Musings on bullying in health care

Stay tuned: Revisions are likely to occur

Today, the last day in February, is #pinkshirtday in Canada, a day to stand up to and prevent bullying of any kind. Taking a stand against bullying with pink shirts began in 2007, when on his first day of school, a student wore a school pink polo shirt and bullies called him a homosexual for wearing pink and threatened to beat him up. Two other students decided enough was enough and began a 'sea of pink' campaign.

Earlier this month a biomedical scientist (aka clinical or medical laboratory scientist, medical laboratory technologist) working as a senior manager in the Haematology and Blood Transfusion department of a hospital in Dumfries, Scotland was suspended for 18 months after a campaign of bullying abuse, creating a 'culture of fear' in the workplace for over five years (Further Reading).

The full transcript of the UK Health and Care Professions Tribunal Service hearing of the Registrant's case is online (Further Reading). The Allegation, Finding, Order, Notes are well worth reading.

ALLEGATIONS
Just a few of the many allegations made against the Registrant:

• Said to colleagues in the blood bank, 'Am I talking a foreign language?! Or am I working with a bunch of  f*cking thickos?!'

• Referred to a colleague's flat shoes as 'lesbo' shoes.

• Sent a text message to a colleague describing another  colleague as '‘a f*kin lying *rse wipe sh*te'.

• Asked a colleague to sign off his competency log despite the fact she had not witnessed his competencies. 

• In the presence of another colleague 
• Referred to a colleague as a 'b*tch' ;
• Threatened to slash a colleague's tyres; 
• Referred to having a 'hit list' of people he would pay back. 

DELIBERATIONS
The Registrant did not attend the hearing despite five months notice and instead submitted a written response to the allegations. Some he denied and a few he sloughed off a merely banter. All but one allegation was found to be proven. The witnesses were found to be credible.

The issue was whether the proven charges of serious professional misconduct, including dishonesty, and creating a “culture of fear” were enough to be stricken off the Registrar or if some other sanction should be applied. Be aware that the purpose of a sanction is not to punish, but to protect members of the public and to safeguard the public interest.

The factors considered by the panel as mitigating factors are fascinating and informative. One that struck me in particular:

• The Registrant’s increased workload appeared to increase his stress levels and cause a deterioration in his workplace behaviour.

Increased workload is a reality for clinical labs everywhere these days and has been for decades. Under the umbrella of cost effectiveness and cliches like 'working smarter, not harder', staff have long been expected to do more with less. Does it create stress? Of course, but I'm unsure that's a valid mitigating factor for abusing staff.

In Canada, CSMLS's CEO Christine Nielsen has said that 35% of society members report feeling stressed or burned out on a weekly basis while on the job (Further Reading). Educating new staff becomes difficult as finding clinical placements in short-staffed laboratories becomes increasingly onerous. The situation is complicated by an aging workforce and is likely to get worse before improving. 

The news item reveals the hearing's outcome, an 18 month suspension. To me this case is an ideal candidate for teaching professionalism to students in all health disciplines. If you are like me, you've experienced and witnessed bullying and unprofessionalism at work.

Sad but it happens in health care more often than we like to admit. And how often do we do something about it, given those bullying are usually in positions of authority?

As always, comments are most welcome. We have some - see below.
FURTHER READING

Dumfriesshire scientist suspended for 18 months for bullying staff (13 Feb. 2018)

UK Health and Care Professions Tribunal Service hearing (Jan. 29-Feb. 2, 2018) | See Allegation, Finding, Order, Notes

Medical lab technologists across Canada feeling the pressure of high job vacancies (15 Feb. 2018)

Musings on review of CBS as an employer by a Donor Care Associate

Updated: 26 Feb. 2018 (expanded the ending)

Decided to write shorter blogs, perhaps one each week. We'll see how it goes.

I've always known shorter blogs were the way to go, because transfusion professionals, like most folks these days, are busy. Busy in their work lives, family lives, and often overwhelmed by the onslaught of digital input, whether via texting, e-mail or social media.

But I credit the motivation to write shorter blogs to a UK transfusion professional who tweeted about the blogs of Mary Beard: A Don's Life. Somehow I'd missed them.

So the first short blog is about a review of Canadian Blood Services by a 'Donor Care Associate" which I came across on my @transfusionnews twitter account. I'll begin with my tweets.

If you click on the review and get 'sign in with'...just click on the text outside the request or access the review here.

CBS gets good reviews as place to work, many from volunteers vs staff or ex-staff. As #transfusion instructor I valued criticism >than praise (which I got lots of) with aim to improve
"Donor Care Associate" https://t.co/838ivD9rlb

— Cyber Bloodbanker (@transfusionnews) February 23, 2018

Now we can choose to dismiss such reviews because they're anonymous. For interest, many folks I know hesitate to critique employers until they retire and are no longer subject to a backlash.

Several points the reviewer made peaked my curiosity. First:

Follow-up on Donor Care Associate review of CBS. They need to meet phlebotomy stats? Really? ~To evaluating #transfusion service med lab techs on no. T&S or XMs done w/o taking into account patients with antibodies https://t.co/838ivD9rlb pic.twitter.com/Gn0qLIh9YJ

— Cyber Bloodbanker (@transfusionnews) February 25, 2018

Second:

Management tactic has long history in AB 🇨🇦's clinical labs. Has it ended & now transferred to Donor Care Associates, among most vulnerable? I always saw this as disgusting way employers exploit staff then brag how cost-effective they are, while drawing 6-figure salaries pic.twitter.com/1dYA1ZcRhF

— Cyber Bloodbanker (@transfusionnews) February 25, 2018

Note that the reviewer worked at CBS part-time for 3 years and included several pros about working for them. Frankly, I cannot dismiss her Cons as outright lies. In general, criticism works best if it contains helpful and specific suggestions for positive change.

In my teaching career, I'd explain to students that feedback is an indispensable tool to help both instructor and learner improve and, when given feedback, model appropriate responses such as, "Thanks for telling me that."  When MLS students entered their clinical internship year, I'd explain that they can improve only if supervisory staff tell them when they are doing something wrong or doing something that needs to be improved.

Can CBS take criticism in the same vein? (no pun intended)

As always comments are most welcome.