Sickness in Health Bullying in Nursing and other Health
Professions
Visit the link below to download the full version of this book:
https://medipdf.com/product/sickness-in-health-bullying-in-nursing-and-other-hea
lth-professions/
Click Download Now
Brenda Happell
Happell Consulting
Merrijig, VIC, Australia
Faculty of Health
Southern Cross University
Bilinga, QLD, Australia
e-mail:
[email protected]ISBN 978-3-031-49335-5 ISBN 978-3-031-49336-2 (eBook)
https://doi.org/10.1007/978-3-031-49336-2
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2024
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable
I dedicate this book to the 12 champions who
shared some of the most distressing
experiences of their lives and allowed me to
tell their stories. To them and every health
professional who has been bullied, this book
is for you.
Preface
You’ve done something for all of us no one else would. You’ve treated us with compassion,
support, and humanity. I am endlessly grateful (Alex).
The health professions are charged with responsibility for positively impacting
the health and well-being of the communities they serve. It is, therefore, surprising
to many that they experience some of the highest rates of bullying of all occupa-
tions. Even more concerning, most of the bullies are other health professionals who
should be motivated by the desire to do good for others. I have witnessed bullying.
I have experienced it far too often. It is not okay, and it needs to change. In what
seems an insurmountable problem, it is my hope that this book will go some way to
raising awareness about bullying and its impact. I hope this book will let those who
are being bullied or who have been that they are not alone and that they are not
responsible for what is happening to them. Bullying is not just a distasteful experi-
ence, it can be life changing, even life-ending. Targets of bullying need a voice. We
need to show the people behind the statistics. I hope this book gives voice to people
who have been bullied and raises awareness in bystanders. This is a book for all
health professionals who seek a positive work environment where they can use their
skills and knowledge to contribute to the health and well-being of their
communities.
Merrijig, VIC, Australia Brenda Happell
Bilinga, QLD, Australia
vii
Acknowledgements
It sounds cliche to say so many people have contributed, directly or indirectly, to
making this book a reality. I start by acknowledging Catherine, Judy, and Jennelle,
managers, leaders, and mentors who believed in me and provided opportunities and
support. You may never know how much you inspired me, and I am forever grateful.
My thanks to the people I worked with who were collegial, supportive, and
shared my passion to make a positive difference to the world. I know how difficult
it can be to shine in the face of toxicity. I can’t name you all and I hope you know
who you are.
Thanks to those who supported me during some tough times. You may not have
realised that your small acts of kindness made such a difference. I did.
Sincere thanks to Brett for encouraging me to continue when I almost gave up.
Trish, Aine, Patrick, Lynn, Clive, and John, thanks for taking the time to read the
book and provide honest, supportive, and encouraging feedback. A special acknowl-
edgement to John who helped me so much with writing style (as if supporting me
during dark times wasn’t enough). Thanks so much to Rasa for her assistance in
finding a publisher.
I could never give enough thanks and praise to the 12 champions who offered me
a window into their experiences and so willingly shared their stories of bullying and
how it changed their lives. Thanks also for taking the time to read the book and
provide suggestions and encouragement. Without you, this book would not have
been possible.
Finally, to my family, especially my partner Steve and son Shannon, my greatest
supporters, without whom I often wonder how I would have survived.
To anyone I have forgotten, my apologies and thank you.
