervene when the problem has been identified

• Lauding or rewarding the success of bullying, ensuring a place in the culture

• High workloads

• Understaffing

• Power imbalances

• Lack of management skills

psych consequences for employeee due to bullying

• Negative effects on self esteem

• Post Traumatic Stress Disorder (PTSD)

• Depression

• Withdrawal

• Alcohol abuse

• Suicide

emotional Consequences for the Employee due to bullying

• Communication skills and interpersonal relationships

• Poor concentration

• Shame

• Anxiety and mistrust

• Living in fear of 1)next encounter 2)being the next victim or 3)retaliation if report

• “Rippling effect” where friends and family become involved

physical consquences for employee due to bullying

• Frequent headaches

• Gastrointestinal problems

• Sleep disturbances

• Fatigue

• Cardiovascular disease

• Manifestations of compromised immune system

consquences of bullying for the unit

• Decreased morale

• Decreased productivity

• Reduced creativity and ability to solve complex problems

• Dysfunctional teams

• Absenteeism

• Presenteeism

Consequences of bullying for the Organization

• Increased turnover

• Compromised employee and patient safety

- increased errors

- decreased reporting

- challenges “Just Culture”

• Legal action

• Decreased patient satisfaction

• Damage to reputation

• Higher healthcare costs

employee level prevention

• Education on the behaviors, risk factors and dangers of bullying

• Education on strategies designed to reduce and address bullying

- Cognitive rehearsal (Griffin, 2004)

• Education on policies that include consequences for those who bully

• Anti-bullying pledge

manager level prevention

• Education and self-assessment

• Create a supportive culture and work environment

• Support a “Just Culture”

• Practice zero tolerance of bullying & act promptly

• Lead by example

• Utilize HR resources (policies, posters, fact sheets)

organizational level prevention

• Support a Code of Conduct

• Create a strong sense of community

• Adoption of zero tolerance policies regarding bullying

• Establish policies and procedures for reporting, investigating and resolving complaints in a timely manner, including anti-retaliation provisions

• Conduct periodic confidential employee attitude surveys to determine if workplace bullying is not being reported

policy level prevention

joint commission slide 46-49

health workplace bill

• Provides an avenue for legal redress for health harming cruelty at work

• Can sue employer (civil lawsuit) for exposure to harmful work environment

• Seeks restoration of lost wages and benefits

• Protects conscientious employers from vicarious liability risk

sexual harassment

Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature

gender harassment

Verbal and nonverbal behaviors that convey hostility, objectification, exclusion, or second-class status toward members of a gender

Unwanted Sexual Attention

Verbal or physical unwanted sexual advances, which can include assault.

Sexual Coercion

Instances in which favorable professional or education treatment is conditioned on sexual activity.

Quid pro quo (“this for that”) sexual harassment

harassment that involves the conditioning of concrete employment benefits on sexual favors”; occurs when "submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such individual,"

Hostile work environment

• Lewd comments or sex-based slurs

• Gossip about someone’s personal relationships or sex life

• Displays of pornography

• Sexual gestures

• Leering or staring inappropriately

• Unwanted touching

• Persistent requests for dates despite discouragement

• Sex-based stereotype comments or name calling

• Talking about someone’s gender in a derogatory way

• Sex-aggregated work assignments

• Comparisons between male and female employees

employee Consequences of IPSB

● Anger

● Guilt

● Fear

● Anxiety

● Self- consciousness

● Depression

● Decreased productivity

● Increased Absenteeism

● Distraction

● Loss of motivation

● Burnout

● Resignations

organizational consquences of IPSB

● Lawsuits

● Quality care

● Resignations/Turnover

● Burn out

● The Bottom Line

employee response to sexual harassment

● Distract/redirect

● Choose a more public space

● Choose a different treatment

● Direct confrontation

● Establish a behavioral contract

● Issue a warning letter

● Transfer care

● Use a chaperone

● ALWAYS DOCUMENT

● Know the policies/laws

● Tell your supervisor

● Terminate care

● File a grievance

● File a claim

ERASE

E - expect misbehavior and make a plan for protection

R - recognize misconduct and inappropriate behaviors

A - address behaviors when they occur

S - support your colleagues when you see misconduct

E - establish/encourage - advocate for workshops, policies

prevention of sexual harrassment

• change culture

• implement protections

• take action

prevention of patient grievances

Clearly identify yourself

Choose your words and language carefully

Use third party witnesses when appropriate

Assess cognitive competence

Practice cultural responsiveness

Ensure informed consent

Know and abide by patients’ rights