Original Article Featured in OR Today Magazine, November 2016 Edition
Do you believe that workplace bullying and incivility are the same?
No. Workplace incivility can best be defined as low-intensity unpleasant behavior that is rude, impolite, or inconsiderate. While the target can feel insulted or angry; an actual desire or intent to harm the other person is ambiguous. Anyone has the potential to behave inappropriately towards a coworker given the right circumstances coupled with a lack of self-management.
Workplace bullying however, is ongoing, offensive, abusive, intimidating or insulting behavior or actions directed at a person(s), causing the target to feel threatened, abused, humiliated or vulnerable. The person experiencing prolonged bullying can feel a range of psychological and physiological symptoms. The research supports that, those who bully, are very aware of their behavior and its effect on the others; even though they may deny that there is intent. Fortunately, there is only a very small percentage of the workforce that is capable of such sustained disregard for another individual.
So these behaviors are very different. Should the management be different as well?
Yes, they should and I want to be clear as to why. The two keys here are insight and sustainability. The person who behaves in an uncivil manner has the ability to self-reflect on that indiscretion, feel remorse or regret and make the active choice to work on their self-management skills and achieve personal growth. A bully does not have this ability.
It is vital that we understand and accept that a nurse bully is a narcissist with a license. A narcissist lacks the capacity for empathy. The ability to reflect empathically on the consequence that one’s poor behavior has on another is vital for driving the desire to change. Bullies (narcissists) are incapable of this.
An uncivil staff member can gain insight though coaching and training. Positive, sustained changes in behavior can be noted within six to twelve weeks of working a clear emotional intelligence improvement action plan. A narcissist typically reacts in one of two ways to someone attempting to hold them accountable. They may escalate their behavior and retaliate or they will tell you what you want to hear and vow to reform. However, they cannot sustain any improvement because they lack a connection with the need to improve.
So why is managing bullying behavior in nursing so challenging?
This is a complex issue but one reason is that nurses are professional caregivers. Nursing leaders have a good deal of difficulty coming to terms with the fact that a bully/narcissist cannot be fixed. It is not a part of our caregiver DNA to “give-up” on someone. We talk ourselves into believing that if we just try a little harder that this individual will have an epiphany and the problem will be resolved.
The bully/narcissist is hoping that you will react exactly in this manner. They are experts at taking your wonderful qualities of empathy, patience and the need to heal and use them against you to achieve their goal of never being held accountable to sustained improvement. Essentially, we need to get out of our own way in order to take charge of this situation. Nurse leaders must try to accept that once someone shows you their true colors, you need to resist repainting them.
The only performance improvement plan for a bully/narcissist is a collaborative effort put forth by administration, human resources and the nurse leader that is time sensitive and rich with mandatory training. The documentation should discuss the need for improvement to be demonstrated within three to six months then sustained for six months as well.
Most bully/narcissists will not be able to withstand this type of scrutiny and may decide to move on. The others may stay but will find it very challenging to sustain the improvement. Should termination be the only option left, you can have the peace of mind that a sincere effort was made on your part; and twelve months’ worth of documentation to support your action.
Q: A good deal of your coaching practice is centered on working with family caregivers. What are some of the challenges facing family caregivers today?
A: Their biggest challenge is to have a life of their own while caring full time for their loved one and not self-destruct in the process. I think it is so important to remember that in most cases, family caregivers never saw this responsibility coming. They didn’t go to school to learn how to be caregivers. They did not make a conscious decision to make a career in caregiving. They responded to a life-changing event, which usually involved a spouse, parent or child. They made the significant changes necessary to be fully present and care for that person. That is not only love and loyalty in action; it is the highest form of generosity. By in large, family caregivers go it alone. What community resources were available are now all but gone since the economic downturn of 2007. So my work with these clients is centered on finding ways to meet their self-care needs and in identifying ways to seek assistance. I am a huge proponent of the care model put forth by The Share the Care Organization. This not-for-profit organization conducts training programs to teach professional and family caregivers how to set up care circles. We usually have a group of friends and neighbors who would like to help but are not capable of rendering physical care. This care model focuses on what people can do. Perhaps you can help with marketing, lawn care, driving to doctor appointments, etc. Creating care circles allow others to help you and your loved one so that the responsibilities of your life do not become overwhelming.
Q: What is your approach to coaching?
A: My approach to coaching is to view my client as whole, competent and capable. I understand how challenging it can be to remain clear and authentic about ones goals and one self as you try to navigate your life. Responsibilities, setbacks and the demands of an adult life can overshadow a person’s understanding of the present and cloud his or her vision for the future. Our very human nature creates blind spots to options and solutions. My goal is to empower my client to access their own innate knowing and personal wisdom. I can support them as they explore where they are now, guide them in clarifying where they want to be, assist them in setting up a timeline, and support them efforts to attain their goals in a nonjudgmental manner.
Q: What is compassion fatigue?