ix
Contents
1 Introduction������������������������������������������������������������������������������������������������ 1
1.1 The Champions ���������������������������������������������������������������������������������� 6
2
Becoming a Health Professional �������������������������������������������������������������� 11
2.1 Motivations ���������������������������������������������������������������������������������������� 11
2.2 Becoming a Specialist������������������������������������������������������������������������ 15
2.3 Becoming an Academic���������������������������������������������������������������������� 16
2.4 Image of Health Professionals������������������������������������������������������������ 17
3 Being Bullied���������������������������������������������������������������������������������������������� 19
3.1 Experiences of Bullying���������������������������������������������������������������������� 20
3.2 Bullied as Students and New Graduates �������������������������������������������� 20
3.3 Downward Bullying���������������������������������������������������������������������������� 21
3.4 Peer-to-Peer Bullying�������������������������������������������������������������������������� 23
3.5 Upward Bullying�������������������������������������������������������������������������������� 25
3.6 Mobbing���������������������������������������������������������������������������������������������� 25
3.7 Beyond the Workplace������������������������������������������������������������������������ 29
3.8 Recognising Bullying������������������������������������������������������������������������� 31
4 Bully Tactics������������������������������������������������������������������������������������������������ 35
4.1 The Screaming Mimi�������������������������������������������������������������������������� 36
4.2 Subtle Bullying ���������������������������������������������������������������������������������� 38
4.3 The Gatekeeper ���������������������������������������������������������������������������������� 38
Withholding Information�������������������������������������������������������������������� 38
Withholding Resources���������������������������������������������������������������������� 40
Blocking���������������������������������������������������������������������������������������������� 41
Micromanagement������������������������������������������������������������������������������ 42
Exclusion�������������������������������������������������������������������������������������������� 43
4.4 Two-Headed Snake ���������������������������������������������������������������������������� 45
Backstabbers �������������������������������������������������������������������������������������� 45
Taking Credit�������������������������������������������������������������������������������������� 46
Favouritism ���������������������������������������������������������������������������������������� 47
4.5 The Saboteur �������������������������������������������������������������������������������������� 48
Humiliation ���������������������������������������������������������������������������������������� 48
Undermining �������������������������������������������������������������������������������������� 50
xi
xii Contents
Attacking Reputation�������������������������������������������������������������������������� 52
Unreasonable Work Expectations ������������������������������������������������������ 52
Changing the Goalposts���������������������������������������������������������������������� 55
Exploiting Vulnerability���������������������������������������������������������������������� 56
5
What Bullying Did to Me�������������������������������������������������������������������������� 59
5.1 The Love of the Job���������������������������������������������������������������������������� 60
5.2 Dreading Work������������������������������������������������������������������������������������ 60
5.3 Loss of Self-Confidence and Self-Doubt�������������������������������������������� 61
5.4 Fear ���������������������������������������������������������������������������������������������������� 63
5.5 Why Can’t I Cope? ���������������������������������������������������������������������������� 64
5.6 Losing Friends and Colleagues���������������������������������������������������������� 65
5.7 With Me Always �������������������������������������������������������������������������������� 69
5.8 Sleep���������������������������������������������������������������������������������������������������� 70
5.9 Alcohol������������������������������������������������������������������������������������������������ 72
5.10 Driven to the Edge������������������������������������������������������������������������������ 72
6 How I Responded �������������������������������������������������������������������������������������� 75
6.1 Subtle Bullying Is Hard to Prove�������������������������������������������������������� 76
6.2 Self-protection������������������������������������������������������������������������������������ 77
Documenting�������������������������������������������������������������������������������������� 78
Trying to Adapt���������������������������������������������������������������������������������� 79
Self-care���������������������������������������������������������������������������������������������� 81
6.3 Seeking Resolution ���������������������������������������������������������������������������� 84
Taking the Informal Approach������������������������������������������������������������ 84
Seeking Help Through Formal Channels�������������������������������������������� 87
6.4 Leaving or Staying?���������������������������������������������������������������������������� 95
7 Why Me?���������������������������������������������������������������������������������������������������� 99
7.1 Gentle Nature�������������������������������������������������������������������������������������� 100
