“Workplace bullying (WB) in healthcare remains a persistent problem, particularly against newly licensed nurses. In nurses, negative outcomes of WB behaviours include burnout and lack of engagement, decreased work productivity^, organizational mistrust, turnover intention, sleep difficulties, and general physical and mental health complaints. Several strategies have been recommended to address the persistence of WB in healthcare.

Developing a positive work culture requires effective communication between employees. Effective communication is believed to reduce the incidence of WB. It is important employees receive education on how to confront other employees demonstrating WB behaviours.” ¹

WMS Koh 2016 review,² “Management of workplace bullying in hospital: A review of the use of cognitive rehearsal as an alternative management strategy,” examines cognitive rehearsal programs (CRPs) as interventions to address workplace bullying among nurses. It suggests that CRPs, which involve role-playing and scripted responses, can help prevent harassment and bullying incidents in healthcare settings. Subsequent studies have supported the effectiveness of CRPs. For instance, a systematic review and meta-analysis found that CRPs significantly reduced workplace bullying experiences among hospital nurses, highlighting their potential as effective interventions.

Refer to Self-Advocacy Phrase Guide in the Extra Resources section of this platform.

The focus of Unit 15 is on self-advocacy in workplace bullying.

Workplace bullying can have a significant impact on both personal well-being and the work environment. In this unit, we will focus on identifying workplace bullying behaviour, building the confidence to confront bullying, practicing self-advocacy techniques and maintaining professionalism during conflict. These skills are vital to ensuring a safe, respectful and productive work environment for everyone.

Learning Objectives

By the end of this unit, you will be able to:

1. Identify workplace bullying behaviours.
2. Build confidence to confront workplace bullying.
3. Practice self-advocacy techniques to address bullying situations.
4. Maintain professionalism during conflict and difficult conversations.

Workplace bullying can take many forms, including verbal, physical and psychological harassment. Recognizing these behaviours early is key to addressing them effectively. Some common bullying behaviours include:

Verbal bullying: Insults, yelling, offensive jokes or belittling comments aimed at undermining someone’s confidence or self-esteem.

Exclusion: Deliberately isolating a person from group activities, meetings or social events.

Sabotage: Intentionally undermining someone’s work or spreading false information about them.

Physical bullying: Any form of physical aggression, such as pushing, hitting or other forms of intimidation.

Cyberbullying: The use of technology to harass, threaten or manipulate others, including sending abusive messages or spreading harmful rumours online.

Pause for Thought

Think about your current or past workplace. Have you ever witnessed or experienced behaviours that you now recognize as bullying? How did it make you feel, and how did you react at the time?

Confronting bullying requires both courage and preparation. The following strategies can help you build the confidence to address bullying effectively:

Acknowledge the situation: Recognize that bullying is never acceptable. Understand that you have the right to feel safe and respected in your workplace.

Plan your response: Think about how you want to address the bullying. It may involve calmly confronting the individual, reporting the behaviour to a manager or seeking support from HR.

Use assertive communication: Practice being clear, direct, and calm when confronting bullying. You can say things like, “I find that comment hurtful, and I would appreciate it if you refrained from making such remarks.”

Seek support: Talk to trusted colleagues or HR professionals if you feel uncertain about confronting the bully alone. Support systems can make confronting bullying feel less intimidating.

Practicing Self-Advocacy Techniques

Self-advocacy is the ability to speak up for yourself and ensure your needs and rights are respected. Practicing these techniques is essential in responding to workplace bullying.

Know your rights: Familiarize yourself with workplace policies related to bullying, harassment, and employee rights. This knowledge empowers you to take appropriate action.

Maintain a professional tone: When addressing bullying, it’s important to stay calm, collected and professional. Avoid reacting emotionally or with aggression, as it can escalate the situation.

Set boundaries: If someone is bullying you, calmly set boundaries by telling them their behaviour is unacceptable. Example: “I would appreciate it if you would not speak to me that way.”

Refer to Self – Advocacy Phrase Guide in the Extra Resources.

Remaining professional during conflict, especially in bullying situations, is crucial. Here are a few strategies to help maintain professionalism:

Stay calm: Practice deep breathing or other relaxation techniques to remain calm during a confrontation. Your response should be measured and controlled.

Use neutral language: Avoid using inflammatory language, accusations, or escalating the situation. Instead, use phrases like “I’m concerned about the way this situation is being handled.”

Stay solution-focused: Focus on resolving the issue, rather than getting drawn into a personal conflict. State what change you want to see and how you can contribute to a positive work environment.

Seek mediation if needed: If conflict persists, suggest mediation with a neutral third party, such as HR or a supervisor, to resolve the issue professionally.

Key Takeaways

• Bullying in healthcare leads to burnout, decreased productivity, turnover, and health issues.
• Open communication reduces bullying and promotes a positive work culture.
• Bullying includes verbal abuse, exclusion, sabotage, physical aggression, and cyberbullying.
• To build confidence acknowledge bullying, plan responses, use assertive communication and seek support.
• Self-advocacy: know your rights, set boundaries, and remain professional when confronting bullying.
• Stay calm, use neutral language, focus on solutions and seek mediation if needed.
• HR and colleagues can provide essential support when confronting bullying.

Next Steps

• Do the exercises.
• Watch the illustrative videos accompanying Simulation 15.
• Participate in Role-play Simulation 15.
• Share reflections and key takeaways during debrief.

1. Smith C.R. et al. “Standing up against workplace bullying behaviour: Recommendations from newly licensed nurses”, https://pmc.ncbi.nlm.nih.gov/articles/
2. 2. WMS Koh, Management of work place bullying in hospital: A review of the use of cognitive rehearsal as an alternative management strategy, https://www.sciencedirect.com/science/article/