A: It is a condition characterized by a gradual lessening of your ability to render empathic care over time. Those at risk for the development of compassion fatigue include: nurses, social workers, first responders, special education teachers, and the family caregivers of those with chronic illnesses. Symptoms include but are not limited to, a decrease in experiences of pleasure practicing a profession you once loved, a sense of relentless stress, anxiety over the thought of going to work, and a pervasive negative attitude that creeps into all areas of your life. Long term, this can have devastating effects on your work performance and relationships and life.
Q: How can you start a person along the process of recovery from compassion fatigue?
A: Caregivers have a difficult time with the idea of receiving care therefore, acknowledging that you may be experiencing compassion fatigue and seeking help is a healthy first step. Everyone’s journey to the development of the syndrome is unique so there is no such thing as one approach fits all. However, the biggest hurdle to get over is to embrace the fact that you must take just as good care of yourself as you do others. It is vital to approach caregiving from a place of fullness and not try to render care when you are fueling yourself from the fumes of your compassionate nature. The airline industry really gives the best advice. Put your own oxygen on first, and then help the other person. A big part of recovery is to incorporate an adequate rest and self-care regimen into your life. This adaptation should be seen as a treatment for compassion fatigue and as a vaccination against developing the syndrome again.
Q: Why do you recommend a regular mindful practice for caregivers?
A: People who are drawn to human services are perpetual doers. They start doing from the minute they wake up and don’t stop until they fall asleep. They only way to add a sense of balance to that approach to life is to incorporate regularly scheduled times when we are just still and breathing. Doers are always in their head thinking about what they need to do and whom they need to do it for. So taking time to just sit and breathe, so that you are more aware of being in your body rather than stuck in the endless loop of thinking, can offer a much needed break from perpetual doing.
Q: What inspired you to write your book; Rediscover the Joy of Being a Nurse?
A: As I was crisscrossing the country speaking and coaching at various nursing events, I was deeply saddened by the degree of personal pain these nurses were struggling with every day. I felt the need to try to offer some guidance to those who felt so disconnected from something that meant so much to them. The insight the book offers is not centered on anything that we learned in nursing school. Rather, it is focused on the development of three vital life skills: the ability to adapt, the ability to make and sustain relationships and the ability to be resilient. I believe that cultivating these three life skills can help nurses refocus their attention on themselves and what they need to have a content professional and personal life for the long term.
Q: What has been the most successful marketing strategy for you?
A: Developing my relationship within the social networks on LinkedIn. I have found LinkedIn to be the most professional and powerful networking medium. Everyone using this platform is serious and looking to connect with other serious individuals. Engaging on LinkedIn is a commitment of time and effort but the return on my investment has been worth it. Many of my most important opportunities have been offered to me through LinkedIn.
Originally published in the AORN Periop Insider Weekly Newsletter July 28, 2016. Authored by Carina Stanton
The term “bully” is often used incorrectly to classify both bullies and those expressing incivility. Understanding the distinction between the two can help to put structure around communication and action in attempts to weed out bad behavior in perioperative nursing care, according to nursing Career Coach Phyllis Quinlan, PhD, RN-BC.
“The 10% of nurses who are true bullies have a personality defect,” Quinlan says. “Knowing the distinction is key to protecting your staff and deciding whether to develop a plan of remediation or to get rid of a toxic staff member.”
Understanding Incivility vs. Bullying
Quinlan describes bullying as a threatening behavior based in intimidation that stems from the bully’s issue with personal power. “For a bully, their personal power is far more important than the other person’s needs—if the other person needs to feel supported, a bully says ‘tough.’”
A person who indulges in bullying is very egocentric and has far more limited opportunity for personal growth, introspection and a commitment to change.
In the practice setting, a bully will intimate to someone that “you are on your own, if you don’t do what I want I have the power to isolate you,” Quinlan explains. She says bullying is not distinct to one professional level because this bad behavior knows no direction. It can be top down (leadership to staff), down up (staff to leadership) or lateral (peer to peer).
Although incivility is also bad behavior, it stems more from not being fully respectful of the other person’s perspective. Incivility is commonly seen by Quinlan during patient hand-offs or when a patient is transferred to a different area of care, such as from the OR to PACU. “As the nurse is explaining the patient’s state and previous care, an uncivil reaction by the nurse listening is to act as though they are being inconvenienced or worse to provide negative judgment about the previous care, making the nurse handing off the patient feel as though they must justify themselves and their actions.
With 80% of communication being non-verbal, much uncivil behavior is expressed with a less-than-polite facial expression or a toe-tapping type of stance indicating the nurse talking should speed it up and finish what they are saying.
Seeing Bad Behavior as Neurotic Need
One common thread between incivility and bullying is denial of wrongdoing. “If you ask an uncivil or bullying nurse to assess their behavior, they will report they were unaware of wrong doing and may say the nurse who reported their behavior was ‘too sensitive’ or ‘took it the wrong way.’”
Yet research indicates that both uncivil and bullying nurses essentially know exactly what they are doing because it fills a neurotic need.
Quinlan recalls the words of Abraham Lincoln, in which he suggested you can see the character of a person when you give them power. “Someone with good character will take a role in power and be collegial, find common ground and be generous enough to give praise for a job well done. On the flip side, someone with problematic character will use a power role to offer criticism and make remarks that are self-serving.”