7.2 Assertive and Outspoken�������������������������������������������������������������������� 100
7.3 Seen as Threatening���������������������������������������������������������������������������� 102
7.4 Honesty ���������������������������������������������������������������������������������������������� 105
7.5 Well Respected������������������������������������������������������������������������������������ 105
7.6 Hard Workers�������������������������������������������������������������������������������������� 106
7.7 Punishment������������������������������������������������������������������������������������������ 107
7.8 Gender������������������������������������������������������������������������������������������������ 108
7.9 Mental Health�������������������������������������������������������������������������������������� 108
7.10 Personality������������������������������������������������������������������������������������������ 109
7.11 Being Me�������������������������������������������������������������������������������������������� 112
7.12 Basically, I Have No Idea������������������������������������������������������������������� 112
8 Life After Bullying ������������������������������������������������������������������������������������ 115
8.1 Where Am I Now?������������������������������������������������������������������������������ 116
Those Who Left���������������������������������������������������������������������������������� 116
Those Champions Considering Leaving�������������������������������������������� 121
Those Where the Bully Was Removed ���������������������������������������������� 122
Contents xiii
8.2 Those Still Dealing with Bullies �������������������������������������������������������� 125
8.3 Me After Bullying ������������������������������������������������������������������������������ 128
8.4 Changing How I Relate to Colleagues������������������������������������������������ 130
8.5 Views About Bullying������������������������������������������������������������������������ 132
8.6 Forgiveness����������������������������������������������������������������������������������������� 132
9
The Toxic Culture of Health���������������������������������������������������������������������� 139
9.1 Problems with Leadership and Management�������������������������������������� 140
9.2 Friendships and Being Liked�������������������������������������������������������������� 141
9.3 Competition, Self-interest and Insiders���������������������������������������������� 142
9.4 Hierarchies������������������������������������������������������������������������������������������ 143
9.5 Not Dealing with Bullies�������������������������������������������������������������������� 145
9.6 Surprised at Bully Culture������������������������������������������������������������������ 151
9.7 Strategies�������������������������������������������������������������������������������������������� 152
Addressing Bullying �������������������������������������������������������������������������� 153
Processes for Reporting���������������������������������������������������������������������� 155
9.8 Making iIt Happen������������������������������������������������������������������������������ 156
Epilogue�������������������������������������������������������������������������������������������������������������� 159
About the Author
Brenda Happell grew up in the south-eastern suburbs of Melbourne with her
parents and three siblings. Her answer to the question “What do you want to be
when you grow up?” was “Author” without hesitation. She attended the local pri-
mary and secondary schools before commencing an Arts degree at La Trobe
University in 1976. Over the next 20 years, she completed her Bachelor of Arts with
Honours, a Diploma in Education, Certificates in general and psychiatric nursing, a
Bachelor of Education, Masters in Education, and Doctor of Philosophy. She
worked as a general nurse and secondary school teacher before finding her passion
in mental health nursing. In 1990, Brenda began her academic career at Victoria
College Burwood (later Deakin University). During her full-time academic career,
Brenda worked at the University of Melbourne, Central Queensland University, and
at the University of Canberra. She held many leadership positions, including the
inaugural Director of the Centre for Psychiatric Nursing Research and Practice,
Director of the Institute for Health and Social Science Research and Executive
Director, Synergy: Nursing and Midwifery Research Centre. Brenda’s academic
career provided the opportunity to fulfil her ambition as an author, having written
more than 500 journal articles, four books, and nine book chapters. She has received
several awards including the Victorian Mental Illness Awareness Council, Lifetime
Ally Award, and the Mental Health Services Award for Exceptional Achievement
for Mental Health. Brenda retired from full-time work in 2018. She currently works
part time as Professor of Mental Health, Southern Cross University and casually as
a Senior Research Fellow at the University College Cork. She has also established
her own business Happell Consulting. She manages her jobs and business remotely
while living in her country retreat in Merrijig, Victoria. Brenda lives with her part-
ner Steve. She enjoys travelling, writing, reading, spending time with her adult son
Shannon and watching her football team, Carlton.
xv
Introduction
1
After all these years, I can still see Andrew’s face. He was a nursing student, a
young man in his 20s, only months away from finishing his degree. His whole life
was ahead of him. The news that he had taken his own life was devastating to all
who knew him. I felt so much sadness for him and his family. A few days after his
death, I was summoned to my boss’s office. I was expecting some kind words and
perhaps an offer of counselling. I sat directly opposite her. She was glaring at me.
“How responsible do you feel for Andrew’s death?” I will never forget these words.
