That’s Just Mean To help battle incivility and bullying in the workplace, some employers are calling on employees to target problem behavior. Features
Free
Features  |   December 01, 2017
That’s Just Mean
Author Notes
  • Bridget Murray Law is editor-in-chief of The ASHA Leader. bmurraylaw@asha.org
    Bridget Murray Law is editor-in-chief of The ASHA Leader. bmurraylaw@asha.org×
Article Information
Professional Issues & Training / Features
Features   |   December 01, 2017
That’s Just Mean
The ASHA Leader, December 2017, Vol. 22, 46-53. doi:10.1044/leader.FTR1.22122017.46
The ASHA Leader, December 2017, Vol. 22, 46-53. doi:10.1044/leader.FTR1.22122017.46
For months, she had put up with her co-workers’ eye-rolling when she spoke. Their snide—and loud—comments about her occasional mistakes on documentation. Their nasty jokes about her abilities.
But finally Sue*, a speech-language pathologist, had had enough. So she called the employee hotline at the urban academic medical center where she works and lodged a complaint that these three junior co-workers were bullying her.
The hotline’s very existence points to the frequency of bullying: Close to a third of the U.S. workforce experiences it, according to the Workplace Bullying Institute (WBI). And bullying and uncivil behavior among employees can hurt workplace functioning: Victims report high levels of mental disorders like depression and physical disorders like high blood pressure, according to WBI.
Bullying and intimidation also threaten employee retention and attendance, indicates the health care research literature (see sources). So, to help battle such incivility among health care professionals, more institutions are setting up employee accountability systems. These include new employee-constructed codes of conduct, peer mentoring and anti-bullying training.
“Kids today have all come up with anti-bullying training in the schools, but 20-somethings on up didn’t get this training,” says Sue’s manager, an SLP. “So they need it at work.”
Attention to bullying can be traced to several forces, perhaps most obviously the online nastiness that’s arisen with the internet, and most recently the low blows among politicians. In the workplace, incivility is sometimes blamed on time and documentation pressures.
Meanwhile, the Institute of Medicine has spotlighted professional civility’s key role in workplace safety and patient care. But incivility isn’t isolated to health care. It occurs in every setting where audiologists and SLPs work, from private practice to the strip-mall clinic to the schools.

The key word is intent. If a co-worker has launched a campaign to belittle and intimidate you, that likely constitutes bullying.

Is it bullying?
If you’re one of those experiencing unprofessional behavior at work, how do you know if it’s relatively minor or if it’s more serious—crossing over into bullying or harassment? If it does—is that illegal? And what, if anything, can you do about it?
First, it’s helpful to define what we’re talking about. Note that not all incivility is bullying—in fact, straight-up rudeness usually isn’t bullying, says Janet McNichol, ASHA’s director of human resources. Problematic workplace behavior falls on a continuum, says McNichol (see graphic below), with incivility on the lesser end, ramping up to bullying and topping out with harassment and, the most serious of all, criminal behavior.
Here is the breakdown:
  • Rudeness/incivility: Generally involves single incidents of undesirable or hurtful social behavior such as ignoring someone, making faces at someone, rolling your eyes at someone, sneering at someone, laughing at someone’s misfortune or calling someone a derogatory name.

  • Bullying: Typically involves repeated, unreasonable and unwelcome behavior directed toward an employee or group of employees that creates a risk to health and safety.

  • Harassment: Unwanted behavior that offends, humiliates or intimidates a person, and targets them on the basis of their membership in a protected group—for example, race, religion, color, national origin, marital status, gender, sexual orientation or disability.

  • Criminal behavior: In the workplace, this type of behavior would include physical/sexual assault, hate crimes, cyber stalking, threats involving a deadly weapon and theft.

The first two categories are not illegal under federal law, but the second two are. For example, sexual harassment and race-based harassment violate Title VII of the Civil Rights Act of 1964. Some states are working to make bullying in the workplace illegal as well, and to protect employees from it, but so far none of that legislation has passed.
Meanwhile, confusion abounds about what workplace bullying actually is, says McNichol. “It’s harder to define with adults than with kids because when was the last time someone at work stole your lunch money or stepped on your sandwich?” she says. “And I can tell you what it isn’t: It’s not somebody not responding to an email you sent or not being your friend when you want them to be.”
Such distinctions are important, McNichol says, because the more company administrators hear frivolous, unfounded allegations of bullying, the less likely they are to take real allegations of bullying seriously. When it comes to bullying, the key word is intent, notes McNichol. If a co-worker has launched a campaign to belittle and intimidate you, that likely constitutes bullying.
But if the person unwittingly says insensitive things to just about everybody, they may have poor social skills, but they likely don’t intend to upset you.
“We experience the world through our own lens, not thinking so much about the experiences of others,” McNichol explains. “So you’ll often have employees thinking they’re being singled out by a person, when actually that person is behaving the same way toward everyone.”

Recognizing the slippery slope from incivility to bullying and other bad behavior, some employers are formalizing efforts to promote civility among staff.

When it’s bullying
If, however, the behavior appears targeted and sustained—toward a particular end, like making a person quit—it could be bullying. And in the case of Sue, the SLP who lodged a hotline complaint against three co-workers, it was bullying, investigators determined.
“Leadership determined that their behavior went against our code-of-conduct policy and the hospital’s values,” says Sue’s manager. “These employees were thriving on negativity instead of patient progress.”
The decision was not made quickly, she emphasizes. It took investigators two years, during which they interviewed everyone Sue named, from the three co-workers to physicians to supervisors. During that time, Sue’s manager worried about the mental health of all in the department. Now the employees found to be bullying are no longer with the department.
That situation involved co-workers ganging up on one another, but bullying can be especially tough to address when the bully is a supervisor, notes Anne*, who recently completed her clinical fellowship (CF) at a large teaching hospital. Most of Anne’s classmates at other sites have supportive supervisors, she says, but Anne’s two supervisors constantly belittled and berated her, she says.
The training supervisors did the same to other CFs at her site. “They constantly made snide comments about their skillsets,” says Anne. As a result, turnover among CFs there is unusually high. But Anne stuck it out, seeking solace from her former classmates. “There were no avenues for any sort of relief or support in my CF, so I just had to stay and endure it,” she says (see article in this issue, “Bullying and Intimidation in Clinical Supervision.”

Relationship-building in the workplace cultivates civility, which, in turn, helps ward off negative behavior.

What can you do?
For the full-time working audiologist or SLP, however, there are always avenues to pursue for relief from bullying, says Tracy Morlan. As the lead SLP for the Amador County Office of Education in California, she and several other special education colleagues found themselves victimized by a bully.
This person—a top special education administrator—regularly yelled at teachers, principals and counselors and cut them off in meetings, while schmoozing with parents and upper administrators, says Morlan. He wanted to make all decisions about students’ IEPs and academic placement, with little to no input from other staff. “He intimidated us to keep us quiet,” Morlan says. “We said nothing in IEP meetings.”
Morlan was splitting her time between four schools, so she had little time to build bonds with others and felt especially defenseless. “We school-based SLPs often work in isolation, plus we have large caseloads, which can make us overwhelmed and contribute to a sense of vulnerability,” Morlan says. “A bully looks for victims like this that they can easily single out.”
But one day, when Morlan’s bully lashed out at her, she decided it was time to act. She took two steps she says are key to dealing with bullies:
  • Start documenting, as soon as you sense a problem. Write down each encounter with dates, details and your emotional reaction to what happened, Morlan advises. Did you feel put down or intimidated? Did the bully use an inappropriate tone of voice? “It can be difficult to write down what happened if you are upset, so wait a day or so before documenting,” she says, “but don’t forget to do it. Your notes may become important later.” She notes that it also can be therapeutic to write out your experiences.

  • Tell your administrators, ASAP. This may seem like a no-brainer, but victims often lack the confidence to do this, notes Morlan. A word of advice about this: If you can, at least try to address your concern in some way with the alleged bully before going to your supervisor, says ASHA’s McNichol. Your supervisor will likely ask if you’ve tried and be more willing to help you if that hasn’t worked, she notes. If, however, you fear violence or other threatening behavior from the bully, be sure to have a colleague with you, says Morlan. If you belong to a union, call your union representative. If you’ve tried talking to both the bully and your supervisor and neither has worked, go to your human resources department or other administrators next in line.

Simple social acts like eating together can strengthen team bonds.

Best prevention? Civility
Also key to handling bullying, says Morlan, is fostering relationships with your colleagues. Morlan reached out to special education teachers and principals at her assigned schools and found they were having the same bullying problem she was.
“Yes, this consumes time and energy but it’s well worth it,” says Morlan. “Even if you have just one ally at a school, that person can become your sounding board.”
Building relationships with other staff also brings other benefits—it pulls you closer together, so you provide more cohesive team services to clients, Morlan says. (That was the positive that resulted from her bullying experience—and she notes that the bullying administrator was ultimately terminated because of illegal activity unrelated to the job.)
Relationship-building in the workplace is a good practice in general, notes McNichol, because it cultivates civility, which, in turn, helps ward off negative behavior. Simple social acts like eating together can strengthen team bonds, she says.
Recognizing the slippery slope from incivility to bullying and other bad behavior, some employers are formalizing efforts to promote civility among staff. Some, for example, are:
Instituting new office policies. Even though your workplace policy may call for civil behavior, it can be tricky to define what that looks like in practice. Behavior one person finds acceptable might not be acceptable to someone else. With this in mind, the hospital where Sue works has mandated civility training for staff—and the hotline she called is also being used to tackle incivility.

Recognizing the slippery slope from incivility to bullying and other bad behavior, some employers are formalizing efforts to promote civility among staff.

