Creating a positive and healthy environment in the workplace can result in better staff engagement, higher performance, and, in many instances, can lead to a lower turnover rate. However, there may be underlying factors that impede our ability to develop this type of culture. Bullying is still a common occurrence in many modern workplaces, including in long-term care communities.

The phrase “nurses eat their young” has been around for a long time and unfortunately, it still seems relevant. 44.0% of nursing staff members have been bullied at some point in their working lives .* In a study of 284 U.S. healthcare workers, 38 percent of them reported psychological harassment. The targets of bullying typically tend to be under 40 years old, unmarried, female employees with less education and who have children at home. In long-term care settings, bullying occurs more frequently during evenings and night hours.
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Bullying contributes to burnout and drives talented and caring people out of the health profession. If left unaddressed, it can lead to enormous expense from absenteeism, high turnover rates, low employee morale, and decreased employee loyalty.

How can we handle bullying and ensure that our employees feel safe and respected in the workplace? Here are some recommended tactics from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO):
  • Educate all staff on appropriate professional behavior, with an emphasis on mutual respect.
  • Hold all staff accountable for modeling desirable behavior and enforce the code consistently and fairly.
  • Develop and implement zero-tolerance policies and procedures for egregious events of disruptive behavior.
  • Provide skills-based training and coaching for all leaders and managers in relationship building, collaborative practice, skills for giving feedback on unprofessional behavior, and conflict resolution.
  • Develop and implement a reporting/surveillance system for unprofessional behavior (possibly anonymous).
  • Address behaviors starting with informal conversations, move toward detailed action plans, and finally progressive discipline if necessary.
*Ariza-Montes A. Workplace bullying among healthcare workers . International Journal of Environmental Research & Public Health, 2013;10:3121-3139 and Li Y and Jones CB. A literature review of nursing turnover costs. Journal of Nursing Management, 2012;21(3):405-418
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This material was prepared by Telligen, National Nursing Home Quality Improvement Campaign contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW-CO-NNHQIC-03/18-001