Origins, solutions, and approaches to the all-too-common problem of bullying and violence
Unfortunately, bullying and violence in healthcare is just as pervasive as it is in any other industry, if not more so. For professionals, stress from the job is often given as the motivation; for patients it’s agitation due to injury or illness, mental health degradation from stress or age, and the general anxiety that comes from being in a hospital.
As a nurse, it should be expected that you will encounter violence in the workplace at some point, as 76 percent of registered nurses report experiencing workplace violence, according to a 2014 study published in the Journal of Emergency Nursing.1
How to deal with bullying
Before tackling patient-related violence, it bears repeating that bullying from coworkers is just as common: 60 percent of new nurses quit their first job within the first six months due to the behavior of their co-workers, while nearly 50 percent of nurses believe that they will experience bullying at some time in their careers.2
In such instances, it’s important to know how to properly deal with bullying and secure your career and wellbeing for the long run.
The first and most important rule is to keep your head in the moment. It’s tempting to snap back at someone who we believe has unjustly slighted us, but doing so can and most likely will cause more problems. If you maintain your composure and deal with bullying calmly, the other party is much less likely to have ammunition against you. Responding to bullying in kind (especially violently) can easily be grounds for punitive action or termination given the circumstance.
One of the simplest ways to counteract bullying is to firmly, but politely call it out when it occurs. Oftentimes, people will only continue bullying behavior if they believe that the person they are targeting won’t fight back or stand up for themselves.
If that doesn’t work, documenting the bullying as it occurs is a great long-term strategy. Start a documentation trail; keep a small notebook with you and write down dates, times, witnesses, verbatim comments, and any behaviors you believe undermine a culture of safety and a professional work environment.
Keep growing this documentation trail until you are at the point where you can file a formal complaint.2 If you feel the need, you can also inform the bully in question that their behavior is being documented for future use. This can serve as an effective deterrent, as the threat of punishment is oftentimes enough to dissuade this type of behavior.
If the bullying continues and you have been keeping up with your documentation of its occurrences, follow through with a formal complaint. Many people are reticent to go through proper channels to resolve what they believe to be a personal issue, but remember HR departments exist for a reason. There’s no point in willingly working in an unbearable environment when the solution might be a few floors away. Just remember to follow through with your complaint, as making empty threats of professional retribution might just embolden your bully into harsher behavior.
As a final note, if the bullying that you’re suffering progresses to physical violence, move directly to filing a formal complaint. Dealing with nasty words is one thing, but no one should subject themselves to potential assault and injury from coworkers in any healthcare environment.
Dealing with Violence from Patients
As previously stated, violence or abuse from patients is sadly to be expected as a healthcare professional, so it is best to make sure that you are sufficiently prepared for that reality. There are proper and improper ways of dealing with these circumstances, however, so try to keep that in mind when dealing with patients. Lastly, though it is not an excuse for poor behavior, try to remember that many patients that act aggressively only due so because of pain, stress, or mental illness.
As before, the most important thing you can do is to maintain control over your emotions and your actions. Reacting in kind to a verbally abusive or violent patient can quickly lead down the road of termination or litigation.
When it comes to patients that verbally berate staff, first do your best to make sure that their complaints are not unwarranted. Though an average day as a nurse can be stressful and tiring, oftentimes patients become agitated simply because they feel as though they are not receiving the care or attention that they need or deserve. Though they can be frustrating, going out of your way to make clear your intentions to make them comfortable and cared for can go a long way.
Along that vein, diplomacy can be an excellent method of dealing with rowdy guests. After attending to a patient’s needs, it is good practice to spend a minute or two conversing with them. Let them know the status of their care and assure them they are receiving the best possible care. Many people just want to know that their concerns are not falling on deaf ears as they stew in their own stress while waiting in a hospital bed.
Once you are certain the patient has been tended to, if they continue verbally abusing the staff it’s often best to employ the simplest strategy: ignore them. Many times, loud and irate individuals just want to get a rise out of anyone they can, so it’s possible that simply ignoring them might cause the problem to abate.
In any of these cases, just as with bullying, make sure to document everything that you can. Documenting what a patient complains about and how it was handled can help protect you against internal issues and litigation.
When it comes to outright physical violence from patients, the simplest approach is often the best: stay back and stay safe. Most hospitals employ staff that have training in specifically dealing with physically restraining patients. If you are not such a staff member, make sure to have one present if you ever feel like a patient could become physically combative. And as always, make certain that absolutely everything is documented to the best of your ability.