The tone of her voice made it clear this was not a question. It was an accusation. I
went cold, numb. I had barely processed the news of his death, yet here I am, sitting
across from an angry woman being blamed for it. “I don’t feel responsible at all, but
I have the impression you think I am”. It was the best I could come up with at the
time. My voice was shaking. I was shaking. She told me I was responsible because
I had kept information from her, which had likely contributed to Andrew’s decision
to end his life. She would not accept my honest reassurance that I was not privy to
the information I had supposedly withheld. All the devastation and sadness we felt
about his death was now in my throat, choking me: was I responsible? Was my boss
right? Could I have done something to change the outcome? Of course, we realised
that none of us had anything to do with Andrew’s tragic death. Had we seen it com-
ing, as trained mental health professionals, we would have done everything possible
to stop it. Why would my boss behave in this way? I don’t know. I can say that she
wasn’t the first bully I had encountered in my career, like most, she had the knack
of twisting whatever was at hand to denigrate and humiliate her colleagues at will.
Through this book, I tell my story and those of 12 individuals who often endured
horrendous abuse from so-called colleagues. These stories need to be told. It is time
to expose what bullies always want: to keep their sneaky toxicity secret.
I did not recognise my boss’s accusation as bullying. Our relationship deterio-
rated, and I was blocked from opportunities to advance my career. The thought of
making a complaint never crossed my mind. I did my best to work around my boss
and adjust to her lack of support. With the gift of hindsight, I see it for what it was,
© The Author(s), under exclusive license to Springer Nature 1
Switzerland AG 2024
B. Happell, Sickness in Health: Bullying in Nursing and other Health
Professions, https://doi.org/10.1007/978-3-031-49336-2_1
2 1 Introduction
the actions of a bully. How did I not see it at the time? I still ask myself. I was a
mental health nurse and a secondary school teacher, well-educated and informed
about mental health issues. I was strong and resilient, yet I did not see it.
Unfortunately, this bullying episode was not my last, far from it. I have seen and
experienced the worst bullying by health professionals who should be motivated to
provide the best possible health care to the community. They should be compassion-
ate and caring, yet they are capable of such cruel and destructive behaviour.
I decided to write this book when I realised I was a victim of workplace bullying.
I can’t recall when I first heard the term. Bullying was what happened in school-
yards. Bullies would threaten or hit other kids, steal their lunch money, or humiliate
them. Bullying was obvious. Everyone knew who the bullies were. They were the
kids who seemed to relish making peoples’ lives miserable. I was aware of bad
behaviour in the workplace. I had seen and experienced it, yet I didn’t think of it as
bullying.
It was about a year before I retired. I was overwhelmed by the toxicity surround-
ing me. I felt trapped, and nothing I did seemed to work. I’d had a glass of wine or
two and wondered why this was happening to me. So, I googled “am I being bul-
lied?” I found a questionnaire from a psychology organisation. I’m not sure how
reputable it was, but I decided to give it a go. Many questions were about being
yelled at and subjected to rumours and threats. That hadn’t been my experience. So,
I was surprised to see the “results” that I was being overtly and consistently bullied.
Then, it hit me! Wow, I have been bullied, and this has been happening for years.
Strangely, there was relief that there was a name for what I had experienced. Even
now, I can’t believe it took that long to realise that what was happening to me was
not just a few unfortunate and unrelated events. I now knew that I didn’t cause it and
it was not my fault. I have since discovered that not recognising the more subtle
forms of bullying is not unique to me. The image of the schoolyard bully remains
influential.
I spent considerable time reflecting on what I had previously considered unpleas-
ant working environments. I realised that being excluded, ignored, micromanaged,
belittled, undermined, and constantly facing changing goalposts and unreasonable
work demands were all examples of workplace bullying. Indeed, these more subtle
forms were more powerful because they were not easy to recognise and address.
Sadly, in my profession of mental health nursing, bullying is rife. I reflected on the
many occasions I was not given the information I needed to do my job. Resources
promised to me were taken, often without discussion or explanation. The lack of
support, not being told things I needed to know, and being excluded, time and time
again. There was little doubt I had been bullied.
