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We convene for ward round. Whilst reviewing a patient, my specialty registrar colleague, who has significant sight impairment, uses a light to illuminate a vital signs record chart in the darkened Intensive Care Unit. The team discusses the best way to approach supporting the patient we are reviewing. We move on to the next patient. Suddenly, amidst the assorted dialogue about our second patient, I hear another of my junior doctor colleagues ask the specialty registrar “are you deaf as well as blind?”
I have spent considerable time reflecting on the impact this ten second comment had on the individuals, team dynamics and functionality, our training environment, and on delivery of patient care. The conclusion I have always come to is that the comment was unnecessary, extremely damaging and, despite the most effective remediation, had long-lasting effects. Just like every single instance of bullying, harassment or undermining.
It is crystal clear that bullying, harassment and undermining should have no place in our NHS. In our working or our training environments. During meetings or team discussions. Via email or by phone. So #knockitout, #hammeritout and #cutitout.
We know that considerable strides have been taken to change the way healthcare professionals interact with each other, and with patients. Yet concerns remain about the possible extent of bullying, harassment and undermining behaviours. These affect the way we are able to train and provide care, and they affect our wellbeing.
We all deserve to train and to work within a culture that fosters an intolerance of bullying, undermining and harassment. A culture that is inclusive to all. A culture that promotes civility, as reflected in the Civility Saves Lives campaign.
I am aware of how difficult it can be to raise concerns and to challenge bullying and undermining. The opinions stated by many of you both to me, and to Welsh Junior Doctor Committee (WJDC) colleagues, are clear evidence of your worries that raising concerns via mechanisms such as the GMC National Training Survey may jeopardise your training or make a bad situation worse. However, we are all witnesses and advocates. As one profession, we can challenge negative behaviours and make the NHS a safer and more effective environment for all. We can all promote positive culture change by:
The BMA, in acknowledgement of the negative impact that bullying, harassment and undermining can have on both safe delivery of care and our own wellbeing, are driving a project, led by Dr. Anthea Mowatt, which aims to raise awareness, destigmatise bullying and the bullied and emphasises how unproductive and damaging bullying, undermining and harassment are for patient care and our NHS. You can read more about the project here and here.
Further information and reading: