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• W1938342224 abstract "Although bullying and harassment occurs in many industries, the continuum of medical education means that the medical profession faces some unique challenges. Bullying and harassment is considered a ‘workplace’ issue,1 yet it often occurs in the context of ‘training’ overseen by a specialty college. As outlined by Jamieson et al.2 in this edition of Emergency Medicine Australasia, dealing with bullying and harassment as a trainee is often a particularly arduous experience. This article provides practical advice for ACEM and other specialty trainees in recognising and responding to inappropriate workplace behaviours. In late 2013, the Australian Government amended the Fair Work Act 20093-5 by introducing explicit national workplace bullying laws. This included a statutory definition of bullying (Box 1) making it unmistakable that this behaviour is illegal.5 Employers now have a public duty to identify, eliminate and prevent this conduct, while reporting is now streamlined.6 The Act also outlines that ‘reasonable management action’ does not constitute bullying (Box 2).6 Also note that some types of bullying and harassment are criminal offences and you would be within your rights to report these to the police. These include violence, assault and stalking. The Health and Safety in Employment Act 19927 in New Zealand mirrors this anti-bullying legislation. ‘Workplace bullying means any behaviour that is repeated, systematic and directed towards an employee or group of employees that a reasonable person, having regard to the circumstances, would expect to victimise, humiliate, undermine or threaten and which creates a risk to health and safety’. Repeated refers to the persistent or ongoing nature of the behaviour and can refer to a range of different types of behaviour over time. Systematic refers to having, showing or involving a method or plan. Whether behaviour is systematic or not will depend on an analysis of the circumstances of each individual case with this general guideline in mind. Risk to health and safety includes the risk to the emotional, mental or physical health of the person(s) in the workplace. The first step in dealing with bullying and harassment is to identify how these behaviours might evolve in different settings and to differentiate these from what might be assertive management at an administrative or training level. For example, a feedback session with your Director of Emergency Medicine Training (DEMT) might be critical of your performance and appear unfair, giving the perception of bullying; in fact, it falls under the ‘reasonable management action’ definition. It is important for you to differentiate these subtleties as both take different paths. To give you an idea of what bullying can appear like in the emergency medicine setting, Figure 18 gives examples of incidents described by victims of bullying in medicine, and Figure 2 gives some specific examples of what bullying can look like in the emergency medicine setting. Examples of incidents experienced by victims of bullying. Adapted from Workplace Bullying in the NHS.8 Examples of bullying in the emergency medicine setting. Constructive criticism can sometimes be mistaken for bullying or harassment. It can make you feel vulnerable, expose weaknesses and reveal emotions that can be similar to those experienced when one has been bullied. Being able to address criticism in the right manner will not only alleviate these sentiments, but also improve individual performance.9 This is not to say that negative feedback provided as part of the training processes cannot ever be considered bullying. Regardless of the intent, if it is delivered poorly (e.g. in a non-empathetic manner or using flawed evidence), trainees might consider that they have been bullied or wronged. An accompanying article written by emergency medicine (EM) educators outlines how supervisors can minimise the chances of making trainees feel bullied when providing them feedback.10 Lindsay succinctly summarises six key points in her article ‘Taking Constructive Criticism Like a Champ’.11 Advice such as ‘don't analyse the assessment … understand the assessment’ and her methods on how to deconstruct feedback can often take the emphasis off the negativity and enhance the productivity of your feedback. Once you have identified that you are being bullied or harassed there is a stepwise process that is outlined by the FairWork Commission (FWC)6 and adapted in Figure 3 for the EM trainee. A stepwise approach to dealing with bullying as an Australasian Emergency Trainee. It is essential that you have evidence to support your assertions. This is even more important should you find yourself in the unfortunate situation of needing to escalate your claims. The FWC suggests keeping a diary of events with as much detail as possible, including when/where, who was responsible and how you felt. Record the names of witnesses willing to support you if needed. Keep any related correspondents including abusive letters, unfair comments, screenshots of social media, text messages, emails or recorded interactions.6 Raising your concerns and handling your complaint informally and locally is the first and often only step required in addressing bullying. This starts with approaching the offender, articulating the unreasonable conduct displayed and asking for appropriate actions to remunerate current and circumvent future behaviour. Under no circumstances should you retaliate to a bully – bullying perpetuates