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I frequently get asked by organizations to help them eliminate workplace bullying. The conversations we have are always about BULLYING – the physicians bullying the nurses, the nurses bullying each other and the support staff, etc. And then I go in, “pull back the covers and lift up the gown” to find out if there is really a bullying problem.

The Difference Between Bullying and Incivility.

Here is what I find:
SOME bullying – not a ton, but an awful lot of incivility.

Even though I’ve written about this, talked about this, and created a few videos about, I’m not confident people truly understand the difference between bullying and incivility. Keep in mind; both bullying and incivility are NOT okay. Both need to be addressed but it’s important to understand the differences because the strategies to eliminate are a bit different.


For a behavior to be considered bullying, it has to include 3 things:

  1. A Target
    There HAS to be a target. This target can be a single person or group of people. For example, someone might pick on just one new nurse and make her life a living hell. But is nice to everyone else. Group targets can include the opposite shift (nurse on days hates all nurses on nights), new nurses, or nurses who have a particular ethnic background.
  2. Harmful
    The behavior has to be harmful in some way. This harm can be to the target (I get diarrhea every time I see that I have to work with this person) or harmful to a patient (a nurse who sabotages or sets a nurse up for failure, affecting patient care).
  3. Repeated
    I do believe this is the most important element of bullying. The behavior can’t be just a one-time event (I scream at you during a code situation). The harmful behavior has to be repeated over time. Some experts say 6 months or more. I disagree. I would consider a behavior as bullying if it repeated several times over the course of a week or so.

How to address bullying:

Bullying behaviors tend to be more actionable because most organizations have policies about bullying behavior. Get a copy of your policy and use the language in that policy to take action against bullying .


Incivility is different than bullying. While the behaviors can be similar, they tend to be lower level. This is your typical rude, inconsiderate, or just crusty nurse. However, make no mistake about it, incivility is a healthy and professional workplace killer! Incivility needs to be addressed too but bullying should be a NEVER event.

How to address incivility:

Uncivil behaviors tend to be less actionable and not always easy to address using policies or codes of conduct. Sometimes the best strategy to address incivility is to actually focus on CIVILITY. What does civility LOOK like? What behaviors SHOULD we be seeing in our coworkers?


If I’m a bully, I’m mean to a target or a group.

If I’m being uncivil, I’m just mean to everyone.

Do you see the difference?

Bullying and incivility can destroy your work environment AND impact the patients you serve in a negative way. The key is to get very clear on the behavior – is it bullying (target, harmful, repeated) or incivility (low level, rude, and unprofessional).

We are hemorrhaging nurses due to bad behavior and it’s time we stop EATING each other and start nurturing, supporting, and celebrating each other!

ReneeThompson_013_HRThanks so much for reading. Take care and stay connected!


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Dr. Renee Thompson works with healthcare organizations that want to overcome the leadership and clinical challenges their people face every day. If you’d like to find out more about her programs, please visit her website

Contact Renee today at to bring her to your organization to talk about ending the cycle of nurse bullying.

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  1. Hi Renee
    Can I have more information on Workplace Incivility and difference between Workplace Incivility and Bullying. How can we define Incivility in a broader sense? I am currently doing my Phd in Univ of Canberra on “The power of workplace Incivility: a case of Front office
    victims in Health care”
    I shall be very thankful for your guidance

    1. Thank you for focusing on incivility. I’ve written so much about this topic – other blog articles, videos on YouTube, and in my book, “Do No Harm” Applies to Nurses Too! which can all be found on my website. You might also want to subscribe to my newsletter too! Best wishes to you. We need more people like you addressing incivility and bullying in healthcare!

  2. I appreciate this article I was wondering about my son and how his attitude has changed which I described as being rude & disrespectful. Knowing that our lives on a personal level has been through a lot caring for terminally sick which resulted in emotional drainage &(numerous deaths of close family members ) back to back unable to grieve one because the next one passed awayand the high negative stress that we endure through our chosen careers. This article put a light on our behavior towards each other and with this new found consciousness I will forward this information and make conscious efforts not to be snappy or uncivil

    1. Thanks for taking the time to comment Nicole. I’m sorry your family has been going through some personal tragedies. It’s easy to get reactive and take things out on each other when you’re all under a lot of stress. So important to take a pause and as you said, make a conscious effort to be more civil – more understanding and more loving towards each other! I hope and pray your family has time to heal. Kind regards, Renee

  3. I have been an RN for over 30 years and have worked in several different positions to gain experience. I have worked as a Cinical Coordiator in dialysis for 8 years. The facility has good outcomes and the patients are given quality care. 2 years ago I got a new Facility Admisitrator. The first day She started I was told I was doing everythig wrong. I was using my knowledge, experience and following company policies. But things changed when she started I had to do thing her way. I have been micromanaged, my hours have been cut, I have been sent home from IDT meetings because I had too many hours. I am called in to her office often because the PCTs think they are the ones who should make to patient care decisions. Example a patient came in for dialysis treatment and was 7 Kg over his target weight. The patient was late and was sent out to the lobby by this PCT. When he was called back for treatment he was even later starting treatment. The PCT told she was going to cut his time. I intervened and said we were not going to cut the time and was explaining why. The PCT went to the FA and said undermined her decision. I was then called in the FAs office where this tech proceeded to yell out me called me an old lady and I needed to grow up. There was no intervention from the FA. I remember that the nurse is the person who makes the clinical decisions. We haveprobesm with PCTs not flollow patient safety and infection control policies I have educated them, done infection control audits and talked with them about the policies. I finally went to the FA to ask why they were not accountable for not following policies. I was told I was not the gastopo. I have made decisions to have a standing bp on a patient after treatment, having them draw a patients labs and was told that is not the FA wants us to do. I have had false accusations and been given verbal warnings, I have been told when I can give the patient there medicaions. I have been able to work as a nurse and to take care of my patients. I filled a grievence with People services and the grievecne was sent to the group FA and ROD that I had tlsked on previous occations. There was no intervention and I was asked if I like my job. Now there is a rumor going around the other facilities in the company that I filled a complaint and not to step on my toes. It is getting harder and harder to come to work due to anxiety. and wondering what is going to happen next. Where can I turn for help?

    1. Renee Thompson

      Wow! I’m so sorry you’re going through this! Not only are the PCTs practicing beyond their scope (they actually are doing things that only a licensed professional can do) but they are putting patient’s safety at risk. I hope you’re documenting everything!!! Get a copy of any policy you have in your organization that includes language about the things you are seeing…when you document, cite the policy violation. So so concerning. I think you’ve done the right thing…be consistent but it’s up to you how long you can manage in this place. Please read the other articles I’ve written and watch my videos. they will help!!! Sending you big air hugs!

  4. Thank you for this article. I thought we had a workplace bully, but really this person treats anyone she wishes with disrespect. Now I understand the difference. I like how you write in the first person, so we are not just talking about others, we are thinking about ourselves and our own actions.

    1. Thanks so much Lynn! In my experience, there is way more incivility going on than bullying. However, they both DO NOT belong in healthcare. Appreciate you!

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