Another hospital, Vanderbilt University Medical Center, has taken matters a step further with its “pyramid” for promoting professionalism. The system puts the responsibility of combating incivility in the hands of staff. If one staff person encounters what they consider unprofessional behavior by another (toward a patient or colleague), they draw that person aside for a “cup of coffee” conversation—a private, brief, nonjudgmental recounting of the incident. Trained peers also help with the coffee-cup messaging, as needed, says audiologist Tamala Bradham, who is quality and safety advisor and clinical educator at Vanderbilt.
If the person continues with unprofessional behaviors and a pattern emerges, staff can escalate their observations to higher levels of the pyramid: non-punitive awareness with data, guided intervention by authority and disciplinary action.
What type of behavior might spur such a peer “cup of coffee” conversation? An observer hearing one professional telling another, “You don’t know what you’re talking about,” says Bradham. Having a colleague privately share their observation allows the person to reflect on what happened and work on improving their behavior without involving management, she says.
Setting team norms. In this approach, also employee-driven, team members jointly develop a set of “team norms”: guidelines for how they want to interact as a team over time. ASHA’s McNichol recommends that employees with incivility concerns suggest creating such norms. “Team norms can be a powerful tool for imagining and creating a different work atmosphere,” says McNichol, noting that ASHA’s various departments have all developed norms for healthier team functioning.
The norms can address a variety of team functions, from how to conduct meetings to how to celebrate birthdays. It can also include “don’ts,” such as don’t talk about team members who aren’t present or don’t publicly denigrate team members for mistakes. But, to work effectively, the norms need to reflect most team members’ wishes, and they cannot be mandated by managers.
What you want to see in a department is all team members treating one another with professionalism, “not swinging back into that incivility,” says Sue’s manager. And that’s exactly what she’s seen in her department since the departure of the employees who bullied Sue.
“Now the staff can converse without fear,” Sue’s manager says. “I actually hear laughter coming from the SLP section, which I never heard before.”
*Names have been changed to protect people’s identities.
Hickson, G. B., Pichert, J. W., Webb, L. E., & Gabbe, S. G. A. (2007). Complementary approach to promoting professionalism: Identifying, measuring, and addressing unprofessional behaviors, Academic Medicine, 82(11), 1040–1048. [Article] [PubMed]
Hickson, G. B., Pichert, J. W., Webb, L. E., & Gabbe, S. G. A. (2007). Complementary approach to promoting professionalism: Identifying, measuring, and addressing unprofessional behaviors, Academic Medicine, 82(11), 1040–1048. [Article] [PubMed]×
Houshmand, M., O’Reilly, J., Robinson, S., & Wolff, A. (2012). Escaping bullying: The simultaneous impact of individual and unit-level bullying on turnover intentions. Human Relations, 65(7).
Houshmand, M., O’Reilly, J., Robinson, S., & Wolff, A. (2012). Escaping bullying: The simultaneous impact of individual and unit-level bullying on turnover intentions. Human Relations, 65(7).×
Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety. (2004). Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington, DC: National Academies Press (US). Available from: www.ncbi.nlm.nih.gov/books/NBK216190. doi: 10.17226/10851
Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety. (2004). Keeping Patients Safe: Transforming the Work Environment of Nurses. Washington, DC: National Academies Press (US). Available from: www.ncbi.nlm.nih.gov/books/NBK216190. doi: 10.17226/10851×
Riordan, C. M., & O’Brien, K. (April 17, 2012). For great teamwork, start with a social contract. Harvard Business Review. Available from: https://hbr.org/2012/04/to-ensure-great-teamwork-start
Riordan, C. M., & O’Brien, K. (April 17, 2012). For great teamwork, start with a social contract. Harvard Business Review. Available from: https://hbr.org/2012/04/to-ensure-great-teamwork-start×
Wenngren A. (December 2015). Team building in the cafeteria. Harvard Business Review. Available from: https://hbr.org/2015/12/team-building-in-the-cafeteria
Wenngren A. (December 2015). Team building in the cafeteria. Harvard Business Review. Available from: https://hbr.org/2015/12/team-building-in-the-cafeteria×
Worline, M. C., Dutton, J. E., & Hardin, A. E. (October 6, 2017). Forming stronger bonds with people at work. Harvard Business Review. Available from https://hbr.org/2017/10/forming-stronger-bonds-with-people-at-work
Worline, M. C., Dutton, J. E., & Hardin, A. E. (October 6, 2017). Forming stronger bonds with people at work. Harvard Business Review. Available from https://hbr.org/2017/10/forming-stronger-bonds-with-people-at-work×
2 Comments
December 5, 2017
Mary Bacon
More than one side to every story
We should not be bullying our co-workers, that is clear. However, it may be worthwhile to remember that there are usually at least three "sides" to every story. In the scenario described, we are only hearing "Sue's" side, supported by her manager. Perhaps these two are good friends; perhaps the manager is not helpful to the "junior" clinicians; perhaps the work environment is hostile to all, including the "junior" clinicians. Perhaps everyone is bullied, but only one person thought to call the hotline. My husband was a school principal, and if I learned one thing from him it was that things are not usually as they may seem.
December 6, 2017
Shannon Planck
Truth
This happens all the time. I had to leave a position due to the supervisor. Everyone else up the chain thought she was wonderful and that I must be the problem, but I notice that turnover has continued to be high.
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
December 2017
Volume 22, Issue 12