Bullying and abuse in the NHS: new support to help staff speak up

Newly qualified nurses and students among those most at risk from colleagues’ or managers’ negative behaviour – but guidance aims to empower them to call it out
Nurse leans on wall looking dejected – as guidance aims to help NHS staff address workplace bullying

Newly qualified nurses and students among those most at risk from colleagues’ or managers’ negative behaviour – but guidance aims to empower them to call it out

Picture: iStock

Newly qualified nurses being told ‘pull your head in’, or students who are merely referred to as ‘the student’ by NHS colleagues or managers have new guidance to support them to speak up about unprofessional behaviour.

The guidance was developed by an international team led by professor of health services research and nursing at the University of Surrey Jill Maben, who told Nursing Standard: ‘When someone goes to work we want them to feel safe and be able to speak up and not encounter unprofessional behaviours, but sadly that doesn’t seem to be the case.

‘I’ve heard of student nurses being referred to simply as ‘the student’ and not by name, or newly qualified staff being told to wind their neck in and not to speak up. This can be really off-putting for new staff who come in with a lot of enthusiasm and motivation.

‘People leave because of these behaviours so this is definitely a retention issue, which is why we need to show it is not tolerated – and that has got to come from the top.’

NHS survey results point to widespread bullying and abuse by colleagues

The guidance, based on an extensive review of research, states certain groups including women, staff from black or minority ethnic backgrounds, those with disabilities, staff who are LGBTQIA+ and staff who new in their careers are at a disproportionately high risk of experiencing unprofessional behaviour at work.

The 2022 NHS Staff Survey results show 22.4% of nurses and midwives reported having experienced harassment, bullying or abuse from colleagues in the previous year. As many as 12.5% said they had experienced harassment, bullying or abuse from managers.

The guidance stresses that tackling poor behaviour is not simply a question of dealing with a few ‘bad apples’ but is about system-wide change.

Negative behaviour more common in high pressure, low-resource workplaces

Factors that can increase the risk of unprofessionalism among healthcare staff include pressure at work and lack of resources, lack of manager awareness, and structures that make it harder for staff to raise concerns.

The guidance suggests a range of employer interventions, including ‘quick wins’ such as providing training and ways to address poor behaviour as and when it happens.

‘We’re asking nurses who see others being bullied to be active bystanders’

Staff should be encouraged to speak out or intervene when they witness unprofessional behaviour, the document states, although Professor Maben admitted this was sometimes easier said than done.

‘We all need to be aware of our own behaviours and how we come across, particularly when we’re in positions of authority,’ she said.

‘We’re also asking nurses and others to try to be active bystanders, so if they see bullying and harassment, incivility or microagressions to call them out, maybe have a quiet word… when it feels safe to do so.’

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