It came to the point that enough was enough, and I decided to retire. It was not
the time or the way I wanted my career to end, but the long-term mental health
impacts of persistent bullying caught up with me. I clearly remember my last offi-
cial workday. I felt both enormous relief and a huge letdown. Finally, I was free. I
would wake up the following Monday knowing I didn’t have to ever subject myself
to that all-consuming toxic environment again. It was time to reclaim myself and
begin the process of healing. Yet, there was such sadness. The thought that I could
1 Introduction 3
have achieved so much more was never far from my mind in the following weeks.
Sure, some of that is being a chronic overachiever and meeting my self-imposed
goals, meaning I should set higher ones. But it was more than that. I felt an over-
whelming sadness that bullying and toxicity had set up so many barriers. I spent so
much time working around roadblocks, time I could have spent doing a better job
and achieving more. I was frustrated by so many “colleagues”. The very people who
should be working with me so often worked against me. I was bewildered and shat-
tered by the pervasive and unnecessary competitiveness I encountered and how
often personality issues destroyed professional relationships. I didn’t need people to
like me. I just wanted to work with people using our mutual strengths to serve the
organisation and the profession more broadly. I worked with many people who, had
I discovered a miraculous cure for mental distress, would have dismissed it as unim-
portant, tried to discredit me, or at the very least refused to acknowledge the achieve-
ment. Whatever faults and failings I might have had, I was passionate about mental
health nursing. I worked extremely hard, and I was successful. I have never been a
back slapper or one of the girls, and I had no intention or desire to do so. All those
traits no doubt went against me. I learned it’s not what you do; it’s who likes you.
Retirement gave me time to consider how bullying and toxicity were a part of my
life for almost 30 years. Unfortunately, in all four of my full-time academic appoint-
ments, I experienced it at some point. I do not regret my career. It was wonderful. I
had the opportunity to work with and for some brilliant and supportive people. They
showed me what collegiality and leadership meant. That fairness and respect could
prevail even in the cesspool many universities had become. They gave me hope.
I learned a lot about managers. Regrettably, I found many to be competitive,
deceptive, and duplicitous. Some managers were the reason I left jobs. But, by
reflecting through the lens of bullying, I realised I was not just unlucky. Some man-
agers were threatened by successful team members, even though nurturing them
would enhance their team’s success. They could bask in that glory, knowing they
had contributed to the environment that made it possible.
While my bullying experiences were hurtful, draining, and distracting, they also
held a degree of fascination for me. I often found myself thinking—why are you
doing this? What need in you does this behaviour meet? I was bemused and even
flabbergasted that health professionals could be devoid of human caring and effec-
tive communication with colleagues. The skills that should have been the very core
of their clinical practice were missing in action. What did they think when they cre-
ated or maintained a toxic environment or bullied their colleagues? Did they ever
reflect on their behaviour and question whether they had gone too far, even a little?
Did they wonder if they had used their voice instead of their power, could the result
have meant less distress and better outcomes for all? Did they ever consider how
their actions affected the broader health service, profession, or university? Did the
health and well-being of the people they bullied ever enter their minds? Did they
believe their actions were justified or even the target’s fault? Were they just sad,
unfulfilled people who projected their unhappiness on others, particularly those
more successful than themselves? Did they feel so threatened in their jobs that they
needed to protect themselves? Ultimately, I wonder if these people considered
4 1 Introduction
themselves to be bullies. Did they realise the environment they created or perpetu-
ated was toxic? Or was it just part of a pervasive culture that has surrounded them
in health, particularly in senior positions they have held? Have they become blind?
Amidst these episodes of bullying and toxicity, I continued, and my career was
successful. I always included colleagues in my activities, sometimes well above
what their contribution warranted. I believe I was an excellent mentor to students
and colleagues. Interestingly, many of the colleagues I did the most for were those
who later bullied me. I learnt to harden my shell, which was easier knowing that
these churlish and inaccurate assertions said much more about the people making
them than they did about me. What did hurt was managers who, for whatever rea-
son, did not like me from the outset or turned from supporter to antagonist with no
apparent reason and no discussion. I honestly thought that health professionals
would have the skills and the desire to work things out. Maybe I was incredibly
naïve to believe they would be motivated by the greater good.