Catching It Early
For new employees, Quinlan recommends a set time frame for a probationary period in which the hire is observed for both clinical and behavioral performance. Quinlan says nurses who are good clinically but lacking in collegial behavior are often kept on staff to work on the behavior piece, what she hears nurses refer to as the “soft stuff.”
“Nonsense, behavior is the tough stuff and should be viewed as equally important to clinical skills,” Quinlan stresses. She advises a strong collaboration between nursing, hospital administration and human resources to establish strict behavioral boundaries that are reviewed wisely through the probationary period to measure knowledge, skills and behavioral benchmarks that are demonstrative of culture.
“Make sure everyone is on same sheet of music with clear descriptives of bullying and incivility weaved into your code of conduct and stand behind a zero-tolerance approach to toxic behavior,” she suggests. “If a true bully is identified, cut your losses quickly, otherwise you will lose good staff members.”
Register now to attend “Bringing Shadow Behavior into the Light of Day: Understanding and Addressing Incivility and Bullying Behavior,” AORN’s Nurse Executive Leadership Seminar with Phyllis Quinlan, and get the skills to build your own zero-tolerance policies and practices against bullying and incivility.
When I was 22, I scored what I thought was my dream job. I moved from the snowy Midwest to sunny Florida with a group of fellow former college athletes to help a global athletic brand launch a sports academy. But within two years I and many of my peers had left our jobs.
We had fallen victim to a work culture rife with bullying, rudeness, and other incivility that was set by a dictatorial head of the organization and had trickled down through the ranks. Employees were at best disengaged; at worst they undertook acts of sabotage or released their frustration on family members and friends. By the time I left, many of us were husks of our former selves.
That experience was so formative that I decided to spend my professional life studying workplace incivility—and its costs and remedies. My research has shown that it is almost impossible to be untouched by incivility during one’s career. Over the past 20 years I’ve polled thousands of workers and found that 98% have experienced uncivil behavior and 99% have witnessed it. In 2011 half said they were treated badly at least once a week—up from a quarter in 1998. Rude behavior ranged from outright nastiness and intentional undermining to ignoring people’s opinions to checking e-mail during meetings.
As I and my colleagues at the sports academy discovered, incivility in the workplace drags down performance and takes a personal toll. In laboratory settings I’ve found that simply observing it makes people far less likely to absorb information. Seeing or experiencing rude behavior impairs working (short-term) memory and thus cognitive ability. It has been shown to damage the immune system, put a strain on families, and produce other deleterious effects.
Unfortunately, people’s resilience to incivility is partly out of their control. Research has shown that responses to threat, humiliation, loss, or defeat—all commonly associated with incivility—are significantly influenced by genetic makeup. Perhaps as a result, the most effective way to reduce the costs of incivility in the workplace is to build a culture that rejects it—to adopt “the no asshole rule,” as Robert Sutton calls it in his best-selling book by that name. But very few organizations can comprehensively enforce this rule. So when individuals encounter incivility, what should they do?
My research has uncovered some tactics that anyone can use to minimize the effects of rudeness on performance and well-being. I wish I could have shared these with my younger self as she floundered in a hostile work environment many years ago.
The Usual Responses Often Fall Short
Many people decide to tackle incivility head-on—through either retaliation or direct discussion. Another common response is to try to work around the problem by avoiding the perpetrator as much as possible. Although these approaches can help in certain situations, I don’t usually advise people to take them. Avoidance often falls apart, because sometimes you have no choice but to collaborate with discourteous colleagues. Confrontation can make the dynamic worse. In my surveys I’ve found that more than 85% of people who chose to avoid or confront perpetrators were unsatisfied with how the situation ended or how they handled it, and those who attempted confrontation were no more satisfied than those who didn’t respond. Relying on institutional remedies rarely works either—a mere 15% report being satisfied with how their employers handle incivility. In fairness, organizations often have no opportunity to act: More than half of survey respondents say they don’t report rudeness, largely out of fear or a sense of helplessness.
A Holistic Approach
Just as medicine is shifting from a focus on fighting illness to one on promoting wellness, research in my field—organizational behavior—has begun to discover that working to improve your well-being in the office, rather than trying to change the offender or the corrosive working relationship, is the most effective remedy for incivility.
That’s not to say you shouldn’t report a rude or bullying colleague to HR, or try to manage conflict directly. But a more sustainable way to deal with bad behavior is to make yourself impervious to it—or at least a lot less vulnerable. To do that, it’s helpful to look at what we know about thriving—the psychological state in which a sense of vitality and self-improvement fortifies people against the vicissitudes of life.
Few people are satisfied with how their employers handle incivility.
In my research I have found that thriving people are healthier, more resilient, and better able to focus on their work. They are buffered against distraction, stress, and negativity. In a study of six organizations across industries, employees characterized as high thrivers burned out less than half as often as their peers. They were 52% more confident in themselves and their ability to take control of a situation, and their performance suffered 34% less after an unpleasant incident.
If you’re thriving, you’re less likely to worry about a hit or take it as a personal affront, more immune to the waves of emotion that follow, and more focused on navigating toward your goal. Yet despite these obvious advantages, fewer than half the people I’ve surveyed focus on themselves and work to foster a thriving mentality after a brush with incivility. Rarely do they consider that the antidote might be totally disconnected from the incident at hand.
