Problems with bullying, undermining and harassment are unfortunately still common. They can relate to individuals or organisational culture, or to both, and are often accompanied by a fear of reporting the behaviour (whistle blowing).
Heavy workloads, staff shortages and external pressures such as performance targets may
accompany this behaviour, but these are not excuses for any bullying or harassment.
This article will cover:
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What are bullying, undermining and harassment?
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How you can raise concerns?
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Bystanderism
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Culture change
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Useful links / articles
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Edits / updates / improvements?
1. What are bullying, undermining and harassment?
Bullying is defined as offensive, intimidating, malicious or insulting behaviour, an abuse or misuse of power through means that undermine, humiliate, denigrate, or injure the person to whom it is directed.
Harassment is unwanted conduct related to sex, gender reassignment, race or ethnic or national origin, disability, sexual orientation, religion or belief, age or any other personal characteristic which:
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Has the purpose of violating a person’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive environment for that person;
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Or is reasonably considered by that person to have the effect of violating his or her dignity or of creating an intimidating, hostile, degrading, humiliating or offensive environment for him or her, even if this effect was not intended by the person responsible for the conduct.
Undermining can be more difficult to identify and describes behaviour that intentionally lowers someone’s professional confidence and/or self-esteem. Some incidents of
undermining can be quite subtle and difficult to identify. These might include ignoring a trainee’s views and opinions, setting unreasonable or impossible targets or workloads, or even setting too few targets whereby the trainee has too little to do, which creates a feeling of uselessness.
Any individual can bully, be bullied, or switch between the two, and others may be affected by viewing this behaviour.
It is important not to confuse bullying behaviour with firm supervision. Bullying is undermining and destructive whereas effective supervision is developmental and
supportive. The latter may well include negative but constructive feedback.
2. How can you raise concerns?
It can be scary and confusing experiencing varying degrees of bullying or harassment. However, it is vital that you raise your concerns to avoid another trainee having a similar experience in future.
Seniors are responsible for ensuring that their organisations provide supportive working environments, free from bullying and harassment. Trainees who raise in good faith an issue or grievance relating to bullying or harassment, or assists in the raising of such an issue, should expect to be protected by the deanery against victimisation both at the time and afterwards.
Here are some practical actions you can take or advise others to take:
1. Keep a record/diary
a. Keep a diary of all incidents.
b. The best way of doing this is via an email to yourself (these are time and date-stamped).
c. These should often include a record of the date, time, any witnesses and how you felt about an incident.
d. Keep copies of anything else that may be relevant for instance written communication (emails, letters) and notes from meetings.
e. Without evidence, it is very difficult to take matters further if required.
f. You may never feel you will need them but it is important to keep a record.
2. Speak to someone.
a. Don’t be concerned or ashamed to tell someone what’s going on. If you think that you are being subjected to bullying behaviour, or that it is taking place,
then you should speak to someone about it in confidence to discuss how you might be able to deal with the problem.
b. Your first discussion should help you explore the issue and decide what to do next.
c. If the first person you talk to is not helpful then speak to someone else.
d. Further discussions may include practical ways to take matters further should you wish.
Who you can contact (you may feel more able to speak to someone outside of your trust or deanery if you feel it may impact your working environment):
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A trusted colleague
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Clinical Supervisor
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Educational Supervisor
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College Tutor
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HR
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Occupational Health
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Freedom to Speak Up Guardian
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Training Programme Director
3. Bystanderism
Bystanderism is the phenomenon of a person or people not intervening despite awareness of another person's needs. Inaction in the presence of inappropriate jokes or “banter” signals to others that harassment and abuse of individuals and marginalised groups is okay.
The 5 D’s are a good model to get started in thinking about bystander intervention:
There are things you can do to become an effective bystander for your colleagues:
1. Educate yourself on the experiences of others by:
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Undertaking regular equality and diversity training - this will help you recognise more clearly types of discrimination and recognise behaviours that are likely to lead to harassment and bullying
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Read BOTA’s Equality, Diversity and Inclusion article page
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Listening (“Shutting Up”) to others experiences
2. Ask the victim whether they were okay or not with comments made to or against them. Give them the opportunity to educate them on how it made them feel and
how they feel you could be an ally. Phrases such as:
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How do you feel with what *** said in theatre?
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Did *** make you feel uncomfortable at all?
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Would it have helped if I’d have said something at the time?
3. Practice responses to situations in which you could have intervened before, but haven’t known what to do or say. Consider gentle challenging such as:
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Is that an okay thing to say given where we are nowadays?
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I don’t understand. Can you explain what’s funny?
4. Pick your moment. Responding at the time may not always be the most effective or powerful intervention. It is not a sign of weakness not to respond immediately.
Consider:
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Approaching the individual during a calmer or more private moment (i.e. the coffee room, changing room).
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Approaching another member of staff to report the behaviour who may be able to approach the individual more easily.
5. Call it out. If something being said or done is clearly unacceptable, it is your responsibility to protect your colleagues from harassment. This includes simple
statements such as:
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That is not okay.
4. Culture change
Hammer It Out campaign
Mr Simon Fleming, Orthopaedic Registrar, was instrumental in setting up and leading this campaign. The aims and description of the campaign are:
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To create a positive workplace culture that is free from bullying, harassment and undermining behaviours.
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To recognise the many positive aspects unique to T&O surgery and develop it as a highly desirable surgical specialty to work in, appealing to a diverse
population and creating a balanced and representative workforce.
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To nurture an environment that empowers individuals to speak up if they experience or witness unacceptable behaviours.
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To promote and share examples of those who demonstrate exemplar behaviours in the workplace and use these to model further improvements in the wider NHS culture
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To inspire positive culture change to improve patient care.
Consider undertaking this Medics Academy course on how we can change the culture of medicine, based on the #hammeritout campaign:
https://www.medics.academy/courses/hammer-it-out
5. Useful links / articles
Listen to this podcast:
https://youarenotafrog.com/episodes/58/
Dr Adam Harrison, a GP, medial leader, and barrister, shares his experience as a victim of bullying and how he conquered his fear of bullies.
Have a look at this website:
https://youarenotafrog.com
You will find personal stories and the opportunity for surgeons to submit their own story to raise awareness.
Glance at this infographic:
https://www.nhsemployers.org/articles/tackling-bullying-nhs-infographic
Statistics and key facts on the impact of bullying on workforce wellbeing.
Listen to this podcast:
https://youarenotafrog.com/episodes/90/
What to Do About Bitching and Backbiting. What to do when colleagues make inappropriate comments about others.
Listen to this podcast:
https://www.boa.ac.uk/resource/orthopodcast-17-bullying-in-the-orthopaedic-workplace.html
Fergal Monsell, a paediatric Orthopaedic surgeon has some interesting views on bullying in the Orthopaedic workplace.
Watch this webinar:
https://www.slideshare.net/slideshow/compassionate-and-positive-cultures-in-the-nhs- support-for-nhs-staff-to-speak-up-250709506/250709506
Compassionate and positive cultures in the NHS: Support for NHS staff to speak up.
6. Edits / updates / improvements?
These support / welfare articles require constant updating to reflect the changing world of the modern Orthopaedic trainee.
If you have any edits / updates / improvements for this article please email them to:
wins@bota.org.uk
Thank you for your support.
Bullying