This begs the question: do these kids grow up to be workplace bullies, or does the workplace make its own class of bullies? Tell us what you think in the comments section.

New York (CNN) — A new study commissioned by CNN’s “Anderson Cooper 360°” found that the stereotype of the schoolyard bully preying on the weak doesn’t reflect reality in schools.

Instead, the research shows that many students are involved in “social combat” — a constant verbal, physical and cyber fight to the top of the school social hierarchy.

To read more visit: CNN study: Schoolyard bullies not just preying on the weak – CNN.com.

While I will not admit to enjoying the downfall of others, it is refreshing to see an executive who treats others poorly fall from power.

Such is the case with David Sokol, once believed to be the heir apparent to Warren Buffett as the next CEO of Berkshire Hathaway. That plan evaporated when Sokol resigned in March after it was revealed that he had bought shares in Lubrizol, a company that Berkshire Hathaway since bought.

Now, according to reporting by Peter Latman and Geraldine Fabrikant in the New York Times, Sokol had an unsavory reputation within Berkshire Hathaway. He could be gruff and abusive and worse his track record as a “Mr. Fix It” was unwarranted. Insiders wonder why Buffett valued Sokol so highly. [Berkshire Hathaway has since announced that Sokol, in violation of corporate ethics policies, gave "misleadingly incomplete disclosures" about his stock purchases.]

Far be it from me to speculate on what Buffett saw in Sokol, but it seems that Buffett, who prides himself on hands-off management, is one more in long line of top executives who willfully or woefully are blind to the negative behaviors of underlings, even when those behaviors rise to the level of bullying.

Bullying Bosses: A Scourge in Corporate America

Bullying is not what Sokol is accused of, but as the Times reported, Sokol suggested getting rid of employees because they were in poor health or going through a divorce, which is bully-like behavior.

Bully bosses are the scourge of many organizations. According to a 2010 survey released by the National Workplace Bullying Institute, bullies are commonplace. One in three workers report being bullied by a boss. Six in ten bullies are men and 58% of their targets are women. Cases of bullying are four times greater than illegal harassment.

Bullies wreck a terrible toll within an organization. Their behavior leads to increased levels of stress among employees, higher rates of absenteeism, and higher than normal attrition. But here is the irony. Bullies do get results, typically because they push people to the wall forcing them to put in longer than necessary hours. Senior managers see only the results and look no further.

If you look at management as an exercise in employee engagement, bullies fall short. Bullies get employees to comply, but not to commit. Compliance is okay for day-to-day operations but when an organization is faced with a challenge or even a crisis, you need employees who are willing to go the extra mile. People who work for a bully are biding their time looking for a way out, or a time when the bully will be replaced.

Bullies also sully the reputation of their department. Talented employees will avoid working there. Couple that with the talented people in the department who have left or are seeking to leave, pretty soon the bully is left with employees whose only option is to endure.

Avoidance of the bullying issue by senior management is a contributing factor to why bully bosses remain in their positions. Until senior management looks more closely at the “numbers behind the numbers” – absenteeism, lower engagement scores, and turnover – bullies will remain with us.

Have you seen CEOs blind to bullies, and what impact has that had on the company?

John Baldoni is an internationally recognized leadership development consultant, executive coach, author, and speaker. In 2011 Leadership Gurus International ranked John no. 11 on its list of the world’s top leadership experts. John is the author of nine books on leadership including his Lead By Example: 50 Ways Great Leaders Inspire Results and Lead Your Boss: The Subtle Art of Managing Up.  Follow him on Twitter

Maté, a Canadian physician and author of Scattered Minds about ADD, spoke with host Amy Goodman about the societal corruption of the conditions for normal brain development in children. Too many are neglected or abused, increasing the number of hyperaggressive children, and in turn, adults.

During critical years of brain development Maté argues that neglect of children by loving parental caregivers who are working two or more jobs or simply not emotionally present for their children because of their own depression or stress from working deprives the children of developing a moral sense. Stressed fathers do not support mothers. Normal childhood development requires non-stressed, emotionally available adults.

The absence of a bond with adults can lead to inadequate development of the prefrontal cortex affecting the ability to show empathy, insight or a sense of social responsibility. Without emotional caregivers available, Thus environments account for the quality of brain development in children and young teens. The reliance on parents and environments reflects our social nature. Contrary to the pseudo-Darwinist (Ayn Rand-type) arguments that humans develop solely as individuals, biology  shows that we need parents, extended families and communities surrounding us to be fully developed in a healthy social way. In other words, bullies remain emotionally immature and incredibly cruel and insensitive toward others. There could be a biological explanation.

The work of Robert Hare with serial killers, psychopaths, suggests too a link between inadequately developed prefrontal cortical areas of the brain can account for seemingly inexplicable evilness.

Anthes, in her Boston Globe report, highlighted the research of Martin Teicher that found verbal abuse by parents was as psychologically damaging as physical abuse. Subsequently he found that kids suffered more depression, anxiety and other psychiatric disorders when bullied by peers than by parents. Teicher said in a 2002 Scientific American article, “Stress sculpts the brain to exhibit various antisocial, though adaptive, behaviors. Whether it comes in the form of physical, emotional or sexual trauma or through exposure to warfare, famine or pestilence, stress can set off a ripple of hormonal changes that permanently wire a child’s brain to cope with a malevolent world.” Teicher’s 2010 fMRI study revealed differences in mylienation of the corpus callosum (the tissue connecting the two brain hemispheres) for kids abused by peers.

Tracy Vaillancourt’s work, also featured by Anthes, found higher levels of cortisol in boys bullied by peers. Too much cortisol can damage brain structures such as the hippocampus that is involved with learning and memory. Paradoxically, girls had abnormally low levels of cortisol. This may reflect living a chronically stressed life.

Cortisol research is burgeoning. In one study, high cortisol levels were associated with feelings of shame and threats to one’s self-image. [Acute threat to the social self: Shame, social self-esteem, and cortisol activity. by T. Gruenewald, et al. Psychomatic Medicine, 2004, 66, 915-924.]

The Boston Globe’s Anthes also described Daniel Peterson’s research with stressed rats demonstrated the impact of bullying by a dominant other resulted in hippocampal damage. New neurons were produced, but in stressed rats, a high percentage of cells died prematurely.

In a 2009 study that deliberately stressed rats that got “stuck in a rut” due to cortical and mid-brain structural changes in response to the stress, researchers were able to reverse the effects. Robert Sapolsky, stress guru, considered this study an important linkage between the behavioral malaise stressed people feel and the underlying neurological explanations for it. [Chronic stress causes frontostriatal reorganization and affects decision making. by E. Dias-Ferreira, et al. Science, 2009, 325, 621-625.]

Finally, we now know that stress interferes with cellular replication that keeps us young. DNA replication is prevented when the protective tips of the chromosomes, the telomeres, fray. 2009 Nobel Prize winner in Medicine and Physiology, Elizabeth Blackburn at the University of California, San Francisco shared credit for the discovery of telomeres. In a study of chronically stressed mothers who had reared children with special needs for 15 years, the shortening of their telomeres represented an average shortening of their life expectancy by 9 to 12 years. [Accelerated telomere shortening in response to life stress. by E.S. Epel, E.H. Blackburn, J. Lin, et al. Proceedings of the National Academy of Science (PNAS), 2004, 101(49), 17312-17315.] So much progress has been made using this cellular marker as predictor of the aging process, Blackburn and her team are developing a commercial process for public use.

We’ll alert site visitors to the latest in relevant neuro and biologically-related research as it surfaces.

Tiatorio argues that bullying serves as a crude “social stabilization strategy ingrained from an earlier clan-based life.” By using violence, the strong eliminate the social outliers, the different ones. Sounds just like social darwinism except that it comes from an advocate of societal ethics. He invokes Greek mythology describing Procrustes who attacked people and had the nasty habit of adjusting the leg length of passersby to fit a bed he had positioned conveniently on the road to Athens. Procrustes shortened legs that were too long and stretched the short ones to fit his arbitrary standard. For some bizarre reason, Tiatorio thinks Procrustes served some important social function. I do not.

However, I do agree that bullying/aggression/violence is infused, perhaps inextricably, in our culture. He doesn’t have faith that school administrators can run their buildings in ways that stop bullying or that laws work. Instead, he believes “this as an educational issue requiring a proactive, early and on-going curriculum response involving children and their families …  bullying can only be reduced through broadening our sense of community, knowing that only this can actually stabilize the group and ensure harmony.” Too bad his solution is curricular (as a former teacher) and so obtuse as to be undoable — “broaden our sense of community” — when our society grows more polarized allowing people to de-humanize and demonize others with impunity more every day.

I’m not as optimistic as in my younger years. Without the threat of undesirable consequences looming, people will choose the more expedient course of interpersonal behavior every time — aggression. No amount of bullying is good for society. It coarsens it. We grow cruder and rougher and more adversarial when no laws are present to ensure good conduct that might have been normative previously. So, let’s get real. The reason we work so hard to push for laws (the WBI Healthy Workplace Bill Legislative Campaign) is to have society officially declare that repeated abusive conduct is unacceptable!

