Why we need psychologically healthy workplaces in the healthcare sector

It’s Saturday night and you’ve been in a car accident. Someone who had too much to drink swerved into your lane and caused a bad collision. You are in severe pain and fear that you’ve suffered serious injuries.

The paramedics arrive at the scene and whisk you to the nearest emergency room. Once there, you find yourself being cared for by a doctor and nurse who absorb information about your condition from the paramedics. As they check your vital signs, you pass out….

30 minutes earlier

For the sake of your own already sky-high stress levels, thank goodness you didn’t know that 30 minutes before your arrival, this doctor had been yelling mercilessly at the young nurse for a small mistake, right in front of her colleagues. The nurse was so rattled and embarrassed that she didn’t handle skillfully an emotionally out-of-control patient, who became angry at her and spat on her uniform just minutes before the paramedics wheeled you in.

It’s better you don’t know that your life is in the hands of a doctor with a short temper and a novice nurse who now is very skittish around him.

Violence, bullying, and incivility in healthcare

Folks who work in emergency rooms and psychiatric wards will tell you that physical violence at the hands of patients (and sometimes their family members or friends) can be a significant risk of the job. Healthcare workers can be hit, pushed, kicked, spat upon, and otherwise assaulted (physically and verbally) by the very people they’re trying to help.

In addition, bullying and incivility are common forms of mistreatment in the healthcare workplace. Nurses and nurses’ aides seem to get it the worst, but others are targets as well. The problem is so serious that in 2008, the Joint Commission, an independent, non-profit organization that accredits health care organizations and programs, issued a standard on intimidating and disruptive behaviors at work, citing concerns about patient care. (See blog series about bullying in healthcare, starting here.)

An imperfect storm

Earlier this week, I blogged about the National Conference for Workplace Violence Prevention & Management in Healthcare Settings, hosted last weekend by the University of Cincinnati College of Nursing. We heard a lot about physical violence committed by patients and about bullying & incivility dished out by co-workers.

What happens, however, when the two mix? Let’s say an emergency room treats potentially violent patients on a regular basis and also happens to be a place where employees treat each other so poorly that everyone is on edge? How do the concurrent risks of violence and bullying interact, to the point where workers are routinely stressed out and thus more prone to mistakes?

Let’s zero in on healthcare

This scenario underscores my belief that healthcare is a singularly important sector for studying and responding to disruptive behaviors of all types. The stakes could not be higher: They relate to workers and patients alike. A psychologically healthy healthcare workplace provides everyone with greater peace of mind, ranging from the workers to those of us who seek their help.

7 responses

  1. Having had many years of experience as a social worker in hospitals, I strongly disagree with the statement that “nurses…seem to get it the worst.” Nurses have more power than social workers in the healthcare hierarchy. There is no doubt that social workers have the most stress, the most work demands, get disrespected the most, and get paid the least when comparing them with nurses and doctors. The vast amount of attention to nurses ignores all the other disciplines besides doctors that typically have it much worse.

    • In my experience (both in hospital and community settings), a significant stressor that applies to nurses more often than other disciplines is the additional and frequently discounted stress of shift work…particularly night shift. There are real risks to physical and mental health, as well as associated social stress and family disruption.

    • Anonymous, I am not a social worker but I have worked in several health institutions and I think you’re right. In the hierarchy, people who understand science and can help the body heal are highly valued, but the people who understand humans and can help the family heal are not.

      Nurses, doctors, and allied health professionals extricate themselves from messy cases and send them to the social workers to fix.

    • Sorry it took me a few days to find the info, but you might want to contact Tracy Whitaker, Director of the Center for Workforce Studies & Social Work Practice at the National Association of Social Workers. She gave a very good presentation about social workers and workplace bullying at this conference. I don’t have contact info, but I’m sure you could find her at the NASW.

  2. Having had a recent major surgery and week long hospital stay, it was quite apparent to me that there was a concerted effort on the part of the nursing staff to respect and treat each other the way that I was glad to see.

    Without any or very little supervision they went about their duties in a professional manner and with a kindness in their hearts that I could feel.

    In my past I worked in a major hospital and suffered bullying there that caused severe depression and anxiety. Read about it here http://judithmunson.com

    This is why I try to help the targets of these workplace issues every chance I can and especially those in the healthcare industry.

  3. Judith, you are a positive influence and survivor. It looks like you have really grown and thrived for the better. One of the biggest ironies and tragedies of bullying in healthcare is that professionals are supposedly there to help and heal patients. Imagine being treated as a patient in an emergency by a staff member who just experienced some ptsd symptoms due to having been abused 5 minutes ago. Or worse than that, imagine being treated in an emergency by a sociopath or narcisist.

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