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Fixing bullying starts at the top

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The Minister for Health, Jack Snelling, is apparently considering introduction of legislation to allow him to sack or move doctors working in the Royal Adelaide Hospital’s Intensive Care Unit after an independent report released last week alleged they had been engaged in ‘dysfunctional behaviour’ amid a ‘culture of bullying’.

Responding to the findings of a review conducted by five senior interstate experts and SA Health’s Chief Medical Officer, Mr Snelling reportedly referred to the behaviour in the ICU as “childish, unacceptable and potentially dangerous”, stating it “wouldn’t be tolerated in a schoolyard and I won’t tolerate it in an intensive care unit”.

While it is commendable that Minister Snelling is making a strong public statement that reflects leadership around the issue of bullying and harassment in the workplace, labelling the alleged behaviour of some medical professionals as “childish’ may perhaps create more problems than it solves.

The cause of these behaviours in the workplace is almost always complex and multifactorial and must be explored by professionals skilled in organisational psychology if they are truly to be unpacked and addressed.

Why do people bully? Many assume bullies are psychopaths when, in reality, less than one percent of the population would be classified as psychopaths.

In many workplace bullying situations, people who engage in bullying behaviour believe they have justice on their side. They have an opinion on an issue which differs from another individual (or organisation, in the case of the RAH) and use this as justification to engage in behaviours which they see as appropriate. These behaviours could include excluding someone because they are ‘annoying’, or consistently giving these workers the worst jobs because they are ‘useless’. Their belief that they are ‘right’ undermines their capacity for empathy (for the wellbeing of others), allowing for bullying behaviours to dominate.

While bullying is most evident at the interpersonal level, to blame individuals in these situations and threaten sacking or sanctions misses the most important aspects of workplace bullying – the organisational context and the managerial response.

Seemingly, it is only when a situation has reached crisis point that experts are called in and situations like the RAH are reviewed.

Where bullying behaviour exists in the workplace, it is often related to the workplace culture, and it appears from media reports that this may be the case with the RAH. The combination of bed shortages, increased demand for services, longer working hours and inadequate resourcing breeds a culture of high stress and low tolerance. Bullying behaviour thrives in these environments as individuals become irritable, short-tempered and frustrated with the perceived lack of organisational response.

Organisations have a responsibility to ensure the health and safety of their employees and this includes mental health as much as physical safety. Inadequate understanding of what constitutes bullying behaviour, lack of clear policies and procedures, lack of action when bullying behaviour is reported and poor training of managers are the responsibility of all employers. Left unaddressed, each of these factors add to existing issues driving poor workplace behaviour.

State Government departments (including the Department of Health) have numerous policies and procedures, including those around appropriate workplace behaviour and bullying. Unfortunately, in many workplaces, these policies remain theoretical standards which have not been adequately integrated into workplace practice.

In large departments such as the Department of Health, it is the middle and upper middle managers who first see inappropriate workplace behaviour which constitutes bullying. In many cases, these managers lack both the skills and confidence to have the ‘difficult conversations’ required to intervene early, curb the inappropriate behaviour and address the underlying issues. They may also lack the power to adequately address these issues.

Managers may believe that the organisation won’t back them if they have the ‘difficult conversations’ and fear being labelled a bully themselves. Taking reasonable action regarding performance is not bullying. Lack of skills and confidence in managers lead to lack of action; problems fester, frustrations rise and behaviour becomes more inappropriate and entrenched.

Seemingly, it is only when a situation has reached crisis point that experts are called in and situations like the RAH are reviewed.

These issues must have been in process for many months, with opportunities for the Department of Health to take action overlooked, ignored or nervously sidelined. With the risks to individual mental health and patient safety, the question remains: why did it take so long for the department to act?

Creating a positive workplace culture after endemic dysfunction takes time. And it starts with leaders, from the Minister down, taking responsibility and promoting change in the form of leading by example.

Calling people childish and threatening sacking runs the serious risk of modelling the behaviour which the Department is attempting to correct.

Luke Broomhall is Director of Broomhall Young Psychology.

Broomhall Young Psychology undertook an audit and made recommendations for Families SA Residential Care in the wake of the recent sexual abuse scandal. Broomhall Young Psychology provides training for organisations on mental health and wellbeing (including bullying).

 

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