Workplace Bullying and Disruptive Behavior

Home , Abuse, Workplace, Workplace bullying, Workplace relationships

Workplace Bullying and Disruptive Behavior:

What Everyone Needs to Know April 2011 Report # 87-2-2011

WHAT IS WORKPLACE BULLYING AND Some bullying situations involve employees WHO IS AFFECTED? bullying their peers, rather than a supervisor bullying an employee. The term mobbing refers Workplace bullying refers to repeated, to a group of coworkers targeting another unreasonable actions of individuals (or a group) worker. Supervisors should intervene directed towards an employee (or a group of immediately to address and stop mobbing employees), which are intended to intimidate, behaviors. degrade, humiliate, or undermine; or which In a prevalence study of U.S. workers, 41.4% of create a risk to the health or safety of the respondents reported experiencing psychological employee(s). aggression at work in the past year representing 47 million U.S. workers (Schat, Frone & Workplace bullying often involves an abuse or Kelloway, 2006). The research found that 13%, misuse of power. Bullying behavior creates or nearly 15 million workers, reported feelings of defenselessness and injustice in the experiencing psychological aggression on a target and undermines an individual’s right to weekly basis. dignity at work. Examples of bullying: Bullying is different from aggression. Whereas aggression may involve a single act, bullying • Unwarranted or invalid criticism involves repeated attacks against the target, • Blame without factual justification creating an on-going pattern of behavior. “Tough” or “demanding” bosses are not • Being treated differently than the rest of your necessarily bullies as long as they are respectful work group and fair and their primary motivation is to obtain • Being sworn at the best performance by setting high yet • reasonable expectations for working safely. Exclusion or social isolation • Being shouted at or being humiliated

• Excessive monitoring or micro-managing

• Being given work unrealistic deadlines

WHAT IS CORPORATE/INSTITUTIONAL BULLYING?

Corporate/institutional bullying occurs when bullying is entrenched in an organization and becomes accepted as part of the workplace culture.

Corporate/institutional bullying can manifest • Workplace relationships (e.g., inadequate itself in different ways: information flow between organizational levels, lack of employee participation in • Placing unreasonable expectations on decisions; and employees, where failure to meet those expectations means making • Work systems (e.g., lack of life unpleasant (or dismissing) policies about behavior, high rate anyone who objects; and intensity of work, staff shortages, interpersonal conflict, • Dismissing employees organizational constraints, role suffering from stress as ambiguity, and role conflict. “weak” while completely ignoring or denying potential HOW BULLYING AFFECTS work-related causes of the PEOPLE: stress; and/or Victims of bullying experience • Encouraging employees to fabricate significant physical and mental health problems: complaints about colleagues with promises of promotion or threats of discipline. • High stress; post-traumatic stress disorder (PTSD)

• Financial problems due to absence Signs of corporate and institutional bullying include: • Reduced self-esteem

• Failure to meet organizational goals; • Musculoskeletal problems • Phobias • Increased frequencies of grievances, resignations, and requests for transfers; • Sleep and digestive disturbances • Increased depression/self-blame • Increased absence due to sickness; and • Family tension and stress • Increased disciplinary actions.

If you are aware of bullying in the workplace and HOW BULLYING AFFECTS do not take action, then you are accepting a share ORGANIZATIONS: of the responsibility for any future abuses. This means that witnesses of bullying behavior should Each of the individual consequences listed above be encouraged to report any such incidences. can be very costly for the organization. Costs of Individuals are less likely to engage in antisocial bullying generally fall into three categories: behavior when it is understood that the organization does not tolerate such behavior and 1. Replacing staff members that leave as a that the perpetrator is likely to be punished. result of being bullied, cost of training new employees. Factors that Increase the Risk for Bullying 2. Work effort being displaced as staff cope Behavior: with bullying incidents (i.e., effort being • Significant organizational change (i.e., major directed away from work productivity and internal restructuring, technological change); towards coping)

• Worker characteristics (e.g., age, gender, 3. Costs associated with investigations of ill parental status, apprentice or trainee); treatment and potential legal action.

Bullies do not run good organizations; staff Another example of harassment could be a male turnover and sick leave will be high while manager who makes unwelcome sexual morale and productivity will be low. Stress, suggestions to a female employee and touches depression and physical her inappropriately. health problems result in time away from work that Bullying also differs from retaliation, which is costly in terms of occurs after a person makes a complaint of workers’ compensation illegal discrimination, and is then the subject of and lost productivity. an adverse employment action or subjected to harassment because he or she made the complaint, The health problems experienced by victims of If you believe that you are being harassed or bullying result in a sense retaliated against for making a discrimination of helplessness and complaint, you should immediately contact the negative emotional states. Washington State Human Rights Commission Low self-esteem and a (1-800-233-3247, http://www.hum.wa.gov). negative organizational climate suppress Bullying, on the other hand, is often directed at creativity and hamper someone a bully feels threatened by. The target employees’ abilities to often doesn’t even realize when they are being respond to difficult bullied because the behavior is covert, through situations or challenging goals. trivial criticisms and isolating actions that occur

