This final article in our series on bullying addresses what organizations can do to end bullying, as well as legislative solutions that have been proposed.
“What should move us to action is human dignity: the inalienable dignity of the oppressed, but also the dignity of each of us. We lose dignity if we tolerate the intolerable.”
—Dominique de Menil
Surveys, studies and scholarly research show that bullying is rampant within the realm of health care. This problem exists in all levels of health care and, although many health journals are silent on the matter, the mental health field is finding more and more correlations between workplace violence and mental health trauma. Now organizations such the Work Place Trauma Institute (WPTI) are drawing attention to the problem by working on legislation to protect individuals who currently are not protected by criminal law statutes.
The WPTI also has shown that bullying affects the bottom line, ultimately, by causing the best and brightest individuals and contributors to leave. Europe has begun to address the situation by providing active education and training within their health care systems with an aim at prevention.
This article will look at how organizations that wish to address bullying behavior can proceed. Once an organization comes to terms with the fact it is dealing with bullying behavior, it must commit to a plan to address the violence. This article also will examine the role of state legislatures in developing a possible solution for both individuals and organizations. (Please note that for brevity my use of the word “organization” in this article includes health care institutions such as hospitals, midwifery group practices, midwifery/nursing organizations and associations, as well as grassroots community midwifery action/social groups.)
What an Organization Can Do
If an organization decides to take action against bullying, those in leadership must be fully committed to zero tolerance and to concrete policies. Just issuing a statement or removing one bully is not enough: A policy of zero tolerance to violence in the workplace must be adopted.
The first step for an organization is to “name it”—recognize that bullying exists and determine to find out how bad it is. This may be done in a variety of ways, including by creating a survey, or by having an organizational discussion to get truthful feedback on the situation. Surveys should ensure confidentiality and provide important statistics on affected employees. They can be a non-threatening way to introduce the topic of bullying. An organization conducting a survey must be prepared to be fully accountable, to ensure the confidentiality of the respondents, and to thoroughly and honestly follow up on the information found in the survey.
Once the organizational assessment is complete, those in charge have a duty to create programs for education and training. These often are referred to as “awareness sessions.” This is the time to begin to raise awareness within the organization about bullying and why it is a problem and about the commitment of the organization to training and support as ways to eradicate the hostility with strong anti-bullying policies. Often organizations are reluctant to provide “awareness sessions” out of concern that they may provoke lawsuits under existing discrimination laws. However, organizations need to recognize that clearly defined laws addressing discrimination and harassment are in place and an awareness session can offer an invaluable service to individuals who perhaps are being bullied due to race, sexual orientation, religion, etc., as well as to offer an opportunity for re-training in areas of discrimination.
Pamphlets and other educational materials should be readily available during the awareness sessions and placed in areas where they can be easily seen and distributed. Organizations should create space within the equal opportunity or affirmative action portions of newsletters, conferences and Web sites to address bullying. Experts can come in on the subject or perhaps submit a letter to a local peer-read journal. Organizations should not tolerate personal attacks in meetings or any other forms of communication (organizations would do well to recognize the legal liability created).
Organizations need to create formal written statements and written policies specific to bullying that have been approved by governing boards. Within the policy should be a clearly written statement on how a target can access the complaint process while at the same time being protected. The policies should be reviewed by legal counsel to ensure that they are comprehensive and consistent with other health care institutions and organizations.
Another idea is to reinforce the organization’s commitment by developing or adopting slogans that instill in employees the sense of a non-hostile work environment. An example is the phrase “Dignity at Work,” which derives from European law and is used in many European workplaces.
Organizations also need to offer both informal and formal methods for resolving bullying problems. An informal method would allow an employee to go to someone in a leadership position without initiating a formal complaint; a formal complaint process would then be implemented if the informal method failed. Often this will allow for resolution much earlier and with less conflict and/or monetary loss.
Managers or others in leadership positions may be able to find a workable informal solution that everyone can agree to, such as scheduling the target on shifts when the bully is not working (or vice versa). Formal methods for resolutions must be clearly documented in the organization’s anti-bullying policies and should include a well-drafted step-by-step procedure that is consistently followed.
Finally, the organization needs to actively prevent bullying in the workplace. This includes providing continuing education and training, as well as promptly addressing incidents that do occur. Again, a zero tolerance policy is generally the best prevention, and bullies tend to back down in such environments.
These steps would go a long way toward derailing bullying in our profession and in the workplace. Once policies are in place, the profession is accountable for ending violence in the ranks of midwifery.
Another avenue for targets and organizations is to bypass workplace politics and head directly to the state legislature. Anti-bullying measures continue to be introduced in state legislatures. Since 2003, 12 US states have introduced 27 bills on bullying, although none has yet passed such a law.
The reality may be that bullying in the workplace will not stop until such laws are in place. Mediation does not work in the current climate to a large degree because neither bullies nor organizations are subject to such a law. Bullies will defame and blast a target, but generally are not interested in peace or problem resolution.
In order to stop bullying we must recognize and assess the problem, discuss it, educate and train employees, and create zero tolerance policies and formal/informal complaint processes, ensuring that they are fair and safe for the person making a complaint.
This series of articles has touched on the very real issue of bullying in our workplaces and among our professional peers in midwifery. My personal goal for this series was to find the essence of the lesson in bullying and how it can become a positive subject. Once it has been “named” and discussed and organizations try to change the tide and individuals find their strength to confront abuse, the transformations in the organizations and the individual can be earth healing.
Colin C. Tipping, the author of Radical Forgiveness, writes, “The extent to which we respond to other people’s actions with a sense of righteous indignation, grievance, revenge and resentment, rather than with a genuine desire to balance the scales with regard to principles of fairness, freedom and respect for others, determines our level of forgiveness. Righteousness and revenge lower our vibration. Conversely, defense of principles and acting with integrity raises our vibration … we should seek to make others accountable for their actions … I am often asked whether, in a situation where someone has done us harm and where the normal reaction would be to seek redress through the courts, a forgiving person would actually take that course of action? The answer is, “Yes.” Early on we learn that our actions have consequences … When I do intervene however, I do it free of judgment and the need to blame anyone. I just do it, knowing that the Universe set the whole thing up for a reason and that there is a perfection in there somewhere … we do not have to like the person to forgive them. Neither do we have to stay in their company if their personality and/or behavior is toxic to us.(6)
This can be a plausible answer to a positive, peaceful and personal solution without excusing or accepting the violent behavior of the bully. A bully should be held accountable but the target needs to set herself free from victimhood by finding a forgiveness that will release the experience. Once the dust has cleared and the necessary changes are made in our workplaces, once we have “dignity at work” and teachers are shepherding their students with grace and kindness, the cycle of violence in our health care systems will be challenged. I suggest that at the end, we look toward “radical” change within our policies, our professional interactions and our own hearts. As we heal from the actions of a bullying culture, we change the culture one individual at a time.
Applying Tipping’s steps for radical forgiveness as a model, we need to acknowledge our role in painful circumstances without guilt or judging ourselves, accept our imperfections so that we are more aware of our own feelings and body, be willing to see how perfect certain situations can be in our own growth and healing and, finally, to chose the power of peace by being fully aware in our decision-making.