Workplace Bullying in Healthcare: A Qualitative Analysis of Bystander Experiences

Abstract

Bystander action has been proposed as a promising intervention to tackle workplace bullying, however there is a lack of in-depth qualitative research on the direct experiences of bystanders. In this paper, we developed a more comprehensive definition of bullying bystanders, and examined first person accounts from healthcare professionals who had been bystanders to workplace bullying. These perspectives highlighted factors that influence the type and the extent of support bystanders may offer to targets. Semi-structured telephone interviews were conducted with 43 healthcare professionals who were working in the UK, of which 24 had directly witnessed bullying. The data were transcribed and analysed using Thematic Analysis. The analysis identified four themes that describe factors that influence the type and extent of support bystanders offer to targets of bullying: (a) the negative impact of witnessing bullying on bystanders, (b) perceptions of target responsibility, (c) fear of repercussions, and (d) bystander awareness. Our findings illustrate that, within the healthcare setting, bystanders face multiple barriers to offering support to targets and these factors need to be considered in the wider context of implementing bystander interventions in healthcare settings.

Factors influencing the behavior of bystanders to workplace bullying in healthcare—A qualitative descriptive interview study

“…Turning the focus to the bystanders, even though there were a few reports of bystanders intervening in an active and constructive way (Ng et al, 2020; Paul et al, 2012), the participants mainly perceived bystanders as being passive either in a constructive way by privately showing social support and empathy for the target, or in a more destructive way by ignoring or avoiding the situation (Ng et al, 2020; Paull et al, 2012). This is in line with other studies focusing on bystanders in healthcare, showing a lack of direct action by witnesses of bullying (Thompson et al, 2020, discussion). This kind of passive behavior can be explained by the more general phenomenon of not knowing how to help the victim (van Heugten, 2011; Keashly & Jagatic, 2003), not feeling responsible for intervening (Mulder et al, 2016), considering the bullying as fair treatment (Leymann, 1990; Ng et al, 2020), or not seeing the severity of the situation (Tracy et al, 2006).…”

“…As an approach to reducing workplace bullying in the healthcare sector, focusing on bystander behavior has been identified as a promising intervention strategy (Illing et al, 2013). This is especially relevant in the healthcare context where employees are encouraged to speak up when critical incidents and errors are witnessed (Okuyama et al, 2014; Thompson et al., 2020). However, for bystander intervention to succeed, it is vital to establish a safe and supportive workplace and to ensure the engagement of management in the issue.…”

“…Organizational culture has been identified as a critical factor for bystander action. In a study focusing on bystander intervention in healthcare, Thompson et al (2020) concluded that the efficacy of bystander interventions is decreased in organizational cultures lacking understanding of bystander action, and where individuals reporting mistreatment are seen as “troublemakers.” Newcomers are typically socialized into the prevailing organizational culture, including how they are expected to think and act (Schein, 2010). Regarding organizational culture, healthcare workplaces have been reported to be characterized by organizational silence (Gaffney et al, 2012).…”

“…Although there is a growing research interest in bystanders of workplace bullying, there is a need for further investigation concerning bystander behavior and the rationale underlying the behavior (Thompson et al, 2020). The current study adds valuable insight to research on workplace bullying by analyzing bystander behavior in relation to the identified bullying situation and the organizational context of healthcare.…”

Does Bystander Intervention Training Work? When Employee Intentions and Organisational Barriers Collide

“…Still, there is need for research that evaluates bystander intervention training relative to contextual barriers to training transfer (e.g. Thompson et al, 2020). This study answers recent calls for more evidence-based bystander training research (e.g.…”