How can you help yourself thrive? I suggest a two-pronged approach: Take steps to thrive cognitively, which includes growth, momentum, and continual learning; and take steps to thrive affectively, by which I mean feeling healthy and experiencing passion and excitement at work and outside it. These two tactics are often mutually reinforcing—if you have energy, you’re more likely to be motivated to learn, and a sense of growth fuels your vitality. But distinguishing between them can help people recognize in which area they may be lagging and take steps to bolster their defenses for the next hostile encounter.
If you’ve dealt with a rude colleague, you probably know how hard it can be to get over it. Perhaps no feeling is more difficult to overcome than a sense of injustice. Neuroscientists have shown that memories attached to strong emotions are easier to access and more likely to be replayed, and ruminating on an incident prevents you from putting it behind you. This can cause greater insecurity, lower self-esteem, and a heightened sense of helplessness.
I encourage people to shift their focus to cognitive growth instead. Your conscious brain can think about only so many things at once—far better that it keep busy building new neural connections and laying down new memories.
You can allow yourself to feel hurt or outraged—but for a limited time only. Tina Sung, a vice president at the nonprofit Partnership for Public Service, shared with me a saying that captures this advice: “You can visit Pity City, but you can’t live there.” I might add that Pity City is a good place to drop off your baggage.
Journaling and other rituals can help bring closure. As David Brooks documents in his new book, The Road to Character,Dwight D. Eisenhower often wrote furious invective in his journal to release negative emotions related to colleagues. He started the habit while working as an aide to the famously tyrannical General Douglas MacArthur.
Once your attention has shifted to more-productive avenues, several steps can help you focus on cognitive growth. First, identify areas for development and actively pursue learning opportunities in them. Teresa Amabile and Steven Kramer have shown that progress is a more powerful motivator in the workplace than even recognition or pay. It can be equally effective in helping employees bounce back from incivility. One young woman working in marketing told me, “A toxic environment was chipping away at my soul.” She saw no quick or easy path out of her position, so she decided to pursue an MBA at night. Events along the way, such as achieving a great GMAT score, provided excitement and confidence. Although her future remained unclear, she became more resilient to her corrosive workplace.
It’s worth noting that these development efforts need not be linked directly to your job. Taking on a new skill, hobby, or sport can have a similar effect. It’s simply harder to be dragged down when you feel on the upswing.
Another way to promote cognitive growth is to work closely with a mentor. Mentors have a knack for helping their protégés thrive by challenging them and ensuring that they don’t stagnate or get caught in an unproductive churn. For example, Lynne, a consultant working in an uncivil environment, built a close relationship with a mentor who urged her to steer clear of any unnecessary drama and focus on her own performance. When Lynne felt that she was slipping into rumination, recrimination, and anger, her mentor reminded her of the toll on her happiness and productivity and pointed her in more-fruitful directions. Following the advice, Lynne was able to dramatically improve her well-being—and her performance, which scored her a promotion.
I find it useful to think of rude behavior in the workplace as an infectious pathogen, like a virus. Your defense against it depends in good measure on how well you are able to manage your energy. In fact, my research suggests that many of the factors that help prevent illness—such as good nutrition, sleep, and stress management—can also help ward off the noxious effects of incivility.
Sleep is particularly important: A lack of it increases your susceptibility to distraction and robs you of self-control; makes you feel less trusting, more hostile, more aggressive, and more threatened even by weak stimuli; and can induce unethical behavior. In short, sleep deprivation (usually defined as getting less than five hours a night) is a recipe for responding poorly to incivility and perhaps even damaging your career.
Exercise is another surefire way to protect yourself against the negative emotions, such as anger, fear, and sadness, that are typically brought on by rude behavior. It enhances both cognitive firepower and mood, distracts you from your concerns, reduces muscle tension, and improves resilience. It has been shown to slash symptoms of anxiety by more than 50%, and in one study it even proved to be more effective at treating depression than sertraline, a leading prescription for the illness. Those who exercise regularly are far less likely to sulk and better able to rebound in the wake of negative interactions.
Maintaining your energy in other ways, such as eating healthfully, will also help put you in top form to respond smoothly to an uncivil encounter. When famished, most people tend to respond to frustration by lashing out.
But it’s not just about caring for your body. Mindfulness—shifting your consciousness to process situations more slowly and thoughtfully and to respond with greater premeditation—can help you maintain your equilibrium in a difficult environment, as can finding a sense of purpose in your job. I and other researchers have discovered that when people are engaged in work they consider meaningful, they are more productive in uncivil teams than their colleagues are. Reminding yourself of nonmonetary attributes that attracted you to your work in the first place may foster gratitude and satisfaction.
If You Choose Confrontation
If you’re thinking about confronting a colleague who’s been rude, ask yourself three questions: (1) Do I feel safe talking with this person? (2) Was the behavior intentional? (3) Was it the only instance of such behavior by him or her?