For the most part, I have loved my jobs. I loved the work, the variety, and the
autonomy. The decision to leave was always hard and meant saying goodbye to
much that was satisfying. —The saying—“people don’t leave jobs, they leave man-
agers”—could not have been truer for me. I could not endure being stifled, particu-
larly when this stood in the way of doing good work. I had to get out.
To help me understand my situation, I did more reading and thinking about
workplace bullying. I knew it wasn’t just me. I saw what had happened to col-
leagues and actively advocated for some. Realising the unrelenting effects of bully-
ing and toxicity left me feeling I needed to do something. A story needed to be told.
It would have been easy to review the literature and come up with figures about the
rates of bullying within the health professions. I could have found media coverage
that described the toxic working conditions many health professionals endure. As a
researcher of 30 years, it might have been the obvious way to go. I didn’t consider
it for long. Existing research describes the extent of bullying and, to some degree,
its consequences. The research tells us clearly that bullying is rife in health care.
Toxic workplaces are common, and bullying is now firmly part of the culture in
many organisations. I didn’t want to do more of the same. I didn’t want to write
papers that followed the formulaic structure with the necessary dissection of peo-
ple’s experiences into neat themes and sub-themes. I am not criticising the process,
which was essential to my work for many years. I wanted this book to be different.
I wanted to talk to people with bullying experiences, to be a conduit for them to
tell their stories. I wanted to present the human side. To show what it feels like when
constant bullying prevents you from doing the job you want to do, caring for people,
looking after students, and contributing to quality health services. I aspired to give
voice to their stories of how the traumatic effects of bullying didn’t end when they
went home. I wanted to show the pervasive impact of bullying and toxicity on their
lives, the lives of the very people with responsibility for the health and well-being
of others. I wanted to tell these stories because they need to be told.
I can almost picture the looks on the faces of some people who have positioned
themselves as my adversaries at the thought of me writing a book about bullying. I
was accused of being a bully, twice to my face. Both times I was asking people to
1 Introduction 5
be accountable. Interestingly, one was a person I consider one of the nastiest bullies
I have ever encountered. The other was experiencing major life upheavals. If I had
made a formal complaint, I could have easily refuted her accusations with extensive
documentary evidence. I did not. I did not feel that would have been useful to either
of us at the time.
So how am I so sure I’m not a bully? I expect many bullies would be shocked to
be seen in that light. I wanted to be sure I was not one of those people and was not
projecting toxic behaviour onto others. Reassuring myself meant going beyond
understanding what bullying is to understand what it is not. Reasonable manage-
ment action is not workplace bullying. While there is a fine line between reasonable
and unreasonable, managers have a right to expect the people they supervise to do
the job they are employed to do. They also have the right to take appropriate action
where this does not occur. So long as the action is supportive and respectful, this is
not bullying. What is essential to understand is that having different opinions, ask-
ing questions, and being assertive are not bullying behaviours. I am assertive, speak
my mind, and communicate my views with confidence and vigour. I am polite and
respect the opinions of others. People tell me I am persuasive. I consider that a com-
pliment, whether intended or otherwise. I expect and welcome the same character-
istics in others. I value honesty and am very comfortable with people disagreeing,
countering my arguments, and presenting new evidence. I prefer someone tell me
they dislike or find me difficult than smile to my face, hatchet me behind my back,
ignore me, or treat me disrespectfully. Sure, I can be wrong, and others can outrank
me. That’s life, and I accept it. I don’t accept being bullied or accused of bullying
because of it. I could counter any accusation of bullying. The bullying I experienced
could not be explained this way. I would welcome the opportunity to talk openly
and honestly with those who have bullied me. I won’t hold my breath.
I hope this book will emphasise the human experience of bullying and toxicity
and give a voice to the people behind the statistics. Will it make a difference to the
bullies? Probably not. What I do hope is that it gets people thinking and talking. I
hope that targets of these toxic behaviours who, like me, have considered them-
selves unlucky or even responsible realise they are being bullied. I hope they see
that what is happening to them is not okay and that they have a right to feel physi-
cally and emotionally safe at work.