behind closed doors. While harassment is illegal; The breakdown of trust in a bullying bullying in the workplace is not. environment may mean that employees will fail to contribute their best work, do not give extra ideas for improvement, do not provide feedback WHAT CAN BE DONE ABOUT BULLYING? on failures and may be less honest about Bullying in general is NOT illegal in the U.S. performance. unless it involves harassment based on race/color, creed (religion), national origin, sex, BULLYING IS DIFFERENT FROM age (40+), disability, HIV/AIDS or Hepatitis C HARASSMENT status and, in Washington State, on marital status, sexual orientation/gender identity, Harassment is one type of illegal discrimination honorably discharged veteran and military status and is defined as offensive and unwelcome or retaliation for filing a whistleblower conduct, serious enough to adversely affect the complaint with the Washington State Auditor terms and conditions of a person’s employment, (RCW 49.60). which occurs because of the person’s protected class, and can be imputed to the employer. However, here is what you can do about Protected classes in employment are race/color, bullying: creed (religion), national origin, sex, marital status, disability, HIV/AIDS or Hepatitis C Employees: status, sexual orientation/gender identity, and Regain control by: honorably discharged veteran and military status. An example of harassment could be when an • Recognizing that you are being bullied; employee tells racist jokes and refers to a • Realizing that you are NOT the source of the particular co-worker or group of co-workers by problem; and using racial slurs, and after a complaint, the employer does nothing to stop the behavior.

• Recognizing that bullying is about control, • Hold awareness campaigns for EVERYONE and therefore has nothing to do with your on what bullying is. Encourage reporting; performance. • Ensure management has an active part in the Take action by: staff they supervise, rather than being far removed from them; • Keeping a diary detailing the nature of the bullying (e.g., dates, times, places, what was • Encourage open door policies; said or done and who was present); and • Investigate the extent and nature of the • Obtaining copies of harassing / bullying problem. Conduct employee attitude surveys; paper trails; hold onto copies of documents that contradict the bully’s accusations against • Improve management’s ability and you (e.g., time sheets, audit reports, etc.). sensitivity towards dealing with and responding to conflicts; and Other actions: • Expect the bully to deny and perhaps • Establish an independent contact for misconstrue your accusations; have a witness employees (e.g., Human Resources contact). with you during any meetings with the bully; report the behavior to an appropriate person.

• Contact the Washington State Employee See the Assistance Program, example (http://www.dop.wa.gov/Employees/Employ Workplace eeAssistanceProgram/) for guidance on dealing with the issue. Bullying Policy at the end of Employers: this document.

• Create a zero tolerance anti-bullying policy. This policy should be part of the wider commitment to a safe and healthful working environment and should have the full support DISRUPTIVE BEHAVIOR IN HEALTHCARE: of top management;

• When witnessed or reported, the bullying Disruptive behavior is described as interactions behavior should be addressed among physicians, nurses, hospital staff, IMMEDIATELY; administrators, patients, guests, vendors that interfere with patient care. Healthcare employees • If bullying is entrenched in the organization, such as nurses and doctors behave professionally complaints need to be taken seriously and as the norm. However, there are benefits to investigated promptly. Reassignment of the acknowledging and addressing unprofessional bully may be necessary; behavior when it occurs;

• Structure the work environment to 1) The organization can identify, quantify, and incorporate a sense of autonomy, individual monitor the impact of disruptive behavior; challenge/mastery, and clarity of task expectations for employees – Include 2) The behavior can be addressed and resolved. employees in decision-making processes;

Some examples of disruptive behaviors are: • Employees sign a statement of commitment to abide by the Code of Conduct; • Profane or disrespectful language; • Encourage reporting - conduct regular surveys and focus groups; • Sexual comments, racial, ethnic, or socioeconomic slurs; • Follow-up – analyze and respond to data; • Inappropriate touching or assault, angry • Provide training for leaders, managers and all outbursts or yelling, name calling; hospital staff on how to respond; and • Throwing charts or instruments; • Form an interdisciplinary committee to oversee and modify the Code of Conduct as • Disrupting meetings; needed; and • Comments that undermine a patient’s trust • and confidence; Define a framework for understanding and addressing disruptive behavior. • Refusal to complete a task or carry out duties; The framework below was developed by Dr. • Intentional failure to follow organizational Gerald Hickson and colleagues at the Vanderbilt policies; and University School of Medicine and represents a • Retaliation against any person who has graduated level, peer involved intervention. This reported disruptive behavior. intervention has strong potential for changing the safety culture because many individuals in the The costs of disruptive behavior are significant: organization are actively involved in carrying out the intervention. The approach to intervening at • Tends to cause distress among other staff; each level should be supportive rather than • Undermines productivity; punitive. • Leads to low morale and high staff turnover; DISRUPTIVE BEHAVIOR PYRAMID: • Results in ineffective, substandard patient

care;

