NEW ZEALAND rated worst in world for Workplace Bullying

New Zealand has some of the highest rates of workplace bullying in the world

• One in five employees being subjected to overbearing or belittling behaviour at work, new research shows.
• A survey of 1728 workers in the health, education, travel and hospitality sectors found 18% had been bullied, while 75% had suffered workplace stress.

The figures are revealed in a university survey released today.

A joint university research team – from Auckland, Waikato, Massey with London's Birbeck University – polled more than 1700 workers from the health, education, hospitality and travel sectors asking how frequently they were exposed to "negative acts" at work.

Overall 17.8 per cent of respondents were identified as victims of bullying.

The international range was between 5 per cent and 20 per cent.

Higher rates of bullying were found in the education and health sectors and also in kitchen "hot spots" within the hospitality industry.

Bullying included bosses picking on workers, workers harassing colleagues and workers intimidating bosses.

Lead researcher Professor Tim Bentley said the cost of bullying had been estimated in Britain at $NZ2165 per person each year and almost $NZ5.23 billion per year in Australia.

Bullying hit costs because of decreases in productivity due to worker absenteeism, staff turnover, lower staff satisfaction and time spent investigating bullying.

He said workplace bullying in New Zealand could be "a billion-dollar problem".

"Who knows how much this is actually costing organisations? It must be a terrific amount ... Minimum it's a multimillion-dollar problem, it could easily be a billion-dollar problem in New Zealand. That's not taking into account all the indirect costs."

He wants changes to health and safety laws to combat workplace bullying alongside harassment and discrimination.

The report was commissioned by the Labour Department.Minister of Labour Kate Wilkinson said it was "an interesting piece of research" but employment courts were able to deal with bullying through personal grievance claims.

"Producing some sort of definition in legislation would be complex and more than likely ineffective," she said.

David Lowe, of the Employers and Manufacturers Association, was sceptical of the survey, saying the "negative acts" research question was too wide.

"What people would normally describe as bullying and `two negative acts in the workplace' are not one and the same," Lowe said.

"If somebody had said to the person, `you're not doing well enough, you need to do it better', and told them that twice in one week, that might amount to bullying under this survey, but it is not bullying, it is simply running your business."

The survey also posed a more direct "self-report" question asking whether respondents felt they were being bullied either "several times a week" or "almost daily" which yielded a smaller figure of 3.9 per cent.

Wilkinson said it was naive to believe bullying did not occur "quite regularly" in workplaces.

Lowe agreed if bullying existed it needed to be addressed.

The Labour Department said it would use the findings to produce fact sheets and other "guidance material" to help employers and staff deal with bullying.

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Workplaces Against Violence in Employment director Hadyn Olsen, said workplace bullying was a huge stress factor for many people - the majority of whom chose not to make a complaint or bring up the issue, out of fear of being bullied further.

Mr Olsen said studies by his organisation showed up to 53 per cent of people who do report being bullied got bullied even more.

"And so the stress factor is huge because they don't know when the next situation will be and they don't feel safe," he said.

Mr Olsen said he had dealt with many types of bullying, which include intimidation, behaviour that offends, makes fun, undermines or excludes.

The more severe cases of workplace bullying include sexual harassment.

In one case, a victim decided to make a formal complaint.

A meeting was arranged where the victim and the bully met senior staff, who then went on to reveal in front of the two that a complaint had been made by the victim, against the bully.

When the bully denied the accusation, the victim was not believed by management staff.

The victim suffered more bullying as a consequence.

The research study, funded by the Department of Labour and Health Research Council, also found that employers across all those sectors surveyed did not understand, or know how to address the problem of workplace bullying.

Professor Bentley said there needed to be a cultural change within New Zealand workplaces, with a zero-tolerance policy on bullying.

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NEW ZEALAND BULLIES - One in 10 are victims of workplace bullies

One in 10 workers has been bullied by a colleague in the past six months, according to the first comprehensive research into workplace bullying in New Zealand.

