Bullying in Healthcare
Bullying doesn’t stop at the school gates or the workplace. It exists in one of the most critical spaces of all — healthcare.
Whether it’s a nurse enduring verbal abuse from colleagues, a resident being humiliated by a superior, or a patient being dismissed and dehumanized, bullying in healthcare is real, harmful, and far more common than many realize.
What Is Bullying in Healthcare?
Bullying in healthcare is the abuse of power within medical environments — where individuals in positions of authority or influence use their role, knowledge, or financial means to intimidate, humiliate, silence, or harm others.
This behavior includes verbal abuse, intimidation, exclusion, and actions that undermine a person’s professional or personal integrity. It often arises from hierarchical structures and can manifest as lateral violence among peers or vertical aggression from superiors.
Perpetrators may be supervisors, colleagues, or even care providers, and the effects erode trust, psychological safety, and well-being within clinical settings.
Unlike general workplace bullying, bullying in healthcare doesn’t just harm professional relationships — it can directly impact patient outcomes, making it a public health issue as much as a professional one.
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Did You Know?
60% of nurse managers, directors, and executives reported experiencing bullying in the workplace.
Among Healthcare Professionals
The culture of healthcare often operates under intense pressure and rigid hierarchies — conditions that make bullying not just possible, but sometimes routine.
Nurses: Between 26% and 77% of nurses report being bullied at work. Nearly 97% have witnessed some form of workplace violence, including verbal abuse and intimidation, over a two-year period. This abuse is often peer-to-peer and is sometimes referred to as “horizontal” or “lateral” violence. Houck, N. M., & Colbert, A. M. (2017), Peaceful Leaders Academy
Physicians and Medical Residents: About 51% of medical residents have experienced bullying. The most common forms include verbal abuse, public humiliation, and threats — often delivered by superiors. This not only erodes morale and job satisfaction but can lead to burnout and drive professionals to leave the field entirely. Ayyala, M. S., et al. (2023), Adelaide Now (2023)
Directed at Patients
While less studied, patient-directed bullying is equally alarming.
- Forms of Mistreatment: Patients may encounter dismissive attitudes, verbal abuse, or even medical neglect from those entrusted with their care.
- Why It Matters: These behaviors cause more than hurt feelings. They erode trust, make patients reluctant to seek help, and can lead to serious health consequences when people delay or avoid treatment out of fear.
- Block, J. (2018)
Why It
Happens
Bullying in healthcare doesn’t happen in a vacuum. Several systemic and cultural factors allow it to persist:
- Hierarchies: Traditional chains of command can create power imbalances and protect abusers.
- High-Stress Culture: The emotional toll of healthcare work can lead to burnout, lashing out, and a lack of empathy.
- Normalization: In some environments, bullying is seen as a rite of passage — something you “tough out” to belong.
- The Joint Commission. (2018)
How We Can Change It
Fixing this starts with confronting it head-on. Here’s what needs to happen:
- Zero-Tolerance Policies: Institutions must adopt and enforce clear anti-bullying protocols.
- Training: All staff should be educated on recognizing, preventing, and reporting bullying behavior.
- Support for Survivors: Victims need safe reporting systems, counseling, and protection from retaliation.
- Culture Shift: The ultimate goal is to replace silence with accountability and fear with compassion — for both patients and providers.
Frequently Asked Questions on Bullying in Healthcare
What is an example of bullying in healthcare?
Bullying in healthcare can manifest as verbal abuse, intimidation, or undermining behaviors. For instance, a nurse openly criticizing a colleague or a physician belittling a nurse in front of others are common examples. Such behaviors can lead to increased stress, errors, and compromised patient care.
What are the three elements of bullying?
Bullying typically involves three key elements:
- Power Imbalance: The perpetrator holds more power, whether through position, seniority, or social influence.
- Repetition: The negative behavior occurs repeatedly over time.
- Intent to Harm: The actions are deliberate with the intention to cause distress or harm.
These elements contribute to a hostile work environment and can adversely affect both staff well-being and patient safety.
Why is there so much bullying in healthcare?
Several factors contribute to the prevalence of bullying in healthcare settings:
- High-Stress Environments: Healthcare professionals often work in high-pressure situations, leading to increased tension.
- Hierarchical Structures: Traditional hierarchies can discourage open communication and empower bullying behaviors.
- Understaffing and Workload: Excessive workloads and inadequate staffing can exacerbate stress and conflict among staff.
These systemic issues create an environment where bullying behaviors can thrive if not addressed.
What is considered unacceptable behavior in healthcare?
Unacceptable behaviors in healthcare include actions that undermine a culture of safety and respect, such as:
- Verbal Abuse: Yelling, insults, or derogatory comments.
- Intimidation: Threatening gestures or actions that create fear.
- Disruptive Conduct: Behaviors that interfere with team functioning and patient care.
Such behaviors can lead to decreased morale, increased turnover, and compromised patient outcomes.
What are the consequences of bullying in healthcare?
Bullying in healthcare can have severe consequences, including:
- Staff Turnover: High rates of bullying contribute to increased staff resignations.
- Patient Safety Risks: Bullying can lead to communication breakdowns, resulting in medical errors.
- Financial Costs: Replacing a nurse due to bullying-related turnover can cost between $27,000 and $103,000.
Addressing bullying is crucial to maintaining a safe and effective healthcare environment.