Dr. Renee Thompson: How Incivility Leads to Bullying

Dr. Renee Thompson: How Incivility Leads to Bullying

This post is part of a series of posts on nurse bullying and conflict in the workplace written by Dr. Renee Thompson, DNP, RN, CMSRN. Dr. Thompson is one of the top professional development and anti-bullying thought leaders in nursing.

Heather was warned about Gina when she started her new job on a trauma critical care unit. Although Heather was not a brand new nurse, she was new to critical care. Gina had worked on the unit for decades, was frequently in charge, and was well known in the organization as the queen bully. Student nurses begged their clinical instructors not to be assigned Gina’s patients. Nobody ever wanted to be precepted by Gina and giving her report meant an instant trip to the bathroom to recover in private. Even the leadership team knew about Gina but failed to do anything about her bullying ways. Why? Because although everyone knew Gina was toxic, she had excellent clinical skills.

Throughout her first few weeks, Heather had successfully steered clear of Gina, but today, she found herself alone with Gina in a conference room. It wasn’t long before Gina zeroed in on Heather. She walked right over to where she sat, leaned over her and said, “So you’re the new girl. I heard you came from Medsurg. All Medsurg nurses are idiots.” Without waiting for a response, Gina laughed as she walked away. Heather was left speechless.

Bullying and incivility are huge problems in healthcare. A recent study found that 73 percent of all nurses have either experienced or witnessed bullying by other nurses in their workplace. How did it get so bad?

When small acts of incivility go unchallenged, they can escalate to bullying. Why? Because bullies gain a heightened sense of power when you ignore low levels of bad behavior. This power leads to more and more acts of aggression to the point where bullies feel untouchable, and the disruptive behaviors often escalate if left unchecked. We know that it’s the low level acts of incivility that lead to higher acts of bullying. So what do you do when you’re up against a bully in the workplace?


Learn to recognize and identify low levels of incivility like the eye rolling, mocking, inappropriate joking, interrupting, or downplaying accomplishments. Although these behaviors might not be directed towards you, they still provide you with a heightened sense of awareness. Knowing who behaves this way can help you avoid becoming a target.

Behavior – Occasionally, bully behavior comes across as subtle, to the point where you may even ask yourself whether it’s all in your head, but more often than not, bullying behaviors can be recognized. Some key behaviors are hard to miss:

  • Criticizes coworkers in front of others.
  • Downplays or denies others’ accomplishments.
  • Yells and screams at target in front of others.
  •  Eye rolling, mocking, gossiping.
  • Excluding, unfair assignments, showing favoritism.

Speak up

The first step in taking action when bad behavior escalates to bullying is to ask for help. Only half of all bullying occurs in front of people. Confide in a friend about what’s happening, or tell someone at work for support. Share your experiences with your boss, but if your boss is the bully, go through the chain of command until you get someone to listen to you. Because 40 percent of all bullying targets don’t tell anyone about their experiences, many unfortunate cases go unresolved. Don’t be a contributor to the statistics. Telling someone about your experiences is taking back some control over the bully.

Strengthen your assertiveness skills

One of the reasons why nurses don’t confront disruptive behavior is because they don’t know what to say or how to say it. Learning to communicate assertively can help. That said, standing up to a bully could feel stressful and scary, especially when that person finds enjoyment in fighting back. However, the best defense is a good offense.

In Heather’s case, she finally stood up to Gina by using this script: “I’m offended by that comment.” Gina left her alone but found a new target. If we are going to finally eliminate bullying and incivility, we all need to do our part.

Thanks so much for reading. Take care. Be kind and stay connected!


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