The research, a two-year project being undertaken by academics at three universities, has surveyed 20 organisations in the hospitality, health and education sectors. About 1600 employees completed a questionnaire on the issue and preliminary results show a significant number say they have been victims of workplace bullying, with many still suffering.

If the figures were extrapolated to the full working population, it would mean as many as 200,000 people were being bullied at work.

One of the researchers, Professor Michael O'Driscoll, an organisational psychologist at Waikato University, says the questionnaire asked people to identify whether they had been intimidated or abused at work, whether their efforts had ever been sabotaged, and what, if anything, they had done about it.

Bullying is defined by the researchers as a situation in which a person feels they have been repeatedly on the receiving end of negative actions from another worker, in an environment where it is difficult to defend themselves. In other words, it must be ongoing and between people with different levels of power within an organisation.

Preliminary findings have confirmed restaurant kitchens are hotbeds of workplace bullying something referred to as the "Gordon Ramsay effect" after the British chef known for his fiery temper.

Hospital staff have reported bullying from patients' relatives, and teachers recorded instances of being bullied by pupils.

In the past year the Employment Relations Authority has investigated several cases of workplace bullying, including a university employee who claimed "insidious bullying" by her superior, and a man sacked for abusive and aggressive behaviour towards an employee that included driving a forklift in a manner that threatened his safety.

Claims of bullying and intimidation were also made against members of parliament last year as part of an in-house staff survey by Parliamentary Services.

O'Driscoll says of the 10% who reported being bullied, half were still being bullied, and the rest had moved to another role, left the organisation or taken other action.

NZ RESEARCH

The research, funded by the Health Research Council and the Department of Labour, aims to show how workplace bullying affects a worker's health, wellbeing and job performance, as well as finding out what is being done at an organisational level to counteract the problem.

Although final results will not be available until the end of the year, O'Driscoll says preliminary findings show bullying occurs not only from the top down but also in reverse. A staff member can bully a manager or supervisor, perhaps because they have a unique set of skills and are therefore in a position to exert influence or power over others."There are definite negative effects for individuals and for organisations," O"Driscoll says. "People being bullied are experiencing high levels of work-based stress which you would then expect to flow on into physical symptoms."

But he warns that people who try to confront their bully won't necessarily help the situation. "It can inflame the bully, who thinks it is right to engage in more of the same behaviour.

"Bullying can be very self-reinforcing. People can feel very powerful, they have a lot of influence and control and it makes them feel good. The most important thing is that workers know there are consequences if they display that behaviour there will be negative repercussions. It's what an organisation does about it that makes a difference."

O'Driscoll says if there was a more organisational response it wouldn't happen as much. "Many organisations don't quite know how to deal with the problem. Most have a harassment policy and a stress policy but they don't often capture issues of bullying, and that's a problem."

O'Driscoll says it is incumbent on management to be proactive and develop a work culture that promotes collaboration, respect and an environment that treats people with dignity. "If you have an environment where aggression is acceptable, it doesn't help when the issue is raised."

O'Driscoll says while stress is an accepted part of the workplace, with bullying the evidence shows that people's stress levels are "beyond optimal" and that affects their performance and health.

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STUDY - Workplace bullying of junior doctors: a cross-sectional questionnaire survey

Journal of the New Zealand Medicsss

Journal of the New Zealand Medical Association, 19-September-2008, Vol 121 No 1282

Abstract Aim Workplace bullying is a growing concern amongst health professionals. Our aim was to explore the frequency, nature, and extent of workplace bullying in an Auckland Hospital (Auckland, New Zealand). Method A cross-sectional questionnaire survey of house officers and registrars at a tertiary hospital was conducted. Results There was an overall response rate of 33% (123/373). 50% of responders reported experiencing at least one episode of bullying behaviour. The largest source of workplace bullying was consultants and nurses in equal frequency. The most common bullying behaviour was unjustified criticism. Only 18% of respondents had made a formal complaint. Conclusion Workplace bullying is a significant issue with junior doctors. We recommend education about unacceptable behaviours and the development of improved complaint processes.