bullying. If it is not safe to approach the offender, or if you do not feel comfortable doing so, then seeking a third party is the next step. Within EM training we are afforded the luxury of appointed mentors, DEMTs or regional censors to advise, advocate and mediate. Having these third parties involved early will also help with your evidentiary support if the process requires escalation. If you or your elected third party are unable to reach a mutual resolution, then you need to review the local policy within your hospital or community centre on how to formally report bullying. Most pathways lead to another third party meeting, usually with someone possessing workplace health and safety experience, in order to maximise the opportunity for resolution internally. If a policy is not readily available or does not exist, your Director (or if they are the offender, their supervisor) are the next port of call to enter into discussions as the third party. ACEM also has a policy opposing bullying.12 This policy holds all members of ACEM accountable (regardless of employer). In ACEM's procedure for the resolution of bullying,13 they advise that informal contact with the chief executive officer (CEO) is an alternative process without having to resort to external means. This can be formalised with a written letter to the CEO to expedite a formal investigation.13 Trainees working in New Zealand should also understand that if mediation requires escalation to an external process, the employer will file the internal process as a ‘personal grievance’ as per the Workplace Relations Act. This has implications on future employment, as you are often required to disclose personal grievances against a previous employer during an application process. To assist in resolving the matter internally and avoid a personal grievance being lodged, gaining legal advice early will ensure that your claims are taken seriously by the employer to allow for a more robust mediation process with clear intentions for resolution. In some circumstances the bullying behaviours might be serious or escalating quickly, and the internal process might have failed or not be viable, either because you might not have anyone to help mediate or you might be unsatisfied with the resolution process. If this is the case, there are a variety of agencies that can assist depending on your country of employment. If the situation arises that you need to lodge a formal complaint the FWC have made available a streamlined application6 to stop bullying in the workplace. You are also able to contact the Australian Human Rights Commission14 if the bullying involves discrimination. You can also obtain advice about your circumstances, your rights and the protection you have against bullying via WorkCover, the FWC, the Commonwealth FairWork Ombudsman or a variety of non-government organisations. Note that non-government organisations in Australia are generally able to support you in an advisory capacity only. EM trainees employed in New Zealand have the benefit of the New Zealand Resident Doctors’ Association (NZRDA) who can support you during both the internal and external process including taking on legal cases.7 Given the strength of this union, it is recommended that you seek help from the NZRDA during internal mediation and before proceeding with governmental processes. If you are not a member of the NZRDA the New Zealand government have outlined a clear stepwise process of escalation.15 If none of these strategies help resolve your circumstances, it is best to seek legal advice. It should be highlighted that in some circumstances of bullying and harassment, including those where there is a large power differential, the behaviour is serious or you are concerned the employer does not have your best interests, it is safer to engage legal advice early (before informal internal processes), regardless of your intention to follow the advice through to court or not. If the behaviour is discriminatory, you should also have a low threshold for engaging legal advice early. As a specialty passionate about patient advocacy, coupled with our cognitively and emotionally burdensome environment, we can sometimes inadvertently portray the bully without meaning so. As individuals we must demonstrate insight into these behaviours so that we can continue to contribute to a culture invested in eliminating bullying in the workplace. Bystanders can either be part of the bullying problem or an important part of the solution.16 Being a ‘supportive bystander’ is another critical element in changing the culture. If you identify that someone is being bullied, you can advocate for your colleague using the process above. Bullying, by definition, ‘creates a risk to health and safety’.5 It comes in all shapes and sizes, sometimes obvious and, in medicine, often covert. The attempt at resolution using the steps above add further strain to an already vulnerable demeanour. When this does occur it is important that you remember and prioritise what you are working towards – your health and well-being, because if you have lost sight of this, the bullies have won. VT is Chair of the ACEM Trainee Committee and a section editor for Emergency Medicine Australasia." @default.
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• W1938342224 date "2015-08-28" @default.
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• W1938342224 title "Dealing with bullying and harassment: A practical guide for Australasian emergency medicine trainees" @default.
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