Since Tiatoro brought up mythology, who knows which god(s) did good deeds and made peacemakers in the world?

Destructive workplace behaviors contribute to the inability to retain nurses in the healthcare environment because of the stress associated with these behaviors. Briles (2003) defined the problem of destructive workplace behavior as “working manners, habits, and styles that can directly and negatively affect the bottom line of a unit, department, and the entire organization” (Red Ink Behavior section 2).

These destructive workplace behaviors cause targeted employees to experience serious physical and psychological damage (Rowe & Sherlock, 2005), resulting in negative aspects of the EVLN model, which consists of exit – leaving employment, voice – verbal threats of retaliation, loyalty – entrapment by the organization, and neglect – willful negligence to work duties.  The resulting organizational decline costs the healthcare organization both time in retraining new employees and money to mitigate the effects of EVLN.

Considering the nursing shortage and the increasing demand for healthcare services, strategies need implemented to improve satisfaction, increase motivation, augment productivity, and improve retention to ensure safe and quality healthcare. The cause and mitigation of these destructive behaviors are illustrated by presenting a background of various aspects of cultural liability in the current nurse environment and are validated by examining three studies that address lateral/horizontal hostility as well as the supervisor or management’s roles in recognizing and addressing abuse.

Lateral Hostility

Destructive workplace behaviors consist of demeaning, abusive, and hostile communications or actions among employees. Lateral hostility or disruptive behavior among or between coworkers is prominent within the nursing profession. A survey conducted by Alspach (2007) revealed that “25% to 32% of … critical care RNs reported only fair or poor quality of interactions with peers…, especially in relation to respect and verbal abuse” (p. 10). Nurses described various forms of verbal abuse or bullying as blatant or subtle communication that caused emotional distress using words or tone as well as intimidating, threatening, or patronizing mannerisms.

Some examples of individual workplace bullying include, but are not limited to sabotaging, engaging in the silent treatment, spreading rumors, devaluing a peer, discounting input, or fault-finding.  The resulting behaviors are manifested in the EVLN model. Individual workplace bullying, “manifested by one RN toward another, represents system and cultural issues, symptoms of an emotionally, spiritually, and psychologically toxic and oppressive environment” (Alspach, 2007, p. 11). Individual or lateral destructive workplace behavior has deep seated origins. Frustrations with working conditions may cause some nurses to redirect hostile behaviors toward other nurses. Another viewpoint proclaimed bullying type behavior emerges from power struggles, leadership styles, and organizational conditions. Furthermore, some believe lateral destructive workplace behaviors are learned from the existing organizational culture.

Horizontal Hostility

Horizontal hostility involves conflict or destructive workplace behavior by group members toward other individuals outside the group or toward group members themselves as a means of conformity. Another definition of horizontal violence is groupthink. Capella University (2005) defined groupthink as a “phenomenon in which the norm for consensus overrides the realistic appraisal of alternative courses of action” (p.217). Groupthink or mobbing emulates the concepts of horizontal violence in which an oppressive leader, who has attained a degree of status, causes oppressed group behavior. The oppressor attains the ability to control others to achieve self-serving goals in a way that humiliates or denigrates the self-esteem of those on his or her hit list and creates a toxic work environment.

Culture as a Liability

The toxic workplace environment created by dysfunctional aspects of internal and external influences creates “a culture as a liability” (Capella University, 2005, p. 491). Cultural liability is amplified when nurses experience burnout because of heavy workloads and lack of recognition. The most pressing trends that contribute to destructive workplace behaviors and foster toxic healthcare work environments include an increasing nurse workload because of an aging and growing population, increasing age of the registered nurse workforce and nurse faculty, increasing turnover of nurses, decreasing enrollment in nursing schools, and cost-cutting pressures of managed care (Jorgensen-Huston, 2003). The increased job stress associated with heavy workloads is amplified and turnover is increased when nurse managers, physicians, patient family members, patients, or coworkers fail to recognize nurses for good performance and impose abusive interactions.

The lack of recognition coupled with decreased job satisfaction intensifies destructive workplace behaviors, increases turnover, affects patient outcomes, and amplifies costs to the organization.

The cost to replace a staff nurse was 1.2 to 1.3 times that of a nurse’s average annual salary. High vacancy and turnover rates can adversely affect patient outcomes due to the loss of experienced staff and increased stress on the remaining nurses whose already heavy workload increases to overcome the effect of vacancies. (Texas Center for Nurse Workforce Studies, 2006, p.2)

Therefore, the goal for healthcare leaders is to mitigate the effects of destructive workplace behaviors causing the toxic work environment by creating a healthy work environment that supports the nurse.