Workplace bullying has been recognised as a major occupational stressor since the early 1980s. However, bullying has become more recognised in the medical profession in recent years.1–3 Workplace bullying can have detrimental effects such as decreased job satisfaction, depression, anxiety, and absenteeism4 which impacts on staff retention and quality of patient care.

Workplace bullying has been recognised as a major occupational stressor since the early 1980s. However, bullying has become more recognised in the medical profession in recent years.1–3 Workplace bullying can have detrimental effects such as decreased job satisfaction, depression, anxiety, and absenteeism4 which impacts on staff retention and quality of patient care.

The recognition and management of bullying in the workplace is complicated by the lack of a consistent definition. It has been suggested by Rayner and Hoel that bullying can be defined as incorporating any of the following five key elements:

• Threat to professional status
• Threat to personal standing
• Isolation
• Enforced overwork
• Destabilisation-(4)

It is generally accepted that bullying incorporates negative behaviour(s) which are carried out repeatedly, rather than a single episode. It is not the perpetrator's intention, but instead the victim's perception, that determines whether the bullying has occurred.

Previous studies of UK junior doctors show that 37% have been bullied in the preceding year.5 An Australian study had this prevalence as high as 50%.6 More recently, an Irish study showed a rate of 30%.1 The studies show that the majority of bullying behaviours were from fellow doctors, in particular, those of greater seniority.

In this study, we attempted to determine the prevalence of bullying at Auckland City Hospital, which is the largest teaching hospital in New Zealand.

Method

Study design - We conducted a cross-sectional survey of all house officers and registrars (registered medical officers—RMOs) working at a teaching hospital with just under 1000 beds.

An anonymous questionnaire was sent via internal mail to 141 house officers and 232 registrars. A self-addressed internal mail envelope was included.

The questionnaire collected information on the participant’s age, gender, postgraduate year, country of training, ethnicity, and whether they were doing a medical or surgical run.

The participants were presented with a table of 14 bullying behaviours (Table 1). They were asked to identify whether they had experienced any of the behaviours in their previous term (3- or 6-month clinical attachment). If they had, they were asked to identify the staff group who perpetrated the behaviour and rate on a scale of 1–5 how frequently they encountered the behaviour.

If they had experienced any bullying behaviours, they were asked whether they had made a formal complaint, and whether this was effective. If they did not make a formal complaint, they were asked why they did not.

Statistics - All analyses were performed using SAS (SAS Institute Inc, v9.1) software. Continuous normally distributed variables were compared using Student’s unrelated groups test and Chi-squared analysis was used for categorical data. All tests were two-tailed and p<0.05>

Table 1. Questionnaire

Bullying behaviour	Consult ant	Registrar	HO	Radio logy	Nurse	Pharm acist	Patient /family	Other (specify)
Undermine your work
Unjustified criticism
Innuendo and sarcasm
Verbal threats
Making jokes about you
Teasing
Physical violence
Violence to property
Withholding necessary information
Ignoring you
Undue pressure
Setting impossible deadlines
Undervaluing of your efforts
Discrimination

Scale:

1=encountered behaviour once

2=once a month

3=once a week

4=>once a week

5=every day

Results

We had a response rate of 34% (48/141) from house officers and 32% (75/232) from registrars. 50% (186/373) of these doctors reported at least one episode of bullying behaviour (95%CI: 41–58%, p=0.047).

50% (93/186) of those who were bullied were either first-year house officers, or first-year registrars (p value=0.008). There was a trend for RMOs doing a surgical run to report a higher incidence of at least one bullying behaviour compared to those doing a medical run (59% [27/46] vs 44% [27/62], p=0.17).

RMOs under the age of 25 reported bullying more frequently than those over the age of 25 (72% [17/24] vs 44% [43/99], p=0.024). There were no differences in gender, ethnicity, or whether the RMO was trained in New Zealand or overseas.

Consultants and nurses were the main perpetrators of bullying behaviour (30% [63/214] each) followed by patients (25% [53/214]), radiologists (8% [18/214]), and registrars (7% [17/214]) (Figure 1). Registrars were more often bullied by consultants, and house officers by nurses.

Figure 1. Who does the bullying?

