Healthy Working Behaviours in Healthcare

Informal Peer Support Group

Usually, you will not be the only person to have been bullied by a perpetrator. An informal peer support group can include those friends or colleagues who have also been bullied or know about the bullying individuals/department that you are experiencing but can also include colleagues or friends who are not in your department, specialty, or hospital.

What is important is that you are all comfortable to talk openly within your group and that members respect the confidentiality of what is revealed. It can be useful to meet outside the workplace.

It can be beneficial to know somewhere where informal meetings can occur outside of office hours and at short notice in a ‘crisis’ moment. The basic benefit of an informal peer support group may be just to hear others reassure you that the bullying activity ‘is not your fault.’

Formal Support Group

Every NHS Trust and Health Board has an Occupational Health Department that you should refer to if you are feeling unwell, stressed, anxious or depressed by bullying at work. By self-referring you can retain your confidentiality right of the Occupational Health department not to share your clinic attendances and outcomes with your departmental management team. However, if you are requested to attend Occupational Health by your clinical leaders or management team then Occupational Health may be obligated to keep the referring managers informed of your attendances and outcomes.

Outside of the workplace you can seek help from your GP if you feel that your mental or physical health is being impaired by the bullying at work. Your trade union (e.g. the BMA) will have counsellors and staff to support and represent you at meetings with your employer about the bullying activity that you are experiencing.

Negotiation Skills

In the high pressure, high intensity surgical workplace, informed negotiation skills can be used to diffuse potentially volatile situations, minimising the risk of resentment, anger, and negative behaviour.

Negotiation aims to reach a mutually acceptable compromise which prioritises patient care without threatening a workplace relationship. It can be informal or formal, and in common with other non-technical skills for surgeons (NOTSS), principles can be learned and skills honed.

Tactics suggested from the Communication Toolkit: Negotiation Skills, a Working in Health Resource published by NHS Education for Scotland include.

• Focusing on the aim of the negotiation, not the minor details. Set clear objectives. Determine the interests of the other party (what they need) rather than their position (what they say they want).

• Conducting discussions in a calm, non-confrontational manner. Inviting a neutral third party to sit in on the negotiation (or to take on a more formal role, such as chairing a negotiation) may reduce the risk of confrontation.

• Developing ideal, realistic, and fall-back negotiating positions in advance, and try to predict the other party’s positions. The area of overlap is often the area of agreement. Be pragmatic.

• Being an active listener. Demonstrate that you empathise with the concerns of the other party.

• Ensuring that any set deadlines are realistic.

• Considering all options and exhaust all possibilities before determining the final agreement.

More information on negotiation skills in the NHS can be found here.

Additional Sources

The Baker’s Dozen of Mental Toughness is a toolkit developed by Cardiff University and Welsh health officials to build resilience and improve well-being under stress, often aimed at healthcare workers. It provides a suite of resources to strengthen psychological, emotional, and physical toughness for enhanced performance.

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