Distinguishing between the terms “bully” and “bullying” is an important step that we can take in order to eliminate or at least minimize any disruptive or undermining behaviors that are often associated with bullying.  Yelling at, humiliating, excluding, gossiping about others are a few of ways we humans cleverly demonstrate disrespect for others.  And we all know that lack of respect is a persistent and pervasive problem in health care.

As we work to establish and maintain safe cultures and respectful workplaces, there are three reasons for using terminology that addresses individual and organizational behaviors rather than trying to identify and blame one person.  Each of these will help to reduce resistance, fear, and confusion about zero tolerance for abuse.

Reveals the true problem. When we use the term “bully,” it allows us to blame one person.  “Bullying,” on the other hand invites us to consider victims, bystanders and culture.  Since all of these are part of the history and cause of workplace violence, it makes sense to understand and address these aspects of the problem.

A bully can’t exist without a victim or in an environment that doesn’t tolerate bullying behaviors.

Reflection process is safer. Looking inward is often a difficult process for many of us and yet an integral part of changing behavior.  Consider how these reflective questions might feel:

“I wonder if I am bullying the new nurse?”

“I wonder if my behaviors could be perceived as bullying?”

“I wonder if I am a bully?”

The first and second statements allow us to be human and imperfect and include another person’s perception as part of the picture.  The third one is more threatening and defines the very core of our being.  If we are going to change these dynamics, doesn’t it make sense that we give ourselves and each other permission to make mistakes?

In so many of our stressful environments, we have to be quick and accurate.  A seasoned nurse’s decisive comment and action may be excluding and humiliating to a newer nurse.  Our chronic sense of urgency becomes a license for poor conduct.

I know that I have been short-tempered, impatient or frustrated at work. With over 25 years as a nurse, I have rolled my eyes, smirked, or used unfriendly body language.  I have also joined in conversations about other professionals behind their backs.  At this point in my life and career, even with much work in communication and emotional intelligence, I am not a perfect communicator. However, I am more able to own my part of a conflict and respect how other’s may be impacted, work to modify my behavior, apologize and forgive myself and others.

Bridges to healing conversations. As we become safer and more skilled in our reflection process, we will automatically be more prepared to show ownership in a conflict.  This is one of the most powerful factors that leads us to productive conflict rather than remaining stuck in a power struggle.  It is part of the dance of speaking up assertively and listening respectfully that I am often referring to.

An example might be a new OR nurse who is upset and fighting tears because her preceptor humiliated her in front of the team.

The preceptor who perpetuates the status quo might say: “You are going to have to develop a thick skin if you are going to make it as an OR nurse.”

The preceptor who is committed to building a more positive workplace might say: “I think I was pretty rough on you this morning.  I could have given you feedback on your set-up without the condescending tone and language I used.  What thoughts do you have?”

The second example is a great way to build a respectful and collaborative relationship which we know will contribute to safer, more cost-effective care and long-term rewarding careers.

Ultimately, as we address disruptive behaviors that arise from stress, lack of awareness, inadequate communication skills, and toxic organizational cultures we will filter out the few remaining individuals who persist in bullying behavior despite feedback and learning opportunities.  These are the bullies, and they should be terminated.

Beth Boynton is the author of Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers.  She can be reached at Confident Voices in Healthcare.

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