If you answered no to any of the questions, do not discuss the incident with the offender. Concentrate on your own effectiveness and, in future encounters, follow the acronym BIFF: Be brief, informative, friendly, and firm.
But if you answered yes to all three questions, consider telling the offender how the behavior made you feel. Some things to keep in mind:
Prepare for the discussion. Think about a good time and a safe environment in which you’ll both be comfortable. Consider whether to invite other people to be witnesses or mediators.
Rehearse your ideas with someone who will give you honest feedback. Ask that person to role-play the perpetrator, complete with temperament.
Be aware of your nonverbal communication. This includes posture, facial expressions, gestures, tempo, timing, and especially tone of voice. People practice what they plan to say far more than how they will say it. But studies show that words convey far less meaning than does the way they’re delivered.
Proceed with the goal of mutual gain. During the discussion, focus on the issue (not the individual) and how the specific behavior harms performance.
Prepare for an emotional response. If the perpetrator starts venting, try to tolerate it: It may lead to a more productive place. Use wording such as “I get that” or “I understand.” Admitting blame when appropriate may also be helpful.
Be an active listener. Paraphrase what you hear and repeat it. People gain credibility and are better liked when they ask humble questions.
Focus on establishing courteous norms for the future. How will you interact so that neither of you suffers degraded performance moving forward?
Positive relationships within and outside the office also provide an emotional uplift that can directly counterbalance the effects of incivility. Research I conducted with Andrew Parker and Alexandra Gerbasi shows that across industries, organizations, and levels, “de-energizing,” negative relationships have four to seven times as much impact on an employee’s sense of thriving as do energizing, positive ones. In other words, you need a small group of energizers to offset the effects of each jerk. So think about the people in your life who make you laugh and who lift your spirits. Spend more time with them, and ask to be introduced to their friends.
Finally, in studies of MBAs, executive MBAs, and employees, I have found a consistently strong correlation between thriving outside work and resilience to incivility. In a study of people who experienced rudeness, those who flourished in nonwork activities reported 80% better health, 89% greater thriving at work, and 38% more satisfaction with how they had handled the encounter. Seeking leadership roles in the community—particularly if you have no immediate opportunity within your organization—bolsters both cognitive and affective thriving. One executive I interviewed decided to join the board of a nonprofit dedicated to improving the lives of patients with dup15q, a condition his daughter had inherited. He spearheaded fundraising efforts, helped build scientific interest, and stewarded the group’s finances. These experiences and rewards, he told me, made him feel nearly bulletproof at work.
Incivility exacts a steep price. In extreme cases a job change or relocation may be needed to avoid burnout and to preserve your health and well-being. My research shows that for every eight people who report working in an uncivil environment, approximately one ultimately leaves as a direct result, and, looking back, I know I was right to exit the Florida sports academy. However, when I encounter rude behavior now, I’m better armed to offset its effects. Like everyone else, I’m still a work in progress, and my response is rarely perfect. But I can say with confidence that focusing on a sense of thriving has made me a more engaged, productive, and happy professional. You can be too.
A version of this article appeared in the April 2016 issue (pp.108–111) of Harvard Business Review.
Christine Porath is an associate professor of management at Georgetown University, a coauthor of Mastering Civility: A Manifesto for the Workplace (Grand Central Publishing, forthcoming), and a coauthor of The Cost of Bad Behavior (Portfolio, 2009).
I will fearlessly assess my personal strengths and weaknesses, work diligently to bolster my weaknesses and to graciously recognize my strengths.
I will fearlessly make my voice be heard with regard to my loved ones care and be a strong ally to those professional caregivers committed to caring for my loved one and a fearless shield against those not committed to caring for my loved one.
I will fearlessly not sign or approve anything I do not understand, and will steadfastedly request the information I need until I am satisfied with the explanations.
I will fearlessly ensure that all of the necessary documents are in place in order for my wishes and my loved ones wishes to be met in case of a medical emergency. These will include Durable Medical Powers of Attorney, Wills, Trusts and Living Wills.
I will fearlessly learn all I can about my loved one’s healthcare needs and become an integral member of his or her medical care team.
I will fearlessly seek out other caregivers or care organizations and join an appropriate support group; I realize that there is strength in numbers and will not isolate myself from those who are also caring for their loved ones.
I will fearlessly care for my physical and emotional health as well as I care for my loved one’s, I will recognize the signs of my own exhaustion and depression, and I will allow myself to take respite breaks and to care for myself on a regular basis.
I will fearlessly develop a personal support system of friends and family and remember that others also love my loved one and are willing to help if I let them know what they can do to support my caregiving.
I will fearlessly honor my loved one’s wishes, as I know them to be, unless these wishes endanger their health or mine.
I will fearlessly acknowledge when providing appropriate care for my loved one becomes impossible either because of his or her condition or my own and seek other solutions for my loved one’s caregiving needs.
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 what I hear from my private coaching clients and other professional caregivers across the country. The elephant remains in the room and the reluctance to talk openly about it continues as well.
I do not feel the need to define bullying behavior or outline the toll such shadow behavior takes on individuals. You are all too familiar with it most likely because you have been on the receiving end of it. What I want to shed some light on is the nature and makeup of someone who engages in bullying tactics. Having insight into the mindset of the enemy goes a long way to taking the power away from them and empowering yourself.
