Workplace Bullies As Health Threats, Especially In Health Care

Normally, we do our best to ignore artificial news events like “disease-awareness” days. But when it crossed my screen that this is “Freedom From Workplace Bullies Week,” I jumped at the chance to write about the devastating mental and physical harm that a bad boss — or co-worker — can wreak.

Over the last couple of years, I’ve watched three friends suffer through jobs turned bad by bully bosses. It was horrifying and infuriating, to see three virtuous, diligent, intelligent people laid low in ways that struck not just the wallet but the deepest sense of self. Said one:

“It was a feeling that never left, that didn’t lift when I went home for the night or weekend. It was starting to color all of my experiences. And I had real suicidal thoughts for the first time since my junior year in college, 22 years earlier.”

Another started to lose sleep and even hair: “It was awful and threw my entire system out of whack.”

The third entered a state of prolonged panic and anxiety-induced exhaustion. I fantasized about writing a letter to her boss: “Do you understand the pain you are causing, not just to her but to her entire family?”

This was not just a flukish statistical cluster. A Zogby International poll commissioned this year by the nonprofit Workplace Bullying Institute — slogan: “Work Shouldn’t Hurt” — found that 35 percent of the American workforce had been bullied at work, and another 15 percent had witnessed it.

Now for the health aspects: The research found that among those being bullied, 45 percent reported related health problems. They are so common that on the Workplace Bullying Institute’s FAQ, the fourth question is: “Is it normal for my health to be falling apart?” (The answer begins, “It is not good, but it is typical.”)

Law professor David Yamada of Suffolk University

David Yamada, a professor of law and director of The New Workplace Institute at Suffolk University, is a leading legal scholar on workplace bullying, and has been helping to lead a new push to pass a law against it in Massachusetts. (His blog is here.)

His “Healthy Workplace” bill died in the latest legislative session, but plans are afoot to re-launch it next year, he said. Organizers are meeting at Suffolk later this week to strategize.

So what is known about the health effects of workplace bullies?

Summing up dozens of studies, Prof. Yamada said that “At a minimum, we’re talking about all sorts of stress-related disorders; clinical depression; in more serious cases, hypertension; at least increased risk of cardiovascular disease; evidence of impaired immune systems. We are seeing symptoms very consistent with Post Traumatic Stress Disorder.”

“The other collateral or peripheral harm we’re seeing is a real destructive impact on families and personal relationships, much like other forms of abuse, when other family members and friends might not fully understand what the mistreatment is doing to someone. And in the most horrible cases, the term now becoming used in the press is ‘bullycide,’” in which “bullying had some relation to someone deciding to take their own life.”

I mentioned my friends’ experiences and how they had horrified me, and Prof. Yamada said that though he’s not “Mr. Sensitivity,” he’s “a different person than I was ten years ago because of what I’ve seen people go through.” (Note: His work is focused on public policy. He does not take on legal work on individual cases of workplace bullying.)

Health care, he added, is a field known as particularly rife with bullying.

Why?

“The current economic situation in health care makes workplace relations more acute,” he said. “It’s work that’s inherently stressful to begin with, and it attracts a lot of very type A personalities, at least among some of the physicians. I realize that personality trait may be partly their gift in terms of being able to be decisive when treating patients, but sometimes it results in less than wonderful treatment of co-workers, and it can create a lot of problems.”

(Nurses are not 100% innocent of bullying behavior either. Check out this Chicago Tribune post titled “Nurses Who ‘Eat Their Young.’”)

The federal commission that accredits health care facilities has even issued a standard requiring that they address “aggressive, intimidating and disruptive” behaviors at work, he said, because it can be a problem not only of employee morale but of medical errors.

Here’s the Joint Commission’s report: Behaviors That Undermine A Culture Of Safety.

So what is to be done? There is no stock advice for the targets of workplace bullies, Prof. Yamada said. When bullies are called on their behavior, some may try to fix it, but others will only become more enraged. He does recommend a book by the founders of the Workplace Bullying Institute, titled “The Bully at Work,” by Gary and Ruth Namie.

(I’d add my own recommendation: “The No Asshole Rule: Building a Civilized Workplace and Surviving One That Isn’t,” By Robert I. Sutton. It should be slipped under every CEO’s door. Here’s what the back jacket says: “The definitive guide to working with — and surviving — bullies, creeps, jerks, tyrants, tormentors, despots, backstabbers, egomaniacs, and all the other assholes who do their best to destroy you at work.”)