• Poor adherence to practice guidelines; No Level 3: Disciplinary Change Intervention • Medical errors and adverse outcomes; Ch Pattern Level 2: Authority • Loss of patients; and Persists Intervention

• Malpractice suits. Apparent Level 1: Awareness

Pattern Intervention WHAT CAN BE DONE ABOUT DISRUPTIVE Single “Informal BEHAVIOR? “Unprofessional Incidents” Intervention” Mandated Organizations can intervene to build a Issues collaborative safety culture by directing attention Vast Majority: No Issues to safety and creating contexts where people can Many are models of professionalism speak up and problem solve together.

• Create a Code of Conduct that defines Hickson, G.B., Pichert, J.W., Webb, L.E., & Gabbe, S.G. (2007). professional behaviors and unacceptable A complementary approach to promoting professionalism: Identifying, measuring, and addressing unprofessional behaviors. behaviors and includes policies and Academic Medicine, 82, 1040-1048. procedures for response;

Description of Intervention Levels: includes restriction or termination of privileges, reporting to government entities and other There is specific training in place for each level. actions related to the Code of Conduct policies Informal Intervention Is “a cup of coffee and procedures as do all levels of the Disruptive conversation” for single “unprofessional” Behavior Pyramid Intervention framework. incidents. A peer or supervisor selects a private Surveillance systems are required to provide setting for a brief review of the event with the information and data related to the disruptive disruptive person, pauses for a response, listens behavior. For further details about these and invites the perspective of the person who interventions and the pyramid framework, see: behaved unprofessionally. The person may be http://www.studergroup.com/home/index.dot defensive, minimizing or rationalizing. The response to this is, “Despite the situation, there Provide Support Services: are professional and unprofessional ways to Healthcare organizations can provide support respond and we expect a professional response.” services to the individual including use of an Conclude with discussing options for Employee Assistance Program or Wellness professional responses. Program, a medical evaluation and treatment planning, and group classes on professional Level 1: Awareness Intervention behavior. The organization can also provide Takes place after an apparent pattern develops service recovery for staff, patients and others and is identified by the surveillance system or who have experienced or witnessed disruptive reporting, when there is a threat to quality and behavior in the workplace. safety. An authority figure or peer shares a compilation of patient complaint data or report BENEFITS OF ADDRESSING DISRUPTIVE data from staff in a supportive manner. Most BEHAVIOR: individuals respond professionally and adjust behavior, reducing patient and staff complaints. • Improved staff satisfaction and retention; • Enhanced reputation for the organization; Level 2: Authority Intervention • Creates a culture of professionals; When the pattern persists and the person is • unable or unwilling to respond to the awareness Important role models for all others; intervention and change their behavior, the • Improves patient safety and quality of care; authority intervention is implemented. At this • level, leaders develop an improvement and Greater staff willingness to speak up on evaluation plan with accountability built in. patient care problems; Leaders specify what behaviors need to improve, • Reduced liability exposure & risk what support or services are needed, a timeline, management; and and what the outcome will be if the improvement • and evaluation plan is not successful. This A more civil, productive, and desirable intervention should be supportive rather than workplace. punitive. Most individuals want to improve but may be hindered by work or family stress, CONCLUSION: substance abuse problems, or mental health Successful healthcare organizations promote issues. professionalism, address disruptive behaviors Level 3: Disciplinary Intervention quickly, and adopt a framework for understanding and approaches for taking action. A lack of response to the authority intervention They also develop strong policies that clearly leads to the disciplinary intervention which define issues and provide guidelines for action to

address disruptive behaviors among healthcare • The Commission of Occupational Safety and providers and employees. Success is measured Health by achieving high levels of patient safety and (http://www.worksafe.wa.gov.au/newsite/ quality of care. worksafe/media/Guide_bullying_emplo.pdf)

RESOURCES & CONTACTS: • Joint Commission on the Accreditation of Health Care Organizations. (2009). The Washington State Employee Assistance Behaviors that undermine a culture of safety. Program (http://www.dop.wa.gov/Employees/ 40, 1-4. http://jointcommission.org/Sentinel EmployeeAssistanceProgram/) has Events/SentinelEvent Alert/sea_40.htm representatives that are available to help state workers with personal or work-related problems • The Studer Group and the Center for Patient that may be impacting your work performance. and Professional Advocacy at Vanderbilt EAP services are only available to state University. Workshops on Disruptive employees and are confidential, voluntary, free Behaviors in Healthcare. of charge, and accessible. EAP representatives http://www.studergroup.com/DB can be reached at these offices: Olympia (360) 753-3260 • Workplace Bullying and Trauma Institute, Seattle (206) 281-6315 Bellingham, Washington Spokane (509) 482-3686 • (http://www.bullyinginstitute.org/)

