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BULLYING is a problem in Australian workplaces including those in the health sector.
In a 2009 survey of 747 registered Australian doctors, 25% of respondents reported that they had been bullied in the previous 12 months. The survey found the most commonly reported sources of bullying were “consultants, registrars and other senior doctors” (44%) followed by “managers, administrators and clerical staff (27%)”.
There’s no question that workplace bullying can cause serious damage to the mental and physical health, and wellbeing of workers. In the worst cases, it has led to victims taking their own lives. And it comes at a cost to employers and the economy in absenteeism, sick leave, lost productivity, workers compensation claims, increased staff turnover and litigation.
Critically, it’s suggested that where clinical staff morale is eroded through a culture of workplace bullying, patient care may suffer.
At the beginning of this year, the federal government introduced national workplace bullying laws under the Fair Work Act 2009. Previously, bullying was principally dealt with under occupational health and safety laws, with serious cases prosecuted by state and federal safety regulators (WorkSafe and WorkCover authorities).
For the first time, the new laws gave us a national statutory definition of bullying and provided workers with a right to make bullying complaints to the Fair Work Commission (FWC). The FWC has broad powers to investigate bullying complaints and issue orders to stop bullying.
Why do these laws matter for hospitals, private practices and other employers in the health sector?
Because, for the first time, individuals and employers accused of bullying, or failing to prevent bullying, may be called before the FWC to explain themselves. If they can’t, the FWC may issue orders against the employer organisation and/or individuals in their personal capacity.
So, the consultant who habitually makes belittling and demeaning comments to a registrar may be ordered not to address the registrar unless another staff member is present. The practice manager who unfairly assigns the worst shifts to the same staff member week after week may be ordered to implement a roster for fair shift allocation. The head of department who is aware of a manager who routinely excludes one of their peers from key meetings might be ordered to take steps to prevent this.
Importantly, the new laws provide that “reasonable management action” undertaken in a reasonable way does not constitute bullying. This means that bullying claims about normal management activities, such as directing and controlling work, performance management or disciplining staff, cannot succeed provided those activities have been carried out in a fair and reasonable way.
The AMA has encouraged doctors’ employers and the medical colleges to introduce anti-bullying policy and has given guidance on what such policies should address. We echo this advice with our clients.
These policies don’t need to be complicated — but they do need to be applied consistently and fairly. All staff need to be made aware of the policies and of their rights and responsibilities under them.
Trish Low is a Melbourne employment lawyer and National Leader of the Australian Equal Opportunity and Training Practice at global law firm, Herbert Smith Freehills. She specialises in equal opportunity and diversity law and has been assisting clients across a range of industries to prepare for, and respond to claims under, the new bullying laws.
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yes. a culture of bullying exists in some hospitals and indeed when a hosptial bully is support, spreads to the whole health service. Individuals – bullied and the bullies – need to feel supported. Unfortunately the manner in which bullying is currently fought is through recording individual incidences which boils down to “she hit me first” type documentation, when what is needed is realisation of hospital as culture and ability to do things like change access to places where bulling takes place, discipline individuals and speak up. Currently speaking up in these cultures changes power structures so that those who speak up become part of the bullied not the bullying.
I think that this discussion should be widened to include the bullying of students.
Many years ago I was in a 5th year tutorial group with a world famous professor in the role of teacher. He would shout and yell at us in a very aggressive and threatening manner. After discussion amongst ourselves we decided to confront him and I was chosen to represent the group. I put it to him that his behaviour was not acceptable and that the group had difficulty absorbing his imparted wisdom in the face of his vicious onslaughts. His response was that he refused to teach us again. Disturbingly our medical school refused to supply us with another tutor, in effect condoning his bullying, and leaving us without a tutor for several months before the end of year exams.
This was several decades ago and I feel somewhat diffident about bringing it up and would not have done so except for hearing some hints from medical students that this is still occurring.
