Making 2019 The Year of Civility in Healthcare: Understanding the Issue of Disruptive Behavior in the Workplace by Phyllis

Stethoscope and broken heart concept for heart disease or illnes
Stethoscope and broken heart concept for heart disease or illness


I find it frustrating to acknowledge that despite all the work of recent years to implement initiatives aimed at creating healthy and safe workplace environments, that lateral and horizontal hostility still remains within the nursing profession. I think we all hoped that when the idea of Zero Tolerance bloomed into an actual human resource policy the darkest days were behind us. Disappointingly, this is not the case. The pink elephant remains in the room and the reluctance to talk openly about it continues as well.


Any form of workplace violence causes the targeted professional to be distracted and therefore, increases the risk of patient error (Saltzberg, 2011). Those who witness bullying but ignore or fail to escalate this behavior appropriately condone and perpetuate this violence by their silence (Hutchinson, 2009. It follows that any organization that fails to address any form of workplace violence through a formal system is indirectly promoting it (Joint Commission, 2008).  As the ANA stated in 2015, “to eliminate harmful actions and actions not taken in the workplace requires that the existence of disruptive behavior must first be acknowledged.”


No one is immune to the psychological distress of prolonged disruptive behaviors. The person targeted by a bully often feels helpless to defend themselves against the relentless onslaught of offensive, intimidating, and often abusive actions. Worse yet, they are often left alone to endure and process the tormenting feelings that accompany repeated humiliation, abuse, and threats to one’s safety.


Bullying is a shadow behavior that relies on techniques that are often obscure, subtle or disguised as something other than what it is. Bullies rely on the sense of powerlessness that is often felt by their victims to allow them to thrive. They also count on the silence of witnesses who fear that they may be the next target. Creating the perception of isolation helps them to perpetuate a sense of hopelessness and underscore their power. It is time to focus our attention on the destructive nature of this toxic behavior and force it into the light.


This is the first in a series of blog posts I will offer on this subject. In subsequent postings, I hope to shed a light on the nature of a bully. I also hope to offer workable approaches to addressing disruptive behavior and then finally discuss the need to incorporate emotional intelligence training into our cultures as the long term solution to this ongoing challenge.


For Further Reading:

  • (2015). Incivility, Bullying and Workplace Violence. An online article retrieved from file:///C:/Users/Phyllis/Downloads/PosStat-Endorsed-ANA-Incivility-Bullying-Violence.pdf
  • Bartholomew, K. (2014). Ending nurse-to-nurse hostility: Why nurses eat their young and each other (2nd ed.). Danvers, MA: HCPro, Inc.
  • Hutchinson, M. (2009). Restorative approaches to workplace bullying: Educating nurses toward shared responsibility. Contemporary Nurse, 32(1–2), 147–155.
  • Lipscomb, J., & London, M. (2015). Not part of the job: How to take a stand against violence in the work setting. Silver Spring, MD:
  • Saltzberg, C. W. (2011.) Balancing in moments of vulnerability while dancing the dialectic. Advances in Nursing Science, 34(3), 229–242.
  • Spector, P. E., Zhou, Z. E., & Che, X. X. (2013). Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies, 51(1), 72-84. doi: 10.1016/j.ijnurstu.2013.01.010
  • Stecker, M., & Stecker, M. M. (2014). Disruptive staff interactions: A serious source of inter-provider conflict and stress in health care settings. Issues in Mental Health Nursing, 35(7), 533–541. doi: 10.3109/01612840.2014.891678

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