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The Difference Between Nursing Bullying, Incivility, and Harassment By Renee Thompson
Date Posted: 10/Apr/2017
This post is part of a series of posts on nurse bullying and conflict in the workplace written by Dr. Renee Thompson, DNP, RN, CMSRN. Dr. Thompson is one of the top professional development and anti-bullying thought leaders in nursing.
 
I frequently get asked by organizations to help them eliminate workplace bullying. The conversations we have are always about bullying – the physicians bullying the nurses, the nurses bullying each other and the support staff, etc. And then I go in, “pull back the covers and lift up the gown” to find out if there is really a true bullying problem or something else.
 
Here is what I tend to find: some bullying – not a ton, some harassment – not a lot, but I do find an awful lot of incivility.
 
Even though I’ve written about this, talked about this, and created a few videos, I’m not confident people truly understand the difference between bullying, incivility, and harassment. Keep in mind; these behaviors should never occur in the workplace. They all need to be addressed but it’s important to understand the differences because the strategies to eliminate are a bit different.
 
Bullying
For a behavior to be considered bullying, it has to include three things:
 
A target: 
There has to be a target. This target can be a single person or group of people. For example, someone might pick on just one new nurse and make her life a living hell but is nice to everyone else. Group targets can include the opposite shift (nurse on days hates all nurses on nights), new nurses, or nurses who have a particular ethnic background.
 
Harmful: 
The behavior has to be harmful in some way. This harm can be to the target (I get extremely anxious and sick every time I see that I have to work with this person) or harmful to a patient (a nurse who sabotages or sets a nurse up for failure, affecting patient care).
 
Repeated: 
I believe this is the most important element of bullying. The behavior can’t be just a one-time event (I scream at you during a crisis). The harmful behavior has to be repeated over time. Some experts say six months or more, I disagree. I would consider a behavior as bullying if it repeated several times over the course of a week or so.
 
How to address bullying: 
Bullying behaviors tend to be more actionable because most organizations have policies about bullying behavior. Get a copy of your policy and use the language in that policy to take action against bullying.
 
Incivility
Incivility is different than bullying. While the behaviors can be similar, they tend to be lower level. This is your typical rude, inconsiderate, or just crusty nurse. However, make no mistake about it, incivility is a healthy and professional workplace killer! Incivility needs to be addressed too but bullying should be a never event.
 
How to address incivility: 
Uncivil behaviors tend to be less actionable and not always easy to address using policies or codes of conduct. Sometimes the best strategy to address incivility is to actually focus on civility. What does civility look like? What behaviors should we be seeing in our coworkers?
 
Harassment
Harassment is unwelcome conduct based on race, color, religion, gender, national origin, disability, or genetic information. Harassment violates Title VII of the Civil Rights Act of 1964, the Age Discrimination and Employment Act of 1967, and the Americans With Disability Act of 1990.
 
Harassment brings with it legal ramifications that extend beyond the work environment. However, to be unlawful, the behavior has to create a work environment that is hostile or offensive to any reasonable person.
 
How to address harassment: Harassment is an equal employment opportunity (EOC) violation and needs to be addressed with your Human Resource Department. By law, they have to protect employees from harassment and investigate any complaints of perceived harassment. They do not have a choice!
 
Bottom Line
If I’m a bully, I’m mean to a target or a group.
If I’m being uncivil, I’m mean to everyone.
If I’m harassing someone, I’m mean to this person(s) because of their gender, race, age, religion, etc.
 
Do you see the difference? Bullying, incivility, and harassment can destroy your work environment and impact the patients you serve in a negative way. The key is to be very clear on the behavior – figuring out if it’s bullying (target, harmful, repeated), incivility (low level, rude, and unprofessional), or harassment (targets disability, race, gender, etc).
 
We are hemorrhaging nurses due to bad behavior and it’s time we stop eating each other and start nurturing, supporting, and celebrating each other!

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