Midwifery clique: was it bullying or cultural control?
As part of my research for a webinar looking at nursing culture I read an article from the UK about a report: A cultural review of maternity services at Wirral University Teaching Hospital NHS Foundation Trust.
The author Shaun Lintern, never used the term “bullying” yet the behaviours and management responses to the existence of a clique of midwives and the effects on other staff did appear to be a clear example of a culture that “while creating a strong and supportive in-group, also resulted in the exclusion, and at times, ostracism of others”.
I have investigated complaints of bullying in the workplace, especially from students on clinical placement where the interpretation of directives, identification of mistakes and correction by staff has been interpreted as bullying by the student. Sometimes there was no doubt that clinical staff were demonstrating hostility and aggression, often as a consequence of frustration with the demands of students. Sometimes the student’s sensitivity and lack of experience with the clinical culture and nursing communication patterns led to these accusations. Other times it was because this was the first time the student has ever been corrected through the use of short, sharp words.
The issue with the midwifery clique being investigated in this report was “the climate, culture and tone that this creates for others in the working environment which needs to be acknowledged.” While there were positives identified; the way clinical information was shared and openness to clinical questions, these were at the expense of other staff being shut out or devalued. Staff who raised issues about behaviours were disregarded.
The report identified that management had ignored complaints from those staff who were outside the clique. In fact the report has since given direction for the facility to implement changes. Change in staffing, rostering and organisation of staff being key aspects. This correction and intervention is both expensive and time consuming no doubt. Not to mention the embarrassment.
What interested me was the fact that here was a unit problem that needed an investigation by outside management consultants and resulted in a formal report that publicised a negative pattern and management failures to deal with complaints about that behaviour. How had this situation developed? Was it because the staff had simply decided “this is just the way it is?” or “this is the way we do things here” or a development of negative behaviours that were seen as normal and reasonable to all except recent recruits and outsiders?
Were they simply discounting complaints waiting for these new staff to grow into the culture and adopt the patterns in place? There is no doubt in my mind that staff do this. We don’t see things the same way as an outsider and there is pressure on the outsider to conform. If they don’t these folk are labelled as troublemakers. It is hard to see our own culture. We live it, it is normal and usually from the inside, it works well. We don’t need to be questioned, insulted or doubted.
Being accountable and an ethically valid nurse means we do need to be on our toes and prepared to analyse and evaluate our own patterns. If we are confronted by an accusation we need the resilience to be able to listen and weigh up the facts. Some people accuse colleagues of bullying as a control strategy. They use it to defend themselves from findings of fault. It is a powerful weapon as the person accused can be devastated and shocked. The way to defend yourself, your unit, the organisation is to be proactive and insightful. Develop awareness and willingness to recognise when and if a negative pattern has developed. To be self-aware and prepared to discuss and monitor ourselves and our habits of speech and practices. We have to take responsibility for the culture we create in our workplace and be critical of it. It isn’t enough to recognise bad behaviour we need to be professionally active in working to develop strategies to promote and maintain the ideal culture and behaviour.
The thoughts of this blog are of the individual writer and not necessarily those of the Nurses for Nurses Network. To read our full disclaimer click here >>
The Nurses for Nurses Network provides great information and CPD in a range of easy learning ways on the latest information that Nurses need to know – remember the Nurses for Nurses Network was created by Australian Nurses for Nurses ! www.nursesfornurses.com.au