Bullying: A Pathological Issue

Over the past few decades, workplace bullying has increasingly found itself a focal point in social and scientific communities as it has moved from the realms of taboo to a widely known social stressor.¹ However, despite the uptick in attention, it remains an extensive problem—a 2021 report by the Workplace Bullying Institute highlighted that the issue affects 49 percent of the US workforce, with 30 percent directly experiencing bullying in their work lives.² Unfortunately, the health sector is not immune to this issue; studies have found that bullying is prevalent among nurses,³ residents,⁴ and other medical professionals of all levels,⁵ and that it is a major factor behind individuals’ leaving the healthcare workforce.⁶ Considering the staffing shortages currently befalling pathology and laboratory medicine (PALM), how common is bullying in the clinical lab? What toll does it take, and what can be done to combat it?

A big bullying problem

“More than 68 percent of clinical laboratory employees report being victims of workplace bullying,” says Lotte Mulder, PhD, director of leadership and empowerment at the American Society for Clinical Pathology (ASCP), referencing a study she co-authored that explored the prevalence and impact of bullying in PALM.⁷ The extent of negative workplace behaviors experienced by over two-thirds of clinical lab practitioners is concerningly greater than in other healthcare settings; compared with non-laboratory professionals working in US hospitals, the occurrence of daily or weekly bullying incidents against those working in the medical laboratory was higher for all but three types of negative behavior. Mulder explains, “We saw that the three most common types of bullying experienced by the pathology workforce are individuals’ having their opinions ignored, being exposed to unmanageable workloads, and being personally ignored or excluded, which impacted 88, 82, and 79 percent of this group, respectively.” Although these forms of bullying were also prevalent among other healthcare professionals, clinical lab staff were exposed to these behaviors at a much higher frequency.

For those at the receiving end of such mistreatment, the consequences can be severe—and can manifest in several areas. “We see that absenteeism and the number of sick days reported are significantly higher among bullied individuals,” Mulder says. “Chronic exposure to bullying is linked to suppressed immune function and increased susceptibility to illness.”

The health impacts of exposure to workplace bullying don’t stop there; victims also experience lower mental wellbeing and higher susceptibility to mental distress, anxiety, depression, post-traumatic stress disorder, and burnout arising from their experiences,⁸ as well as higher rates of chronic headaches and pain.⁹ However, an individual doesn’t need to be the direct recipient of mistreatment to suffer ill effects; people who witness bullying can also suffer increased stress, problems with sleeping, and other health issues including headaches and fatigue.¹⁰ For clinical laboratories, this ultimately leads to employees who are significantly less fulfilled in their work, are less able to effectively carry out the duties of their jobs, and who are more likely to eventually leave.

“The wider effects of bullying in the clinical lab extend to several areas, from patient outcomes—where longer laboratory turnaround times for important tests potentially affect patient care—to further exacerbation of staffing shortages, because we know that a high prevalence of bullying can lead to increased turnover and recruitment challenges,” Mulder warns.

Standing up to bullying

What can be done to combat the high rate of bullying in the clinical laboratory? The first step is being aware of the issue and having the ability to recognize behaviors that constitute bullying—something educational efforts can support. “Laboratory managers and administrators can provide resources and educational seminars as safeguarding steps to help the workforce understand and manage bullying,” Mulder says.

Such efforts can also equip employees with a better understanding of the characteristics of clinical laboratory bullies. According to Mulder’s study, perpetrators are most likely to be a victim’s peers (an experience shared by more than half of all respondents) or a direct supervisor or manager (almost one in four respondents). Witnesses recalled that the most common motivators driving the acts committed were racism (cited by 36 respondents), toxic work environments (28 respondents), discrimination (26 respondents), microaggressions (26 respondents), and COVID-19-related stress (25 respondents).

However, better education is only part of the battle. “Laboratories need to establish a zero-tolerance policy towards bullying and create a supportive work environment within their labs, doing so with a genuine commitment from top to bottom to addressing workplace bullying,” says Mulder. Of particular importance is ensuring that effective systems for reporting bullying incidents are implemented, publicized, and accessible—something she says appears to be untrue of most workplaces:

“Close to 70 percent of our participants indicated that there is no reporting structure and 80 percent said that their workplace does not openly discuss the issue.” This lack of openness and support with respect to workplace bullying not only enables it to continue, but can emphasize the negative effects experienced by unsupported victims. The research team established that laboratory professionals who worked in a supportive environment that provided resources to prevent bullying experienced higher job satisfaction and took significantly fewer sick and mental health days. This is why Mulder also encourages clinical lab professionals to take action to support themselves and others: “Build support networks within the workplace for mutual support against bullying.”

Turning the tide

Ultimately, bullying hurts everybody. That’s why combating it is a task for everybody—and one that must be addressed quickly. “The research underscores the urgent need for comprehensive anti-bullying policies and supportive work environments to enhance employee wellbeing and retention,” Mulder says. Although the current landscape of bullying in the clinical laboratory is bleak, it is not set in stone. Its high rates can be reduced, but to do so, those who have the power to prevent bullying can no longer remain silent. The clinical laboratory works consistently to identify and overcome pathologies—and, based on the revelations of recent research, bullying needs to be added to the list of diseases it tackles.

References:

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