It amazes me that in a profession that is based on empathy and caring we still hate-on each other! From eating our young to work shaming our colleagues, there is a dark underside of our workplace dynamics that if not dealt with, can threaten the quality of care we provide our patients.
I feel there is a direct relationship between staff that feel powerlessness in their daily work lives and are burnout, to horizontal violence and workplace bullying and harassment.
POWERLESSNESS + BURNOUT = ↑ BULLYING AND HARRASSMENT
It is this equation that employers need to be aware of and advocate for supportive work environments and health workplace policy. But what can we do when we find ourselves on the receiving end of this equation.
2. Confront the Behaviour and Call it What it is: Name the behaviour so it has meaning
I have and still do (despite writing this article) get bullied frequently at work, albeit subtle at times. I have in the past justified the behaviour because let’s be honest its easier, confrontation takes work and is uncomfortable. Also, sometimes the behaviour is so insidious you view it as just part of that persons’ personality, so that makes it ok. She’s just cranky or “needs to retire”. However, there are no excuses, we are all professionals and you must act that way until the bitter end. Sometimes all someone needs are to be reminded of that, and often they are not aware that their behaviour or language is harassing.
Dr. David Augsburger coined the term carefronting to describe a peaceful approach to conflict management and I really think it’s the cat’s ass for health care professionals. Carefronting is a process that focuses on using respectable and caring communication with intent to maintain an effective and productive work relationship. Unlike conflict resolution which can spark anger and defensive communication, carefronting, operates on principles of truth telling, owning anger, and inviting change.
So, what does carefronting look like?
It was a long nightshift and was made even longer when I colleague of mine wouldn’t communicate with me. I had no clue what the problem could be, I would try and talk to her, and at one point had to inform her of a prn medication I had given one of her patients and nothing, no response, nothing. I started to worry that if a critical case came in how would we be able to effectively communicate. She ended the shift by throwing the narcotic register for me to sign, like I mean throw. I was fuming and I had enough. I couldn’t recall an argument or issues that would have set her off. She is known for this type of passive aggressive behaviour so I chalked it up to her being her. Once at home I realized that she may have taken I comment I had made regarding workload personally.
The next set, I walked in took report and looked at my college, she was still cold and reactive. I asked “what is the matter, have I done something to bother you”? She replied “yes, you are a job snob”. After a brief discussion about what the hell a job snob is, I told her that her behaviour was inappropriate and hurt my feelings. I also gave her the facts. “Have I ever in the six years you have known me been a job snob”? She replied “no”, so I said, “so you heard some hearsay and instead of fact checking with me you choose to bully me”? She looked bewildered and went on to try and defend herself. But I took the wind out of her sails. She was no longer upset with me, she was embarrassed by her behaviour. I also had reflected that this particular colleague is sensitive about her job and feels unheard sometimes, like her opinion means nothing. She felt powerless and I can assume after working at this facility for many years is also dealing with burnout. This was at the root of her lashing out, and because she assumed I had made a comment that made me seem like I am unsupportive of her, she took her feeling of powerlessness out on me. Now I never made a rude comment that’s just not my style, and when reminded of that, she could see how a simple out of context discussion, that she wasn’t privy to, could affect our working relationship. She apologised and so did I. I had to be humble and empathetic to more forward. I had to let go of anger and focus on the truth of the issue.
Carefronting is a process and uses principles of letting go, accepting blame, and peacemaking. And, being a professional is the ability to look beyond yourself to identify the root cause of someone’s behaviour and try with empathy and respect to solve the problem. We do it with our patients so we can do it with our colleagues. Despite a piece of me that would have loved to have given her the finger and walked out of the room, that wouldn’t have helped our working relationship and could have jeopardize the care of our patients.
2. Role Modelling: You want awesome co-workers BE an awesome co-worker – it’s simple
The above experience had a good outcome because of my reputation. I wasn’t a job snob, I come to work and act authentic, engaged, and committed to my profession. Although, I too have had moments where I get frustrated and disengage and hope the problem will solve its self. Then I stop and think, what is the one thing I can do? – I can role model. I can be the example. I can be accountable and if I want respect I need to show respect. Role modelling gives me power, makes me feel I am part of the solution and the movement forward. Feelings of powerlessness can lead to horizontal violence in the workplace; so if we are empowered and we show this to our collogues, we empower them too. Empower them to communicate, to resolve conflicts, and be supportive.
The other beauty of role modelling is that you don’t have to like the person, you don’t have to be buddy buddy, you just have walk the walk, and talk the talk. I have a big problem with mommy shaming, I think its so ridiculous and disrespectful to judge another mother, she may do things differently, but she is doing it for the same reasons because she loves her child. The same goes for nurse shaming. Another nurse does things a little differently why does that matter? At the end of the day we all have to abide by the same policies and procedure. Who care is you don’t piggy back your meds and run them continuously -like who fucking cares? But some of your colleague will and this will be the cause of workplace violence. We have all done it, nurse shaming is horrible, but it’s also a by product of this job. Nurses are independent thinkers, highly efficient, and sensitive people. And let’s be honest most of us want to be super nurse or think we are super nurse. Role modelling means you emanate what you value in a clinician but don’t judge others if they fit outside your definition of a “good nurse.” This extends to other professionals we work with like physicians. Sometimes we don’t understand their vantage point and can be critical of their roles and or practice. But I got to a point in my career where I accepted that our roles are different and so is perspective, therefore, it’s ok to have a conversation for clarity but it’s not ok to be a dick about it.
3. Advocate for Cultural Change within the Organization: Take back the power.
I sit on the Joint Occupational Health Committee (JOHSC) at my place of work and although it’s not the most riveting of committees it is a great venue to engage in change and advocacy. I encourage all nurses at some point in your career to check it out, go to a meeting, bring up workplace bullying and harassment issues and make it heard. In Canada, JOHS committees are legislated and any issues brought forth to the committee must be dealt with by the employer, so it’s a vital tool in getting action.
A JOHSC is one way to cultivate change but another simple method is to do my first two steps and call the behaviour what it is and role model the ideal. In a small site, I find nurses are less likely to go to management with their issues because of fear that the accused will find out who told. So really the best way to deal with workplace dynamics is talking directly with the colleague who is giving you grief. Albeit not an easy solution, but using some carefronting techniques it can be done in a constructive tactful way that is aimed at coming to a solution and moving forward.
Now I realize that we may confront a workplace bully and things don’t change, so find another venue to bring your issues up, chances are you are not the only nurses having challenges. Request a staff meeting, put it on the agenda, check-in and see if others are struggling. Another great technique – kill them with kindness. Cliché I know but powerful. It’s hard to be a bitch to someone who is being nice to you, don’t give a reactive colleague an excuse to react. Take the high road and give them a silent middle finger with a smile on your face and move on.
Another technique, party your face off. No seriously plan a workplace social. I started to do Christmas parties at work, and it was so amazing to have a place to be regular people and socialize. You get to see your colleagues as humans and guess what? Most humans are good people. The work environment is a powerful place and can make some people act outside their character. So, have a party and get to know the bully, chances are you will like them, and maybe you can find some common ground in which gives you the platform to stand up to them.
When people feel they have a voice that gives them power, and when we have power, we feel less helpless and move from a complaining critical space to one of action and growth. Be the nurse at your workplace to challenge the status quo and bring the power back.
MA.
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