Bullying targets are often advised to seek counseling, but Prof. Yamada said that “a lot of therapists don’t understand what this is all about, whereas if you told them you were being abused by a partner or were being beaten up at school, people would understand it and there’d be something like a therapy protocol.”

“We don’t have that for bullying,” he said. “We’re making strides in the media but I compare this to where we were with sexual harassment maybe three decades ago: the term was just starting to hit the radar screens but there was still a sense of denial that there was a problem.”

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  • abused at DMH

    The entire top tier of so called leadership at Solomon Carter Fuller Mental Health Unit in Boston is guilty of continuous bullying behavior via public humiliation of medical staff or abusive verbal attacks on nurses by those in charge who remain there because there is no oversight in DMH/state employment especially at the highest levels. Get to work and clean up DMH Gov. Patrick, it is long overdue!

  • Shelby

    I know of a healthcare provider who was bullied, harassed, subjected to a hostile environment and of course became a target by the department director and supervisors. In a matter of two months the healthcare provider was terminated due to a medical error; his license to practice in the state was suspended which basically means his career is over. Lawyers advised the law does not protect him from bullying/harassment, that he did not have a case. In the meantime, a peer in the same healthcare facility commits more or less the same degree of medical error 3 months after previous healthcare provider was terminated, no bullying or harassment involve and of course, no disciplinary action is taken against the healthcare provider. If the terminated healthcare provider cannot take legal action against the bullies, which organizations can a medical error be submitted to, to ensure the incidents are investigated?

  • aliana von richthofen

    If you want to read about a horrific case of employer bullying please look up ALIANA’S CASE under:
    http://www.stopemployerbullying.org

  • Beth Boynton, RN, MS

    Workplace violence, staffing shortages, and medical errors are all interconnected. I think consumers need to know more about what is going on in healthcare systems.

    Year after year after year the Joint Commission’s stats show that communication failure is the leading root cause of sentinel events. We need more time, we need more staff, and we need to work in workplaces where we are treated and treat each other respectfully. This is about changing behaviors though and checklists, communication models and engineering safety, although important, are not enough. We need to get at the underlying dynamics. Sadly, our tough economy fuels fear and allows employers to continue to treat employees disrespectfully. This trickles down and contributes to a variety of aggressive and passive-aggressive behaviors.

    Check out ANA-ME webpage on workplace violence and my own recent newsletter and website:

    http://www.anamaine.org/displaycommon.cfm?an=1&subarticlenbr=116

    http://bit.ly/bWoRKp (scroll for article: Workplace Violence, Poor Communication & Medical Errors: What Should We Tell Consumers?)

    bethboynton.com

    Beth Boynton, RN, MS, Author of Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces

  • http://sleepapneacure.biz Mark

    This makes sense. If the body has a fight or flight response to perceived threats that impulse to run or fight has to go somewhere. Since we can’t just punch the bully and we can’t just quit. (We could quit but, we would also need to quit eating and living in a house too.) What does a person do.
    Of course there are some protections against employers allowing “hostile work environments”.

  • Voter

    Great article. Has anyone looked for a link between health insurance-based job-lock and workplace bullying? In theory, the best way to cope with workplace abuse is to quit, but if you (or your kid) has a condition where life depends on health insurance, then the most rational choice may be to suck it up and stay with the job…. Exactly what free markets were supposed to prevent.
    This may not be a problem in Massachusetts, but it is in the states that lack health insurance protection, and if national health reform gets rolled back, it will continue to be a serious problem for anyone who gets sick in those states.

  • Katherine Crowley

    Bullying is an ongoing issue and I think it’s especially prevalent in those industries that are largely personality based. Health Care (where star doctors can make or break a facility), TV (where deadlines are tight and drama is part of the job), Wall Street (where stakes are high and tough guys often finish first). Thanks for this article

  • http://newworkplace.wordpress.com/ David Yamada

    Carey, thank you for this article and for interviewing me for it.

    Readers in healthcare may be interested in a series of short posts I wrote about workplace bullying in healthcare for my blog, Minding the Workplace:
    http://newworkplace.wordpress.com/2009/12/15/workplace-bullying-in-healthcare-i-the-joint-commission-standards/

    Sincerely,
    David Yamada
    Suffolk University Law School