August 02, 2002

Bullying as an occupational safety issue

Now that we are finally starting to talk about the bullying and horizontal violence that is endemic in nursing and midwifery, it seems appropriate to look at this as perhaps the major occupational health and safety issue facing front line caregivers in our health services. In terms of working conditions, stress and psychological trauma being caused by other members of staff could well be the final straw that forces nurses and midwives to leave the field. I have been told many times by midwives that if things don’t improve amongst the staff, then they will leave. I am also frequently told that management is “not interested” or is “doing nothing” to rectify the situation.

The bullying comes from the doctors in many cases, but is also carried out by other midwives, many of whom take the doctor’s side in a dispute and fail to support colleagues. When midwives are in disarray, doctors who want to exercise control and install unreasonable policies within a unit can exercise unwarranted influence. Many get away with it because key midwives collude with the medical team rather than side with their midwifery colleagues to argue against unethical or unprofessional behaviour from doctors in the unit. The labouring woman doesn’t stand a chance as she is a distant player when the internal politics hots up amongst the staff!

For those midwives suffering from the stress of horizontal violence, calling on the occupational health and safety team to investigate might be a solution worth exploring. It is time more attention was paid to mental health as well as physical well being in the workplace — for example it could be argued that finding ways to reduce stress on the job would result in fewer infections (and sick days) and a reduced risk from physical injury caused by a lack of attention to safety issues due to an inability to act appropriately because of mental turmoil.

I think that nurses and midwives can understand that they are sometimes at risk of violence from sick or disturbed patients and clients and they are therefore more likely to be on the lookout for possible dangerous situations. If they are attacked, there are Security staff to assist and services to help them deal with the aftermath.

Bullying from colleagues is, however, often unexpected. Yet it might be more prevalent and have more wide reaching ramifications than we realise. If we want to attract and keep our midwives in the system, a safe an satisfying workplace is an obvious essential. Until these issues of horizontal violence are acknowledged and addressed by management, there will continue to be a shortage of experienced staff and we risk losing new graduates and midwifery students as well.

As I see it, mental health is the occupational health and safety issue of the moment and it needs addressing constructively and rapidly. It should be the subject of intensive workshops where strategies to recognise and deal with it are explored and mechanisms to stamp it out are devised. I will certainly be making it a major focus of the next “Managing Midwifery” program (early 2003) for midwifery managers and leaders — they need help in handling these issues too.

Posted by andrea at August 02, 2002 04:47 PM

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Posted by: fp292003 on January 21, 2004 01:41 PM

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Hi there,

Thanks for the read.

I call it the 360 degree of violence. In other words it's happening everywhere you go in nursing. I constantly experience it in the operating suite. It comes in all forms. Suttle and explosive ways of delivering condescending remarks to colleagues.

The worst thing is is that if you stick up for yourself your seen as uncooperative and some colleagues will even brow beat you for being strong, assertive and confident enough to stand up to the bullies out there.

I'll be candid enough to say nurses are leaving the profession mainly because of horizontal violence.

Thanks for listening
MP

Posted by: Mary on February 17, 2004 03:49 PM