Study after study shows that not addressing bullying in healthcare has a major negative impact on employee engagement, well-being, retention, and patient outcomes. And it’s getting worse. A recent study conducted by AONL and Joslin reported the #1 factor impacting psychological safety is incivility. According to SHRM, 57% of employees reported being on the receiving end of bullying and incivility in the previous week, up from previous studies. Finally, in a new study by Eaton, 80% of respondents describe their workplaces as toxic, a 13% increase from just 2024. Therefore, if we want to retain great people, we must make addressing bullying in healthcare a top priority.
So… how can we do that effectively?
Maybe we can learn something from the airline industry.
The Southwest Approach: “We Love You, But We Will Leave You”
Years ago, while waiting to board a Southwest Airlines flight, I overheard a gate agent call out for four passengers who hadn’t boarded. After three announcements, she finally said something I’ll never forget:
“Look, (said their names), we LOVE you, but we will LEAVE you if you’re not here in 30 seconds!”
The entire gate area burst into laughter.
And as I sat there, my first thought was that I hope they make it. My second thought was — that’s exactly how leaders should approach addressing bullying in healthcare.
The “We love you, but we will leave you” mindset means that while we genuinely care about our people, we also hold them accountable. We can’t allow anyone — no matter how clinically competent — to stay if they consistently harm the team or culture.
Just like that gate agent was willing to close the door to protect everyone else’s experience, leaders must be willing to close the door on unprofessional behavior.
Step 1: Set Clear Behavioral Standards
In healthcare, we’re great at setting clinical expectations:
- Scan patients before giving medications.
- Document patient education.
- Scrub the hub for 15 seconds.
But when it comes to behavior? We’re often vague. You can’t just start shutting the door on everyone who misbehaves.
Addressing bullying in healthcare starts with clear behavioral standards. If you’ve never set behavioral standards before, it might feel awkward to tell adults how to behave in a professional environment. But without structure, even adults can run amok. Leaders must set behavioral expectations just as firmly as clinical ones.
If you’ve never done this before, start simple. Ask your team two key questions:
- How do we ALWAYS want to treat each other?
- How do we NEVER want to treat each other?
Use their responses to create a department compact — a shared agreement on what respectful, professional behavior looks like. We teach leaders how to do this in our foundation program, Eradicating Bullying and Incivility: Essential Skills for Healthcare Leaders.
If you believe the way they treat each other is just as important as the care they provide, you need to articulate that clearly. When you clarify what “professional” means in your environment, you empower everyone to recognize when behaviors fall short — and you make accountability much easier.
Step 2: Have Honest Conversations (with Love and Accountability)
When an employee violates one of your behavioral standards, meet with them shortly after the incident. Then, refer directly to your behavioral expectations (norms/compact):
“According to our compact, we agreed never to yell or criticize in patient care areas. You violated this by yelling at Brittney in front of a patient. Brittney is new, and although feedback is important, our standard is to never criticize publicly, especially in front of patients.”
Then add compassion (love):
“What happened? Are you okay? What would make you do something like that?”
Note: Even if someone is right or their concerns are valid, yelling or criticizing in front of others is never a professional way to address them.
This balance of accountability and compassion is key to addressing bullying in healthcare effectively. You’re setting boundaries while showing that you care about the person behind the behavior.
If this person is your most competent nurse, recognize their clinical excellence but make it clear: professional behavior is just as important as clinical competence.
Step 3: Love Your People
According to Gallup, the top reasons employees stay or leave their jobs have nothing to do with pay, patient type, or staffing ratios. They’re relational. The strongest predictor of retention is the relationship someone has with their boss, followed by whether they feel a sense of belonging.
That’s why successful leaders combine care with confrontation.
Be the leader who genuinely cares about your team and who holds everyone accountable. That’s the heart of addressing bullying in healthcare: creating a workplace where people feel valued, respected, and safe.
Final Boarding Call
Healthcare leaders, we are losing incredible nurses and clinicians every day because of bullying and incivility. The time for silence is over.
Like that Southwest gate agent, love your people enough to hold them accountable…and be willing to “leave” those who refuse to meet your standards of professionalism.
Because at the end of the day, the way we treat each other should be just as important as the care we provide.