First I want to point out that we often use the term Bully to describe a coworker or leader that exhibits uncivil conduct but is not a true bully. Unfortunately, we live in a time where uncivil behavior is celebrated. Just consider some of the popular reality TV programs currently enjoying high ratings let alone the antics demonstrated along the campaign trail of 2016. Engaging in uncivil behavior is the consequence of a low emotional intelligence and an unrefined ability to manage one’s emotions under stress in the workplace. Keep in mind that we are all capable of giving into the needier side of our neurotic selves under pressure.
People who are, at times, uncivil usually have the ability to step outside themselves and reflect on a disagreeable interpersonal exchange and take ownership of their behavior when they cool off or are held responsible and accountable by others. They are also capable of expressing genuine remorse and of taking steps to improve in the future. Bullies do not have that capacity.
Consider the following characteristics of an individual with the neurotic personality disorder known as narcissism. They include but are not limited to:
Having a strong need for control
A desire to dominate people and situations
Perceiving themselves as a special, elite individuals that are deserving of VIP treatment
Lacking in empathy toward others
Having a tendency to be exploitative of others
Now think of someone you work with that is knowingly intimidating and/or cruel; someone who has no desire to consider how their words or behaviors affect others. That’s right! Bullies are narcissists. Investing time and efforts into trying to appeal to their higher nature and grow from coaching sessions or disciplinary actions will prove very frustrating. An individual must first be capable of acknowledging that there is an issue before they can buy into their responsibility to remedy the issue. Narcissists lack the ability to grow from insight and introspection.
Addressing both uncivil and bullying behavior requires a true collaboration between administration, the human resources department and in organizations with collective bargaining agreements, labor. All stakeholders must agree on a unified definition of bullying behavior and a unified approach to bullying conduct. The finish line for tolerating this type of misconduct must be fixed and unaffected by the manipulating skills of the bully.
Managing someone who is given to uncivil behavior is very different than addressing someone with a true bullying mentality. The person given to regular demonstrations of low emotional intelligence must understand that we are now in a time in the industry of healthcare and the profession of nursing when skills and knowledge are not enough to secure your professional future.
The literature demonstrates that the level of one’s emotional intelligence directly correlates with that person’s ability to demonstrate a consistent caring behavior to patients and families as well as own their responsibility to maintain a healthy work environment (McQueen 2004). If these individuals are not willing to grow from in-the-moment feedback, coaching and in-depth discussions during the performance evaluation process then; the conversation must move onto asking if they are in the right working environment.
Unfortunately, the personality of a narcissist does not make them amenable to demonstrating sustained improvement with conventional managerial interventions. In these instances, clear performance improvement plans must be crafted and immediate and sustained improvement demonstrated. The push-back will be relentless but there are very few options.
So my question becomes, if we are not willing to put an end to abusive conduct in the workplace now, when will we be willing? Let us resist getting caught up in finger pointing and complaining about how our inter-professional colleagues may mistreat us. Let us decisively address the issues in our own house first. We must commit now, not later, to peace in our time.
Bakr M, Safaan S (2012) Emotional intelligence: a key for nurses’ performance. Journal of American Science. 8, 11, 385-393.
Benson G, Martin L, Ploeg J et al (2012) Longitudinal study of emotional intelligence, leadership, and caring in undergraduate nursing students. Journal of Nursing Education. 51, 2, 95-101
Codier E, Codier D (2015) A model for emotional intelligence and patient safety. Asia Pacific Journal of Oncology Nursing. In Press
Codier E, Kooker B, Shoultz J (2008) Measuring the emotional intelligence of clinical staff nurses: an approach for improving the clinical care environment. Nursing Administration Quarterly. 32, 1, 8-14.
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McQueen A.C.H. (2004) Emotional intelligence in nursing work: Journal of Advanced Nursing 47(1), 101–108
Most of us have experienced incivility in the workplace. Inappropriate behavior toward coworkers typically stems from a variety of factors: increased workloads resulting in stress and fear, inflated self-importance, the desire to win at all costs, and insensitivity to the needs of others. But what it all boils down to is a lack of respect for colleagues.
Many of my executive-coaching assignments have been triggered because talented professionals simply treated their coworkers badly. The worst part is that these managers weren’t even aware of how inappropriate their actions were.
The good news is that a hopeful countertrend to incivility is emerging: the rise of an increased emphasis on emotional intelligence (EQ) in the workplace. EQ is the ability to recognize both your emotions and those of others, and to use that information as a behavioral guide.
The concept of EQ has been around for a while, but its increased value has been spurred by the new workforce, especially Millennials. Employees want to feel understood, appreciated, and respected at work. An emotionally intelligent leader will fulfill these needs. It’s no secret that organizations that foster high levels of EQ have more engaged and productive employees.
Being emotionally intelligent doesn’t imply that you’re soft; it means that you have higher levels of self-awareness and self-regulation. It also means that you have empathy and an ability to interact effectively with others.
Can EQ Be Taught?