The Australian government has put together a • Guide for Employers on Workplace Bullying publication on “Advice to Supervisors on http://www.worksafe.wa.gov.au/newsite/ Bullying in the Workplace” that includes useful worksafe/media/Guide_bullying_emplo.pdf resources for employers, including a checklist to • assess whether you have a bully-free workplace. Guide for Employees on Workplace Bullying Use this checklist to see whether you are being http://www.worksafe.wa.gov.au/newsite/ bullied or have a bullying workplace: worksafe/media/Guide_bulling_employ.pdf http://www.defence.gov.au/equity/issues/ AdviceonBullying.doc Research References: • Fox, S. & Stallworth, L. E. (2009). Building a The following websites/organizations have put framework for two internal organizational together valuable information that includes approaches to resolving and preventing definitions and facts about bullying and workplace bullying: Alternative dispute disruptive behavior in the workplace: resolution and training. Consulting Psychology Journal: Practice and Research, • Bullying in the Workplace 61(3), 220-241. http://www.docep.wa.gov.au/WorkSafe/PDF/ Guidance_notes/Dealing_with%20bullying_e • Hickson, G.B., Pichert, J.W., Webb, L.E., & nglish.pdf Gabbe, S.G. (2007). A complementary approach to promoting professionalism: http://www.ccosh.ca/oshanswers/psychosocia Identifying, measuring, and addressing l/bullying.html unprofessional behaviors. Academic Medicine, 82, 1040-1048. • European Agency for Safety and Health at Work Facts: Bullying at Work • Rosenstein, A. H. & O’Daniel, M. (2005). (http://agency.osha.eu.int/publications/ Disruptive behavior & clinical outcomes: factsheets/23/factsheetsn23_en.pdf) Perceptions of nurses and physicians. American Journal of Nursing, 105, 54-64.

• Salin, D. & Hoel, H. (2011). Organisational causes of workplace bullying. In Einarsen, S., Hoel, H., Zapf, D., & Cooper, C. (Eds). Workplace bullying: Development in theory, research and practice. London. Taylor & Francis, 227-243.

• Schat, A. C. H., Frone, M. R., & Kelloway, E. K. (2006). Prevalence of workplace aggression in the U.S. workforce: Findings from a national study. In E. K. Kelloway, J. Barling, and J. Hurrell (Eds.), Handbook of workplace violence (pp. 47-89). Thousand Oaks, CA: Sage.

• Vartia, M. (2001). Consequences of workplace bullying with respect to the well- being of its targets and the observers of bullying. Scandinavian Journal of Work Environment and Health, 27, 63-69.

SHARP – Research for Safe Work

This document was produced by the Safety & Health Assessment and Research for Prevention (SHARP) Program – A research program within the Washington State Department of Labor & Industries. SHARP’s researchers and scientists partner with business and labor to identify industry- wide hazards and then develop sensible, effective solutions to eliminate those hazards.

If you have questions about this report or the SHARP program, please contact us at:

SHARP Washington State Department of Labor & Industries PO Box 44330 Olympia, WA 98504-4330 Tel. (888) 66-SHARP (toll-free) Fax (360) 902-5672 Email [email protected]

Check out our website at: www.Lni.wa.gov/Safety/Research

EXAMPLE WORKPLACE BULLYING POLICY Adapted from The Commission of Occupational Safety and Health, Government of Western Australia

Company X considers workplace bullying unacceptable and will not tolerate it under any circumstances.

Workplace bullying is behavior that harms, intimidates, offends, degrades or humiliates an employee, possibly in front of other employees, clients, or customers. Workplace bullying may cause the loss of trained and talented employees, reduce productivity and morale and create legal risks.

Company X believes all employees should be able to work in an environment free of bullying. Managers and supervisors must ensure employees are not bullied.

Company X has grievance and investigation procedures to deal with workplace bullying. Any reports of workplace bullying will be treated seriously and investigated promptly, confidentially and impartially.

Company X encourages all employees to report workplace bullying. Managers and supervisors must ensure employees who make complaints, or witnesses, are not victimized.

Disciplinary action will be taken against anyone who bullies a co-employee. Discipline may involve a warning, transfer, counseling, demotion or dismissal, depending on the circumstances.

The contact person for bullying at this workplace is:

Name: ______

Phone Number: ______

(http://www.worksafe.wa.gov.au/newsite/worksafe/media/Guide_bullying_emplo.pdf )