In my opinion, bullying has been exacerbated by the failure of the relevant training programs to adapt to the tsunami of medical graduates, which has, in turn, resulted in junior doctors continuing in ‘junior’ positions when they are anything but.
With graduate medicine, often DITs are into their 30s by the time they commence vocational training with HMO5-7s becoming all too common. However, consultants, department heads, nursing staff and HR departments have generally failed to adapt and recognise the cultural change implicit with the evolving demographics of trainees.
There is only so long that DITs can tolerate condescending, demeaning and passive aggressive language in the workplace. Phrases such as ‘you are just the resident’ or ‘get your registrar, residents always stuff this up’ are a part of daily life in today’s hospitals. Yet in some cases, residents are remaining residents for longer than it took their consultants to complete their entire training whilst completing masters, PhDs, anatomy diplomas, taking time out to teach – all in the search of a training place or a consultant position that isn’t 1000km from home.
Furthermore, It is common now for residents to be parents, homeowners and providers for an entire household. Yet the cultural expectation remains that residency lasts 2-3 years and that residents are 24-26 with no responsibilities and no commitments outside of the hospital – with treatment by staff reflective of that.
So whilst a survey is useful in identifying the symptom – bullying – more work needs to be done to address the underlying cause, namely the terminally ill training system and archaic hospital culture.
‘In the last 12 months, have you been subjected to persistent behaviour by others which has eroded your professional confidence or self esteem?’ Exposure to bullying was assessed in the study by asking participants to respond in the positive or negative to the question above.
Having a bad day, occasionally being harsh or hard of hearing does not constitute bullying and without doubt culture and expectations of what is acceptable is changing with the next generation of doctors being younger , more international and no longer purely male graduates. Whether the old guard is ready for this change is another question though.
Few workplaces tolerate and protect bullying as part of ‘normal’ behaviour in the way that medicine does though and I trust it is going to change with the first successful prosecutions.
I’ve been around hospitals for many years. The worst bullies I’ve encountered have been nursing staff administrators, and labour ward sisters. Thankfully, they are an extraordinary low number. However, it is culturally difficult to complain about women bullies: most men are too gracious to cross that line and do something official. Such reluctance is seldom reciprocated from those mentioned.
On the other hand, I completely resent vulnerable young women graduates, often from other countries, who totally misinterpret the request to speak up to a hard-working presbycusic sexagenarian, and again completely misinterpret the lack of social graces sometimes present when one has been without sleep for over 24 hours (something they THEIR roster would consider far too punishing!!). Ward handovers flavoured with a tired sense of exasperation are NOT the same thing as bullying!!……Some sensitive young graduates have to grow up a little before they start firing off complaints …….
Without a definition of what is ‘bullying’ and what is not, this trial is uninterpretable. Which is a concern given that it is being conducted by an organisation committed to verifiable science.
What can you do when competitors use AHPRA to bully you. It seems they are out of control and it has been reported this is occurring in the media but they ignore this when you comment that a complaint is obviously ridiculous .
Isn’t it funny that everyone in a hospital knows who the bullies are and have been – and yet nobody dares to touch them, simply because they are bullies and because usually they sit on top of the pyramid.
New laws are a good first step – but what they need is someone to enforce them. As long as it’s on the backs of junior staff to put their career and good name on the line to file a complaint precious little is going to change, the old boys network will make sure of it.
Why not put management in the driving seat and make them prove with questionnaires, reviews and 360 degree assessments that no bullying exists in their workplace? And promptly hold them responsible if it does and they do not fix it?
The difficulty for doctors in training (and other junior staff in healthcare) is that often the bullies are also their supervisors and so are responsible for performance review and feedback to the college. If a doctor in training or a junior member of staff speaks up it may jeopardise their future. In all cases of bullying there is a power differential between the victim and the perpetrator. Bullies know who to target and it is always those with less power who are much less likely to retaliate or speak up. The best way to combat bullying is by peer pressure. Anyone observing bullying should speak up for th victim and provide support. All health care workers have a responsibility to counter bullying in tyhe workplace.