Bullying and Harassment

Bullying and harassment in the workplace can express itself in many ways¹. We often think of it as a junior being shouted at by a senior, anger expressed in the theatre environment, however bullying and harassment can manifest in many scenarios and forms. Often those involved may not recognize the signs of bullying or harassment or may be too scared to speak up. The National Training Survey has highlighted ongoing issues faced in this domain.

Insights from the National Training Survey

In 2022, the national trainee survey highlighted that at least 25% of plastic surgery trainees have experienced some form of bullying and harassment in their career.

Further Information:

20% of trainees report being treated differently due to gender
5% of trainees report being treated differently due to race
45% of incidents are not reported. This is due to:
- Lack of knowledge of appropriate channels
- Concern over career progression being affected by reporting

The impact of these findings:

Clearly, bullying and harassment is still an issue affecting a significant number of trainees. Lack of reporting of incidents suggests trainees feel disempowered or afraid to speak up and may feel unaware of how to appropriately report concerns.

There is no role for harassment of any kind in the workplace. If you experience this as a trainee, you should be confident that the issue is dealt with and have no fear of its effect on you, the workplace or career progression.

How to Prevent Episodes of Bullying and Harassment

1. RECOGNISE

The first step in tackling bullying and harassment is recognizing it. Sometimes doctors may not feel comfortable with the way they are being treated or witness someone else being treated but may not be able to define why it does not feel right.

Persistent behaviour that makes you feel intimidated, inadequate or reluctant to engage is bullying.

Signs that you or someone you know is being bullied or harassed include²:

Avoiding a colleague you know that will make a derogatory remark about your or others you know.
You feel scared or intimidated to contribute to a discussion or raise a question.
When someone in the team often raises their voice or uses bad language, such that the team try to avoid triggering such behaviour, this may lead to concealment with subsequent patient safety issues.
Derogatory comments about your beliefs or an individual’s belief.
Negative comments about yours or an individual’s physical disabilities.

2. SPEAK UP

End the silence. If individual people do not speak up or seek help, then problems cannot be addressed. If unchallenged, this practice can become normal culture.

Reporting episodes of bullying and harassment does not need to be daunting. People can be concerned that formal complaints processes may make matters worse for them. Trusts often have dedicated roles designed to support healthcare workers when they feel unable to raise issues through other routes.

Freedom to Speak Up Guardians

Individuals appointed to NHS trusts and independent sector organisations from the National Guardian’s office. There are over 900 appointed within the NHS and independant sector organisations throughout the UK³.

There is a lack of engagement with freedom to speak up guardians from doctors, only 6% of cases made come from doctors compared to 31% of nurses⁴.

3. ENCOURAGE

Sometimes, direct action against bullying or harassment may not feel safe…

In these situations, recognizing harmful behaviours and offering support to victims can be impactful.

This can be through:

Validating their experience and feelings
Offering a safe space to talk
Offering to accompany them, if appropriate, to speak to a senior member of the team
Highlighting ways that they may want to seek support such as freedom to speak up guardians or other forms of local pastoral support

Sometimes, it may be appropraite to challenge bullying or harassing behaviour directly...

How does this work?

Informs perpetrators that their actions are unacceptable
Breaks the silence on toleration of bullying and harassment
Works towards changing culture into one that does not stand for harmful behaviours in the workplace
Helps victims not to feel isolated when they are experiencing bullying and/or harassment

4. EQUIP

Some common reasons that bullying and harassment are not escalated are:

Fear that It may make things worse
Fear that if escalated nothing will change

In some situations, early, informal intervention can prevent unprofessional behaviour from escalating into bullying and harassment. This involves recognising low level behaviour or rudeness and having the confidence and skills to speak up.

There is also an important time and place for formal complaints and individuals should feel safe and confident that they will be protected throughout these processes.

Tackling bullying and harrassment in the workplace can feel overwhelming, but there are resources and individuals available to help and support you.

RESOURCES

RCSEd - #LetsRemoveIt campaign

This site contains evidence-based information about bullying and harassment including their impact on individuals and patients in the workplace.

Specific resources include:

posters that can be printed and used at your local trust
e-learning modules in how to deal with bullying and undermining behaviour
pre-prepared 10-minute and 30-minute presentations that can be delivered at your own trust to spread awareness

BMA

The BMA provides a 1-hour online module on recognizing and preventing bullying and harassment in the workplace.

Their bullying and harassment policy also contains facts and figures about bullying and harassment and strategies for individuals and trusts to change culture and eradicate harmful behaviours.

PLASTA

If you would like to discuss your experience of bullying and harassment personally, we are here to help.

You can always contact us on equality.plasta@gmail.com for further impartial, informal advice.

Cut It Out