Bullying – not a disease to watch and wait
Bullying is often first encountered in the playground – whether as a victim, perpetrator, or pupil being taught to treat others with respect and consideration. How then, when we advance from school to higher education, passing examinations, learning complex anatomy, physiology, pharmacology and researching their clinical application, do we fail to remember one of the earliest lessons we were given? Tales of bullying behaviour have been recounted in medical autobiographies with angry outbursts from surgeons throwing scalpels, humiliation of medical students at ward rounds or preventing trainees operating to finish a theatre list faster. One may say ‘back in the day’, but evidence demonstrates that bullying and undermining behaviour remain a prevalent issue.
In 2017, 28% of NHS staff reported bullying, harassment or abuse in the workplace, of which approximately a quarter originated from colleagues. This factor poses numerous harms, primarily to the victim, who may be oblivious to the situation but feel they lack ‘resilience’ or aptitude to be a ‘successful trainee’. This then has repercussions on training and contributes to high burnout rates, endangering the sustainability of the healthcare workforce. Effects on training can manifest as harmful to patient safety, as can a failure to identify or report bullying behaviour, a key finding in the Francis Report of 2013.
However, it’s not all ‘doom and gloom’. Representative bodies in medicine, surgery and subspecialties are making moves to highlight the problem and implement changes to fight bullying behaviour. Among campaigns from the Royal College of Surgeons Edinburgh, the Association of Surgeons in Training, the British Orthopaedic Trainees Association and #ILookLikeASurgeon, just to name a few, there exists a common theme – this is not a battle to be fought by a few. Change needs to come at all levels, from individuals to departments, and from each hospital to national institutions. It is not a disease we can watch and wait, it’s one that requires radical therapy.
What are your thoughts?