Bullying Cultures Are Plagued with These Micro Behaviors

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The most common forms of bullying behaviors among healthcare professionals aren’t necessarily the high level toxic behaviors such as surgeons throwing scalpels at the OR nurses or the crusty, older nurse screaming and yelling at the new nurse. The most common forms are the low level, micro-aggressions between co-workers that whittle away at a person’s confidence and performance; and ultimately are the behaviors that lead to an unhealthy workplace.

Micro-aggressions are the everyday verbal, non-verbal, and written insults that communicate disrespect, incivility, and hostility. A term originally used to describe racial insults, this term is starting to be used to describe low level bullying behaviors in the workplace.


Excessive teasing and mocking

Nit-picking either verbally or via written form (email)

Using rank to “win” or justify behaviors/mistakes

Public shaming for incorrect answers; especially during patient rounds

Eye rolling and sighing


Offensive body language

Whispering to others while laughing and looking at you

Condescending language

None of these behaviors when displayed once constitutes bullying. However, when they are repeated over time with a conscious or unconscious attempt to do harm, we can label it bullying.

What makes them micro-aggressive behaviors is that typically when the target speaks up, others easily downplay the behavior by saying things like, “You’re too sensitive. Lighten up a bit. Don’t take everything so personal, etc.” The target in turn, focuses inward and begins to question herself/himself. “Maybe I am too sensitive. Maybe I should lighten up a bit.”

As a result, the behavior continues, the flow of information decreases, and the target suffers physical, emotional, and mental stress.


When we don’t address low-level behaviors, they always escalate.  “I’m offended by your comment about…”


Dates, times, witnesses, and just the facts. Be sure to include any verbatim comments in your documentation. If you can, try to link the behavior to the following 2 negative outcomes:
Patient safety
Team performance

File a complaint
in 2008, the Joint Commission released a sentinel alert stating that all healthcare organizations have to adopt policies that address formal complaints of disruptive behaviors that undermine a culture of safety. Use the documentation you’ve been collecting as your evidence of bullying behaviors.

While throwing things at co-workers and deliberately sabotaging them are behaviors that should prompt immediate termination, don’t discount the more subtle, micro-aggressions that can equally contribute to a hostile work environment. It’s not okay to treat people in ways that undermine the team’s performance and negatively impacts patient care.

We all have an ethical responsibility to take action – low level or high level – when patient’s lives are at stake.

What micro-aggressions have YOU either experienced or witnessed in the workplace? I’d love to hear from you.

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About the author: Dr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate bullying behavior. To find out how you can bring Renee to YOUR organization or nursing event, click here.

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