Culture as an Asset

In a healthy workplace environment, nurses thrive because of increased morale, increased job satisfaction, and decreased turnover. “The environment in which RNs work is an essential issue in their job satisfaction and turnover…. and a healthy work environment is the base for recruiting and retaining nurses and ultimately for providing optimal care for patients…” (Ulrich, Lavandero, Hart, Woods, Leggett, & Taylor, 2006, p. 46). Hospitals that have achieved Magnet Status – best practices in nursing – have high satisfaction, low turnover, and optimized nurse-to-patient ratios.

Factors that contribute to Magnet Status include nurse autonomy and control over his or her working environment and effective/respectful communication among nurses, physicians, team members, and management.

The American College of Critical Care Nurses (AACN) recognized the issue of hostile or destructive workplace behaviors, mandated a zero tolerance for abuse policy, and identified some components in a healthy workplace environment to include collaborative communication; mutual respect; competent nursing leadership; protection from physical, verbal, and emotional abuse; influence and control over practice; professional development; and recognition.

Despite the AACN policy for zero tolerance for abuse, an open – online survey reported over “9000 instances” (Ulrich et al., 2006, p.54) of verbal, emotional, and physical abuse.  Nurse leaders must strive to create healthy work environments; however, as evidence from the survey results more research is needed to address destructive workplace behaviors of nurses, groups of nurses, coworkers, leadership or physicians, and clients. The following studies will explore the phenomena of destructive nurse workplace behaviors and will identify potential causes and solutions to the problem.

Rosenstein’s Study

Nurses cite physician abuse as one of the major reasons they resign. “…disruptive physician behavior refers to any inappropriate behavior, confrontation, or conflict, ranging from verbal abuse, to physical and sexual harassment….; two-thirds of nurses say they [have] been abused by physicians at least once every two to three months…” (Rosenstein, 2002, p.27). To determine the relationship between nurse turnover and abusive physician relationships as well as divergent views amongst nurses, physicians, and administration, Rosenstein (2002) administered the Nurse-Physician Relationship Survey.

The most striking finding in the survey indicated that 92.5% or 1,089 respondents have seen physicians abusing nurses (Rosenstein, 2002). The most frequent forms of abuse witnessed include physicians yelling at and berating nurses. Nurses feared retribution and believed they received minimal administrative support when physician abuse occurred. Abusive physician behavior toward nurses does increase turnover; the survey indicated that 30.7% of the respondents have either quit or witnessed another nurse quitting because of hostile physician behaviors.

Although respondents did not concur on the best approach, the most cited solutions were collaboration and communication, education and training, open forums and group discussions, and greater accountability for both nurses and physicians (Rosenstein, 2002). Accountability could be enforced by using a professional’s code of ethics, reporting abusive behaviors to the ethics committees, and establishing a zero tolerance for abuse policies as recommended by the AACN.

Rowe and Sherlock’s Study

Rowe and Sherlock’s (2005) study explored the frequencies, types, and effects of verbal abuse experienced between nurses. Based on previous studies, nurses are an oppressed group that displays characteristics of occupational burnout that turns the oppressed into the oppressor. Bullying is both psychological and physically damaging and has a direct influence on job satisfaction, morale, and retention. Victims report feelings to include, but not limited to isolation, lower self-esteem, rejection, powerlessness, uselessness, depression, and hopelessness (Rowe & Sherlock, 2005). Frequent verbal abuse with the accompanying psychological and physiological manifestations causes nurses to accept or perpetuate the destructive behavior or resign.

The results of the survey indicated that verbal abuse does occur both laterally and horizontally between nurses, but also from other sources such as physicians, patients, patient family members, and ancillary staff. The most prominent source for verbal abuse is lateral hostility between nurses (Rowe & Sherlock, 2005). The most frequent types of abuse were hostile, judgmental, and critical communications. Nurses reported both constructive and unconstructive coping behaviors ranging from clarification by dealing directly with the abusive nurse to using silence, calling in sick, complaining about the work environment, or resigning.

The recommendation to mitigate verbal abuse and its effects centers on practice management. Using creative morale building strategies is a start to change destructive workplace behaviors. One way to improve morale is to get nurses involved in decisions involving policies and procedures (Rowe & Sherlock, 2005). Empowerment is a strong motivating factor. When nurses are involved, organizational commitment and positive organizational behaviors increase. In addition to empowerment, a nurse’s morale is increased by enforcing a zero abuse policy, encouraging nurses to report abuse, and educating staff on destructive workplace behaviors.

