Australian research sheds light on bullying in hospitals

Nov 18 2004

New research by the University of Western Sydney has found that some nurses are abusing patients and compromising hospital care as part of their bullying attacks on other nurses.

The findings, from stage one of the University's three-year Bullying in Nursing research project, depict the deliberate and predatory bullying tactics used by small but influential groups of nurses within our hospitals, and the devastating impact their behaviour has on the lives of their nurse targets.

According to one of the chief researchers, Associate Professor Margaret Vickers, who is conducting the study in partnership with two NSW Area Health Services, the study aims to build more awareness, better education and more support in order to improve nurses' working lives.

"There is a complex array of bullying behaviour being carried out by small pockets of nurses within our hospital system. These bullies set out to hound their targets and make their work lives impossible by increasing their stress and decreasing their control of situations," says Associate Professor Vickers.

"In most cases, the bullying was so bad the targeted nurses abandoned the nursing profession, taking lower-paid jobs and pay cuts of up to $40,000 a year.

"Many continue to suffer the physical and emotional trauma as a result of their abuse, such as panic attacks, worsened chronic illness, significant weight fluctuations, alcohol abuse and depression, and there was one report of suicide directly linked to bullying."

The study found that bullying of nurses can happen in a number of ways: rostering bullies on shifts together to "pick on" their nurse targets; controlling work tasks and withholding information; abusing and bullying patients to indirectly pressure the conscientious nurses being targeted; protecting and covering up for each other; and pinning the blame for mistakes on nurse targets to make them crack under pressure.

"One of the most disturbing findings was some of the bullies using patients to strike at their nurse targets, which we didn't expect at all," says Associate Professor Vickers.

"A bully nurse might verbally abuse a patient, fail to provide adequate patient care, or withhold critical patient information. The conscientious nurse who is being targeted is then forced to work even harder to fix what the bully has done, hide any wrongdoing from the patient, and undo any harm that might have been caused.

"In some cases, the bully would set up the situation so the target nurse became responsible for the mistakes - placing even more stress and strain on already overworked and under-resourced nurses."

Associate Professor Vickers says the research team interviewed twenty six nurses from two NSW Area Health Services - one metropolitan and one regional - who courageously came forward to speak of their experiences as victims of bullying, or having intervened in bullying behaviour.

"We were surprised by the extent of the sabotage carried out. It was described to us that bullies tend to work "like wolves in a pack" in order to bring their victims down," says Associate Professor Vickers.

"The bullies almost always 'gang up' on others so they can work on their chosen target from different directions. This gang mentality also enables them to protect and cover up for one another if complaints are made.

"Bullies are often in key positions, where they can control work tasks and the flow of important information. One of the other tactics is rostering several bullies on at the same time in order to keep up the pressure on the individual nurse target."

While other colleagues might be aware of what is going on, Associate Professor Vickers says many prefer to distance themselves, for fear the bullies might turn on them.

"Bullies often know the system well, and know what they can get away with and how to defend themselves. They also seem to solicit passive support from others, who, because of fear and intimidation, choose to stay silent and do nothing," she says.

Associate Professor Vickers says far from being a nurse bashing exercise, the research is important because it's identifying some of the issues causing conscientious and caring nurses to leave the hospital system.

"The fact that two NSW Area Health Services are collaborating with us demonstrates their commitment to tackling this important issue. By working with our partners we intend to devise recommendations and policy directions for government and health care providers so they can respond effectively and appropriately to the problem."

The next research phase will involve a nationwide survey of nurses about the extent and nature of bullying.

"Nurse bullying is a worldwide phenomenon. We are currently planning to internationalise this study in the near future. Hopefully Australia can become a world leader in dealing with and overcoming the problem of workplace bullying," adds Associate Professor Vickers.