The most widespread bullying behaviour encountered was unjustified criticism from consultants, followed by ’undervaluing of efforts’ (Figure 2).

Only 18% (33/186) of those who had experienced at least one episode of a bullying behaviour made an official complaint. 63%(20/33) of those who complained were house officers, and 83% (27/33) were female (p=0.042). Of those who made a complaint, 54% (18/33) reported some improvement. Of those people who did not make an official complaint, 82% (125/153) were not sure how to complain, and 79% (121/153) were afraid of the consequences. 72% (134/186) of those who had been bullied dealt with it themselves.

Figure 2. Most common bullying behaviour (total complaints = 214)

Discussion

Our study indicates that junior doctors at Auckland City Hospital perceive that they are bullied at the same prevalence rate as similar studies performed overseas.1,3,5,6 Studies such as this, however, suffer from problems of definition, perception, and response bias.

Bullying is clearly a difficult behaviour to define. It must be recognised that the medical education system is a hierarchical, high-pressure environment in which differences in knowledge often lead to an imbalance in power. In such an environment it would be common for performance feedback to be misinterpreted as bullying rather than a misguided attempt to improve performance.7

Irrespective of these qualifying factors, the perception of the victim is still the most important aspect of bullying behaviour. Secondly, in our study, junior doctors have identified instances where they have been bullied on a single occasion which would not meet the accepted definition of bullying.

Finally, the presentation of bullying behaviours in the survey may have prompted respondents to declare bullying behaviours and those who are bullied are possibly more likely to respond (i.e. responder bias).

Despite this, it is reassuring (although still totally unacceptable) that the prevalence of bullying amongst medical staff at our hospital when measured by similar methods and limitations is in line with the reported prevalence (30–50%) as defined from other overseas studies.1,3,5,6

In addition, this study identifies two further issues. Firstly, while our medical personnel may be accused of bullying due to the hierarchical nature of the education structure, it is difficult to explain the high frequency of bullying by nurses towards house officers. Secondly, the majority of doctors who had experienced bullying behaviour did not complain and 79% stated that they were afraid of complaining. This is in line with a study by Dickson in which he states, “It is not that the victim cannot complain; it is that they perceive themselves as helpless or they perceive the consequences of complaining as worse than the status quo.”8

While the bullying behaviour may not have been of sufficient stature to warrant a formal complaint it is still a major concern that a significant number of doctors did not know the process by which they could address the issue. In contrast, however, it was reassuring to note that 54% of those that did complain noted an improvement which somewhat validates our current processes.

In summary, our study has identified a high prevalence of perceived bullying by junior doctors. While the bullying may be a misperception by the victim, it is still of sufficient concern that it requires further study. Organisational support should be given to all employees to minimise such behaviour and support potential victims. We recommend training sessions on effective communication and delivery of constructive criticism for the main perpetrator groups identified in this study. Possibly a formal complaint process should be identified with a standardised format, open accessibility, and confidentiality restrictions. Following these interventions, a repeat study should be conducted to confirm a positive change in bullying behaviours.

Competing interests: None known.

Author information: Joanne Scott, House Officer, Department of General Medicine, Auckland City Hospital, Auckland; Chloe Blanshard, House Officer, Department of General Medicine, Auckland City Hospital, Auckland; Stephen Child, Director of Clinical Training, Clinical Education and Training Unit (CETU), Auckland City Hospital, Auckland

Acknowledgements: We thank David Spriggs (Clinical Director, Department of General Medicine, Auckland City Hospital, Auckland); Gill Naden (Manager, CETU, Auckland City Hospital, Auckland); and Medical Council of New Zealand for their assistance.

Correspondence: Dr Stephen Child, CETU, Level 15, Support Building, Auckland City Hospital, Park Road, Grafton, Auckland, New Zealand.

References:

1. Cheema S, Ahmad K, Giri SK, et al. Bullying of junior doctors prevails in the Irish health system: a bitter reality. Ir Med J. 2005;98(9):274–5.
2. Kelly S. Workplace bullying: the silent epidemic. N Z Med J. 2004;117(1204). http://www.nzmj.com/journal/117-1204/1125

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