Yildirim, Yildirim, and Timucin’s Study

Yildirim’s et al (2007) study explored mobbing or groupthink type behavior among nurse faculty in Turkey. The psychological terror of mobbing begins when a group of individuals single out one or more victims and attack their “honor, honesty, reliability, and professional ability…” (p. 447).  The various attitudes and behaviors of the oppressors create a type of “psychological violence” (p. 447) that frightens, excludes, isolates, and delays a victim from accessing organizational resources that enforce his or her rights. Mobbing is becoming more prevalent among nurses in a variety of healthcare and education environments and has devastating physical and psychological effects on victims.  Various responses to mobbing include, but are not limited to fatigue, stress, headaches, post-traumatic stress disorder (PTSD), suicide, unexplained fears, insomnia, loss of appetite, heart palpitations, depression, weight gain or loss, neglect of work duties, absenteeism, and turnover.

Yildirim’s et al. (2007) study revealed that 91% of nursing staff who took part in the study had experienced mob type behavior and 26.6% of nursing staff experienced mobbing behavior two times a week on the average. “The most frequent forms of [mobbing] behaviors included attacks on personal status (85%) and attacks on personality (82%)…” (p. 451).  In addition to the aforementioned responses to mobbing listed in the description of the authors’ study, victims of mobbing experienced mistrust of coworkers, continuance organizational commitment, and retaliation toward other nurses. The coping mechanism most used in a mobbing situation was the victim working harder and becoming better organized to avoid criticism. Other nurses assumed a proactive approach by confronting the abusers directly and trying to work out a resolution. Fifty percent of those that experienced mobbing reported that they resigned their position.

Healthcare leaders, nurse managers, nurse educators, and nursing staff need to become more aware of mobbing behavior through formal educational forums. The extreme negative implications of destructive workplace behavior such as mobbing create long-lasting psychological consequences for the victim. Yildirim et al (2007) suggested that mobbing behavior be prosecuted as a felony. Policies and procedures, such as the zero tolerance for abuse policy recommended by the AACN, should be enforced and abusive behaviors should be reported. To avoid fear or apprehension in reporting abuse, the authors suggested forming a committee of nurses who have witnessed or experienced mobbing behavior.

Conclusion

In conclusion, destructive workplace behavior among nurses is a very real and serious phenomenon that affects the health of the victims, the bottom line of the healthcare organization, and the quality of outcomes for patients. By examining the nurses’ culture as a liability, one can appreciate how both internal and external factors contribute to these dysfunctional behaviors. In a healthy workplace environment, nurses thrive because of increased morale, increased job satisfaction, and decreased turnover. What are the differences in these two environments? The answer is empowerment, recognition, trust, autonomy, communication, professional development, respect, and accountability. The three studies emulated the components of both a healthy and toxic workplace and revealed issues that involved lateral, horizontal, and institutional response to abusive behavior. A common theme in the three studies and the nurses’ current work environment is the importance of job satisfaction in the retention of nurses.

References

Alspach, G. (2007). Critical care nurses: Are our intentions nice or nasty? Critical Care Nurse, 27(3), 10-14.

Briles, J. (2003). Zapping conflict in the healthcare workplace. Denver, CO: Mile High Press, Ltd.

Capella University (2005). OM: 8004: Managing and organizing people (An Edited Work). Boston, Prentice Hill Custom Publishing.

Jorgensen Huston, C. (2003). Quality health care in an era of limited resources: Challenges and opportunities. Journal of Nursing Care Quality, 18(4), 1-12.

Rosenstein, A. (2002). Nurse–physician relationships: Impact on nurse satisfaction and retention. American Journal of Nursing, 102(6), 26-34.

Rowe, M. & Sherlock, H. (2005). Stress and verbal abuse in nursing: Do burned- out nurses eat their young? Journal of Nursing Management, 13, 242-248.

Texas Center for Nursing Workforce Studies. (2006, September). The economic impact of the nursing shortage. E-Publication # 25-12515.

Ulrich, B., Lavandero, R., Hart, K., Woods, D., Leggett, J. & Taylor, D. (2006). Critical care nurses’ work environments: A baseline status report. Critical Care Nurse, 26(5), 46-56.

Yildirim, D., Yildirim, A., & Timucin, A. (2007). Mobbing behaviors encountered by nurse teaching staff. Nursing Ethics, 14(4), 447-461.

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Feature documentary Murder by Proxy: How America Went Postal offers a provocative examination of the possible role of hostile work environments in mass murder incidents, starting with the earliest USPS mass murder-suicide in 1986.

At a time when tensions are rising again in the Postal Service and in other workplaces across America, Murder By Proxy is a simply a must-see film.

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