Healthcare facilities are supposed to be places that offer support and healing, but did you know workers within the healthcare industry experience more bullying and deviant behaviors than in any other industry?

According to the Workplace Bullying Institute, an organization dedicated to the eradication of workplace bullying, 36% of all complaint calls are from nurses, making them the most frequent callers. In fact, one study found that within the first six months, 60% of nurses leave their first job due to the behavior of their coworkers.

Statistics also show that bullying behaviors within the healthcare industry start as early as nursing school. In the same study mentioned above, within a six month period, 78% of students experienced bullying in nursing school. In another study, over 50% of nursing students reported seeing or experiencing nurse-on-nurse bullying during their clinical rotations.

A third study also found that bullying occurs at all levels within the healthcare industry with 60% of nurse managers, directors, and executives reporting they experienced bullying in the workplace. Furthermore, 26% considered the bullying to be “severe.”

The American Nurses Association (ANA) defines nurse bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient.” It can include incivility, exclusion, physical violence and death threats, among other things. ANA also says the behaviors are “a very serious issue that threatens patient safety, RN safety and the nursing profession as a whole.” In fact, in 2014, the Joint Commission found that 63% of cases resulting in the unanticipated death or permanent disability of a patient could be traced back to a communication failure by hospital staff.

“We fail to recognize deviant behaviors because it’s just the way it is here, but the first step to stop bullying, incivility, and deviance is by raising awareness of behaviors that undermine a culture of respect, professionalism, and patient safety,” says Dr. Renee Thompson, a nursing professional development leader and founder of the Healthy Workforce Institute. “You can’t expect people to adapt their behavior if they don’t realize their behavior needs to be adapted.”

Thompson, who has been conducting workshops on addressing disruptive behaviors for nearly 10 years, says healthcare organizations have an ethical responsibility to stop bullying and deviant behaviors. While there are many steps that must be taken to combat nurse bullying, Thompson offers the following three steps to help get started.

1. Infuse Content Related to Behavior Throughout Your Facility

By infusing content related to behavior in all places, it heightens awareness of behaviors that undermine a culture of safety. Thompson recommends including content during orientation, in nurse and physician residency programs, preceptor programs, and leader orientation.

She also recommends including content related to workplace conduct in ongoing events such as staff meetings, leadership meetings, performance reviews, and annual competencies — not just when employees are hired.

2. Pay Attention

Thompson recommends paying attention to your coworkers’ behaviors by standing back and observing.

“Like a fly on a wall does right before pouncing on your picnic barbecue, you’ll be amazed at what you see and hear,” she says. “If you’ve been normalizing bad behaviors in the past, once you rip off the Band-Aid and discover the wound, you’ll have no choice but to treat the wound.”

Here are some statements she says to look out for:

• You’ve got to pay your dues.
• It’s always been done this way.
• I’m making her a stronger nurse.
  If she thinks I’m hard on her, wait till she meets _______.
• It’s sink or swim here so if you want to survive, you’d better learn how to swim.
• Just ignore him like everyone else does.

3. Look in the Mirror

“If 73% of healthcare professionals report witnessing or experiencing disruptive behaviors, the disruptors can’t be everyone else,” Thompson says.

Thompson urges all employees to take a look in the mirror to determine how and what each contributes to workplace culture. Healthy Workforce Institute offers a free self-assessment called “What If You are the Bully?”

For more on how you can help your organization address the ongoing threat of nurse bullying, visit healthyworkforceinstitute.com.

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