Workplace Stressor: Deviant Behavior in Healthcare

Healthy Workforce Institute

Nurses, physicians, and technicians can be so caring and compassionate to their patients, yet they can be cruel towards each other. Surprisingly, there are more bullying and deviant behaviors in healthcare than in any other industry. Healthcare tolerates disruptive behaviors, even though study after study shows the negative impact on employee retention and patient outcomes. The reason is simple: We’ve accepted bad behavior as the norm in healthcare.

“We fail to recognize deviant behaviors because it’s just the way it is here, but the first step to stop bullying, incivility, and deviance is by raising awareness of behaviors that undermine a culture of respect, professionalism, and patient safety,” says Renee Thompson, DNP, RN, CSP a nursing professional development/bullying and incivility thought leader and founder of the Healthy Workforce Institute. “You can’t expect people to adapt their behavior if they don’t realize their behavior needs to be adapted,” Dr. Thompson adds.

We Have Blinders On

Dr. Thompson points out a healthcare leader in her online course, Eradicating Bullying & Incivility: Essentials Skills for Healthcare Leaders, told her she wasn’t sure WHY she was asked to take her course.

  • She didn’t think they had a problem.
  • After she completed the course, she talked with Dr. Thompson. She revealed that, for 29 years, she had become numb to the eye-rolling, condescending attitudes, nitpicking and even the overt criticisms, gossiping, and mocking.
  • She didn’t notice it. Once she took her “blinders” off, she was appalled at how badly people treated each other.
  • She had normalized the deviance!

Ethical Responsibility

Dr. Thompson says healthcare organizations have an ethical responsibility to stop bullying and deviant behaviors in healthcare and are now being held accountable to do so.

How to Heighten Awareness of Deviant Behavior in Healthcare

Dr. Thompson has been conducting workshops on addressing disruptive behaviors for almost 10 years. One of her favorite comments was from an executive leader who said, “We had a wound we didn’t know we had. A nice Band-Aid covered the wound that we didn’t know was there. You came in, ripped off the Band-Aid, and exposed the wound!” It’s time for healthcare organizations to rip off the Band-Aid to expose their wounds.

Dr. Thompson offers a few ways to expose healthcare organizations’ wounds.

  1. Infuse content related to behavior everywhere. Heighten awareness of behaviors that undermine a culture of safety by infusing content related to behavior everywhere.

    Dr. Thompson recommends including content regarding behavior in orientation, in nurse and physician residency programs, preceptor programs, leader orientation and ongoing leadership development, etc. Include content related to conduct in everything ongoing, such as staff meetings, leadership meetings, performance reviews, annual competencies, etc. Not just when employees are hired.

    Every employee should know that the way they treat each other matters.

  2. Pay attention. As the leader in Dr. Thompson’s course, start paying attention to your coworkers by standing back and observing.

    Like a fly on a wall does right before pouncing on your picnic barbecue! You’ll be amazed at what you see and hear.

Pay attention to these types of statements:

    • You’ve got to pay your dues. 
    • It’s always been done this way.
    • I’m making her a stronger nurse. 
    • If she thinks I’m hard on her wait till she meets _______.
    • Just suck it up buttercup.
    • It’s sink or swim here, so if you want to survive, you’d better learn how to swim.
    • Just ignore him like everyone else does.

“If you’ve been normalizing bad behaviors in the past, once you rip off the Band-Aid and discover the wound, you’ll have no choice but to treat the wound,” says Dr. Thompson.

  1. Look in the mirror. If 73% of healthcare professionals report witnessing or experiencing disruptive behaviors, the disruptors can’t be everyone else.

    Dr. Thompson says each person must look in the mirror to determine how he or she contributes (good or bad) to the workplace culture. (Click here to take Healthy Workforce Institute’s self-assessment titled, “What If You Are the Bully?”)

Bullying and incivility are alive and well in healthcare, yet those in that field are ignorant to their surroundings.

“If you’re not doing anything about this in your organization, not only are you putting your patients and employees at risk, but you’re also in violation of regulatory requirements,” says Dr. Thompson.

She urges healthcare leaders to make a commitment that they’ll no longer accept bad behavior as the norm and take action. “The way we treat each other SHOULD be just as important as the care we provide!”

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