Not all health professionals are bullies, and not all health environments are toxic.
Those who work within unhealthy environments often desire change. I hope these
people are sufficiently motivated to take action to create a more positive and con-
structive environment. At the very least, I want to contribute to the conversations
about workplace bullying, to the understanding that people have a right to be treated
respectfully at work. Enough is enough. The time to change toxic cultures is now.
6 1 Introduction
1.1 The Champions
With great pleasure and a sense of privilege, I introduce you to the 12 people who
generously shared their workplace bullying experiences with me. I call them cham-
pions. Champions are people who strongly support or defend a cause. Sharing their
experiences of bullying and toxicity in health care and its impact on their lives
makes them champions in my mind.
Finding people willing to tell their stories was more difficult than anticipated. I
searched Facebook for pages and groups dealing with workplace bullying and
harassment and joined several. I set up a Facebook page and group: bullying and
toxicity in the health professions, and a Twitter account, @bullyhealth, as none of
the existing social media accounts explicitly related to health professions. I later set
up a LinkedIn page. I posted on my own and other Facebook pages and groups, ask-
ing people to contact me if they were willing to share their stories. The response was
slow. Some people contacted me through social media, and one became the first
champion. I chatted with others on social media for a while, and ultimately, they
decided not to be involved. One person didn’t feel well enough. Another wanted to
tell her story but was worried colleagues would recognise her. Others said they
would contact me when they were ready and did not make further contact.
I may have given up if not for Rory. Perhaps people were not interested. Maybe
they were too distressed to share painful experiences or were concerned their story
would be recognised and management would punish them. They may not have
trusted me—all perfectly understandable. Rory was so generous with her time; she
sent me a comprehensive written summary of her situation and additional documen-
tation. Her story was poignant and strongly impacted her work and personal life.
She motivated me to continue this work.
Slowly people began to join my Facebook group, retweet my tweets, and com-
ment on my postings on other pages. I started sending private messages to people
who commented, telling them more about what I was doing and asking if they
would like to talk to me. Gradually people said yes. Some champions passed my
details on to colleagues, and over the following months, I had taped conversations
with 12 champions. I had at least two and up to four follow-up conversations with
each, some lasting for hours. Some champions sent notes and other documents.
They were amazingly generous and trusting, and I thank them sincerely. It was an
honour to be entrusted with their stories.
The champions related their stories in vivid detail, many heartbreaking to hear. I
found myself feeling guilty that I dared consider myself badly treated. I shouldn’t
complain. I had to remind myself that this was not a competition. Everyone has a
right to go to work, be treated with respect, feel safe, and have every opportunity to
do a good job. I, too, had been bullied, and no amount of bullying is acceptable.
Now to the champions themselves. When telling stories, it is customary to intro-
duce people using a pseudonym and describe their discipline background, career
summary, length of experience, and more personal details such as gender and age.
Revealing these details would be risky. Some champions still work in or have strong
connections with the health industry. Some are still employed by the toxic
1.1 The Champions 7
organisation, while others have ongoing complaint processes. Confidentiality is
essential for them. With their permission, I am using pseudonyms. I have chosen
unisex names, and gender is not specified unless by the champion. I use the pro-
nouns she/her for all champions other than Terry, who identifies as male in his story.
At Taylor’s request, I am using the non-gendered language them/they/their for the
people she describes in her story. Despite best efforts, someone reading this book
may recognise a story and think wow, that is Chris. They may be right. They might
also be thinking of someone who has unfortunately had experiences similar to
Chris’s. Despite the uniqueness of everyone’s experience, sadly, there are many
common ways bullying impacts people. Every champion had something in their
story that I’d observed or experienced at some point. Many health professionals will
feel the same. The champions have reviewed the book and are comfortable with the
final version.
The champions were all living in Australia at the time of our conversations. They
had been bullied at least once in this country. They were located across Australia;
some had worked in more than one state or territory. The champions worked in dif-
ferent roles, including clinical practice, management, and academia. Most had 20 or
more years of experience with career lengths from around five years to 40. I will
briefly introduce each champion and their discipline background and bullying
experiences.