Absolutely, but as with any skill, there must be a desire on the part of the learner. People who want to improve by replacing a bad habit with a good one are likely to have greater success in change.
The “why” that motivates such a change is an internal or intrinsic desire. When people think they have to change, the motivation is extrinsic rather than intrinsic. If your job hangs on the thread of a behavior change, you might be extrinsically driven to make the change. You’ll do it because you have to, but the impact of the change will be less effective because it will take so much more effort.
Self-awareness is the starting point for change. If you don’t possess a reasonable understanding of your behavior, it’s hard to make a change. My experience is that many badly behaving professionals aren’t conscious of their behavior because it’s so ingrained and because few people call them out on it. Even frustrated executives who are painfully aware of the repercussions of such managers aren’t as direct as they should be when delivering feedback.
A Case for Change
I worked with a client who was clueless about the degree to which his lack of emotional intelligence was contributing to his professional downfall. He was horrified to learn how his coworkers perceived him, and claimed that his manager hadn’t told him about the extent of the complaints. Upon further examination, I discovered that his manager had indeed skirted the issue because she was self-conscious and embarrassed to confront him.
After this rocky start, we made excellent progress. The client intrinsically wanted to change and was determined to reverse his behavior. We went through a self-awareness exercise where we mapped the “bad” behavior against the direct impact on his coworkers, as well as the indirect or “ripple effect” impact. The ripple effect is equally as important as the direct effect because people are usually shocked by how one cruel or insensitive remark can go far obsolete beyond the immediate recipient of the comment.
After he gained clear (and painful) cognizance of the impact of his conduct, he was highly motivated, and positive changes came relatively quickly. We worked for several months to anchor and solidify the improved behaviors. The feedback from his manager and coworkers was encouraging, and he had renewed confidence about his performance.
In today’s business world, leaders who understand the value of EQ will render obsolete badly behaving bosses. As employees continue to call for an end to incivility in the workplace, increasing EQ at all levels of leadership will become critical.
Tips to Build Self-Awareness
Self-awareness is the starting point for improving emotional intelligence, so consider the following steps:
Keep notes on how you react in stressful situations at work. Review these with a trusted friend or colleague and ask for feedback.
Pay attention to the impact your behavior has on others.
Compare your patterns of behavior at work with those at home to determine consistency.
After you have reflected on your behavior, ask your trusted friend for direct feedback and really listen.
Pick one aspect to work on, and make one small change. When you’re ready, select another area and repeat.
Peg is a legend. Not because of how great she is. Peg is a legend because of how HORRIFIC she is! Peg is a bully and everyone knows it. Her stories are legendary and are told by her victims around the campfires of the 21st century – Starbucks and wine bars.
Peg befriends new nurses until she gains their trust and then she stands back and watches them drown.
Peg deliberating withholds important details (like the patient needs to lie flat for 4 hours) when giving report to the nurses she secretly hates so that they make mistakes.
When in charge, Peg assigns the most acute and complex patients to the newest nurse on the unit while her “friends” get the easiest assignments.
Everyone knows Peg’s reputation, even administration. Yet Peg is still employed and terrorizing new and existing employees.
Because nobody can ever really catch Peg in the act.
Peg is a professional bully.
Peg and bullies like Peg are some of the biggest challenges nurse leaders face. These are the employees who they KNOW are bullying others but they can’t seem to catch them. They can’t find a clean way to fire them. However, these folks pose the greatest risk to the organization.
Workplace bullying has been linked to intent to leave, poor patient outcomes and poor productivity.
How to Catch a Professional Bully
STEP 1: JOIN FORCES
Just like tracking down a criminal, numerous departments get involved – FBI, Secret Service, local police, CIA, etc. They meet to discuss the criminal and then use their specialized skills to capture him!
Schedule a meeting with human resources, the bully’s front line manager, clinical director, CNO and CMO.
Discuss the bully and ask these questions: What has been done so far? Is there anything documented in their file? Any disciplinary actions? Any written documentation, etc?
Develop a strategic plan for how you will collect information and confront bullying acts.
Determine what you need to terminate the bully. Your human resource representative can help with this piece.
STEP 2: CONFRONT THE BULLY
When I ask leaders if anyone has actually had a conversation with the bully about behavior, the answer is either no or they don’t know. Using silence as a strategyis one primary reason why professional bullies remain employed. It’s because when called into the HR office, they often can’t be held responsible if nobody sets the expectations.
Meet with the bully. Tell her that you KNOW she is behaving in ways that are compromising patient safety and a healthy workplace.
Look her in the eye and say, “This is what I expect from you starting today.” And then spell it out very clearly how you want her to behave and what will happen if she violates your expectations.
Get a commitment from her by saying this, “Can I count on you to meet these expectations?”
STEP 3: REMOVE HER POWER
Why do we put people who we KNOW are destructive into power positions?
If she is a preceptor, stop letting her precept new nurses.
If she is in charge, take her out of that role.
If she is leading any committees, remove her.
Strip her from anything that gives her power.
STEP 4: BUILD A CASE
I know you think you can’t catch her. That she is so stealth – always hovering under the radar. However, SOMEBODY knows and witnesses what she’s doing – ALWAYS. You need to figure out who are the witnesses (they are usually the victims and support staff) and empower them to act.
