Incivility and Bullying in the Workplace, Part 1: The ANA Speaks Out

Article Categories: Legal and Ethics & Nurse On the Job

It’s quite simple: Everyone is entitled to work in a safe and respectful environment. The American Nurses Association (ANA) 2015 Code of Ethics for Nurses with Interpretive Statements states that nurses are required to “create an ethical environment and culture of civility and kindness, treating colleagues, coworkers, employees, students, and others with dignity and respect”



Yet when the American Nurses Association published a position paper on Incivility, Bullying, and Violence in the Workplace in July, 2015, the long-avoided topic finally was addressed. The paper was written especially for Registered Nurses and employers, but also applies to all healthcare professionals who share a work environment.

American Nurse Today shared the results of a survey at a large medical center:

• 65% said they had regularly observed bullying among co-workers
• About 70% of the bullies left their jobs, causing huge turnover and staffing gaps
• If a new RN was bullied, he or she quit within six months of hire

Let’s look more closely at the definition of each:

Incivility: Rude, disruptive, intimidating, and undesirable behaviors that are directed toward another person (Clark, 2011)
Bullying: Any type of repetitive abuse in which the victim suffers from behaviors by the perpetrator that interfere with his or her job performance, and are meant to place at risk the health and safety of the victim (Center for American Nurses, 2007). Workplace bullying can also involve abuse or misuse of power and authority.
What does incivility or bullying look like?

• Spreading rumors or damaging another’s reputation
• Using the “silent treatment” with a co-worker
• Undermining someone’s work or setting someone up for failure
• Sarcasm, humiliation, and constant criticism
• Back-stabbing or turning others against someone else
• Giving a workload or deadline that is impossible to complete
• Offensive language or jokes, use of profanity
• Removing responsibilities or duties without cause or reason
• Intruding on someone’s privacy or tampering with personal belongings
• Withholding information or intentionally providing wrong information
• Threats of physical abuse or actual physical abuse

The ANA position paper also addresses issues that are employer-related. Terri Townsend, MA, RN, CCRN, CVRN explains, “In many healthcare facilities, administrative hierarchies promote and perpetuate oppressive conditions, such as inability to take uninterrupted breaks or meals, inadequate staffing ratios, limited supplies, and little recognition of nurses’ ability to think critically. These conditions contribute to the problem.” What is the cost of healthcare bullying? Over $4 billion a year, due to hiring and training, absenteeism, and lower productivity.

Incivility and bullying in healthcare is not new. Sadly, it has become part of the nursing culture over decades. The phrase, “Nurses eat their young” has been around for years; nurses themselves acknowledge that the kindness and compassion they show for patients does not always extend to their colleagues. The ANA finally addressing the issue, we can all hope for a happier and healthier workplace.

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