Alex worked as an emergency medical dispatcher with ambulance services. She
was assaulted by a colleague soon after commencing her training. After reporting
the assault, a tirade of persistent and intrusive bullying was unleashed from all lev-
els of the organisation. Alex was on WorkCover for several years until her legal
action against the organisation was finally settled.
Andy is a registered nurse. Her story includes two significant incidents of persis-
tent bullying by managers. The first time Andy’s honesty and openness appeared to
be the trigger. The second came from a misunderstanding that seemed to have
labelled Andy a troublemaker and a fair target.
Chris is a mental health nurse. She was a new graduate the first time a registered
nurse bullied her. She worked in a clinical role for the second time, and her positive
relationship with her manager changed dramatically. Unfortunately, the bullying
continued until she resigned. Chris was bullied for the third time by another boss.
She was one of many singled out as a target in what had become a very toxic
environment.
Jesse completed a degree in psychology before moving into public health. Her
manager bullied her for the first time after they applied for the same position, and he
was successful. After moving into the university sector, Jesse was bullied by her
boss in two successive university appointments. She is now semi-retired.
Jordan is a registered nurse who spent most of her career in academic roles.
Successive bosses, colleagues, and staff bullied her. Her roles often extended across
departments and organisations, with several reporting lines and reliance on external
funding, which made her situation more complicated. Therefore, Jordan found it
hard to know where to start dealing with bullying. She was also actively engaged in
8 1 Introduction
her broader professional communities, where bullying extended further. She is now
retired.
Lee has a background in psychology. She spent most of her career in mental
health research, where she experienced bullying and witnessed it happening to col-
leagues. She moved into an education and training role with a boss who bullied
staff, and Lee was a primary target.
Pat is a social worker. She had experienced bullying frequently. However, our
conversations focused mainly on one example. She had worked at the organisation
for many years. After returning from extended leave following surgery and a life-
threatening illness, her new manager seemed to dislike her instantly, and the bully-
ing began. Pat subsequently left and is working as a social worker in another role.
She is enjoying the new position and not experiencing bullying.
Rory is a medical doctor. At the time of her bullying, she was in training to spe-
cialise in a specific field of medicine. Unfortunately, a personality clash with an
influential staff member progressed to bullying at multiple levels. Once Rory made
a formal complaint, the situation worsened, and she was forced out. She now works
at another hospital and is finding the environment very positive. Rory’s circum-
stances were particularly complicated because of multiple reporting lines relating to
rotations in specific clinical areas, her education program, mentorship, and line
management.
Sam is a mental health nurse. She has worked successfully in the same organisa-
tion for many years in clinical, professional development, and management roles.
Sam has a mutually respectful relationship with her direct manager. She reports
professionally to the senior nurse who has bullied her for some time.
Shannon is a mental health nurse. She was first bullied when her manager over-
heard a comment she made to a colleague. When management took formal action,
Shannon found the environment so challenging that she took extended leave and
ultimately resigned. The second time she was bullied by peers over an extended
period. She recently resigned and now works in a new and very positive environment.
Taylor’s background is as a peer worker. In these roles, she uses her lived experi-
ence of mental distress to support people accessing services for their mental health
needs. Taylor has experienced intense and sustained bullying throughout her career,
both in the workplace and through her broader professional activities. She is now in
a senior executive position in a designated lived experience role. Taylor’s lived
experience is valued and facilitates positive change. Despite her bullying experi-
ences, she has continued to be successful in her career.
Terry is a mental health nurse. Most of his career has been in academic roles in
his home country. Terry first experienced bullying as a nursing student. He moved
to Australia a few years ago to take up a research position between a university,
health service, and a not-for-profit organisation. The bullying was particularly chal-
lenging because of multiple reporting lines and complex systems. Terry now works
for another Australian university and has found the environment more positive.
After the first couple of drafts of this book, I chose to tell my own story. I related
to many of the champions’ experiences, and it seemed wrong to hide behind them.
I became braver because of them and overcame my reluctance to speak of what