Meet with folks individually who work with her. Ask for their help by documenting any incident involving a patient safety risk. I would even go so far as to admit that there have been reports of this person putting patients at risk by behaving in unethical ways and that you need their help so that you can protect patients (again, this will all be decided in your strategic meeting).
Gather any and all documentation about behaviors. It doesn’t matter if this documentation is anonymous, has a signature, is something verbalized to you, etc. Gather ALL EVIDENCE. Because what you’re doing is building a case. Just like a jury, they make decisions based on the preponderance of evidence.
STEP 5: FIRE THE BULLY
Stop letting one person have control over you and your organization. Focus all of your efforts on the steps above until you have enough evidence and then FIRE THE BULLY! Don’t wait until you have everything – remember, you’ve just built a case. Now do something with it!
A culture of silence must be replaced by a culture of safety. Disruptive behaviors happen because they can. It takes willing individuals and leaders to stop it.
About the author: Dr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate bullying behavior.
The way we communicate with others is a primary way we build trust. Along with specific behaviors and actions, communication serves as the vehicle for building trust in relationships. What we say, how we say it, and how we respond to what others communicate can make or break trust. That’s why it’s important to develop your interpersonal communication skills. There are some basic communication do’s and don’ts…the 10 commandments if you will…that everyone should know to facilitate the growth of trust.
Check yourself against this list to see how many of the 10 Commandments of Communication you adhere to:
1. Thou shalt demonstrate genuine care for the other person – People can see right through a phony. If you don’t genuinely care for the other person in the relationship it will show in your words and actions. If it’s important for you to build trust with someone, then you should find ways to genuinely care about them. Examine the relationship to see what it is about the person, or the role they play in your organization, that you appreciate and value. Focus on those aspects of the relationship in an authentic and genuine way.
2. Thou shalt listen to understand, not to respond – Most of us have poor listening skills. Instead of listening to someone to understand their point of view, we spend our mental energy formulating a response. Practice active listening techniques such as asking open-ended questions/statements like “Tell me more” or “How did that make you feel?” Paraphrase key points and check for understanding throughout the conversation and listen with the intent to be influenced by the person speaking, not with the intent to argue or debate. Listening can be one of the easiest and quickest ways to establish trust with someone.
3. Thou shalt use open body language – Studies have shown that 70% or more of communication is nonverbal. Our body language often conveys much more meaning than our words so it’s important than your body language is in alignment with the intent of your words. If at all possible, eliminate physical barriers, like a desk, between you and the person you’re speaking with. Sit side by side or in front of each other, don’t cross your arms, roll your eyes, or grimace. Be sure to smile, nod in understanding, and verbally respond with phrases like “I hear you” or “I understand” to show the other person you’re tracking with the conversation.
4. Thou shalt look for commonalities with the other person – People intuitively trust people who are similar to themselves. When first establishing the relationship, emphasize things you have in common such as where you grew up, went to school, common hobbies/interests you have, or the activities/sports of your children.
5. Thou shalt express empathy/mirror emotions – You’ve probably heard the old saying, “People don’t care how much you know until they know how much you care.” Expressing empathy toward another person is an excellent way to show you care, particularly if you mirror their emotions. Neurological studies have shown our brains contain “mirror neurons” that have the capacity to help us feel the emotions being expressed by another individual. I’m not suggesting you mimic the emotions of others in an attempt to manipulate them into trusting you, but rather taking genuine interest in their plight and letting your natural empathetic instincts express themselves.
6. Thou shalt be transparent and show vulnerability – Establishing trust in a relationship requires one person to make the first move in extending trust. Someone has to make him/herself vulnerable to another and one way to do that is to be transparent (appropriate for the context of the situation) in sharing information. A lack of transparency or vulnerability breeds suspicion in the relationship and is usually the result of one party wanting to minimize risk and maximize control.
7. Thou shalt be positive and respectful – Right or wrong, people will judge the quality of your character by how you speak about and treat others. If you are positive and respectful in your words and actions, people will trust that you will treat them the same way. The opposite is also true. If you speak disparagingly about others or treat others as “less than” yourself, people will not trust you will act with fairness and integrity in your dealings with them.
8. Choose the right time, place, and method to communicate – Just as the secret in real estate is “location, location, location,” the secret to trust-building communication is “timing, timing, timing.” In addition to finding the right time to communicate, it’s important to choose the proper place and method. If your communication involves sensitive personal information, have a face-to-face conversation in a private location. Use email, phone, and other methods of communication that are appropriate to the specific situation.
9. Thou shalt look for opportunities to build up the other person – Your words can be used to build other people up or tear them down. Which do you think will build trust? Building them up, of course. Look for every opportunity to use your communication to help others learn, grow, and become the best version of themselves possible. Doing so will cause people to see that you have their best interests in mind, a key driver of deciding to place their trust in you.
10. Thou shalt own your words – Say what you mean, mean what you say, be forthright, honest, compassionate, caring, and responsible with your communication. If you say something that harms another, apologize sincerely and make amends. It’s really that simple.