Bullying in the nursing profession remains commonplace. At its worst, it can have serious negative effects on workers’ physical and mental wellbeing, workplace culture, productivity, and patient care.
Working in fast-paced and stressful settings that typically create pressure cooker environments, nurses and midwives are often exposed to bullying behaviour.
According to the Fair Work Act 2009, bullying occurs when a person or group of people repeatedly behave unreasonably towards a worker or group of workers. This behaviour creates a risk to the person’s health and safety.
Common types of bullying behaviours include aggression, teasing or practical jokes, putting pressure on someone to behave inappropriately, exclusion from work-related events, belittling comments and unreasonable work demands.
It’s also important to note what bullying isn’t. For example, some workers may think they are being bullied when they are, in fact, being performance managed.
Nurses and midwives who experience workplace bullying should talk to a supervisor or manager, a workplace health and safety representative, their Employee Assistance Program (EAP), their union, or contact Nurse & Midwife Support for free and confidential support throughout the process of taking action.
When it comes to reducing workplace bullying, the Australian Nursing and Midwifery Federation (ANMF) believes one potential solution lies in providing clinical (reflective) supervision for nurses and midwives. Ideally, employers should take responsibility for making sure this is available.
What is clinical (reflective) supervision?
The ANMF’s position statement on clinical (reflective) supervision for nurses and midwives defines it as:
“A formally structured professional arrangement between a supervisor and one or more supervisees. It is a purposely constructed regular meeting that provides for critical reflection on the work issues brought to that space by the supervisee(s). It is a confidential relationship within the ethical and legal parameters of practice. Clinical supervision facilitates development of reflective practice and the professional skills of the supervisee(s) through increased awareness and understanding of the complex human and ethical issues within their workplace.” 1
Among other benefits, clinical (reflective) supervision offers nurses and midwives the opportunity to explore how they relate to others in their professional practice and the impact these relationships have on how they feel, think, and act in clinical situations , ANMF Federal Professional Officer and Clinical Supervisor Naomi Riley points out.
“The basis is to actually unpack a clinical scenario and maybe gain a new perspective on what happened in that scenario and look at where you could grow professionally or you could respond in future scenarios that are the same in a more productive way,” Ms Riley says.
“Being aware of how you act and respond to other members of the healthcare team might make the team more cohesive because you’re becoming more aware of your contributions to a scenario and the outcomes and more consciously going to work thinking about how your relate to other people in heightened emotional clinical scenarios.”
The clinical supervisions sessions Ms Riley runs typically go for an hour. They are conducted in small groups, or one-one-one. Generally, clinical supervision is often misunderstood and poorly defined.
“When people hear clinical supervision they think about a clinical education supervisor that supervises students or graduates, they don’t think of it as CPD activity for a qualified person. Alternatively, they think about it as someone who has been performance managed and needs clinical oversight or supervision. The term is really quite problematic.’
In its position statement, the ANMF advocates for regular clinical (reflective) supervision to be made available to all nurses and midwives during work and implemented across every level of the professions. Best practice clinical (reflective) supervision incorporates trust and confidentiality and regular evaluation.
How clinical (reflective) supervision can help reduce workplace bullying
“Embedding it in to a normal part of practice is how we will create more positive practice environments,” ANMF Senior Federal Professional Officer Julianne Bryce suggests.
Having a chance to unpack bullying behaviour within a session may give nurses and midwives the opportunity to confront it and reduce trauma. It can help nurses and midwives feel heard, process the feelings and thoughts that have been triggered by the bullying, and decide what to do next.
“I think over time it changes things,” Ms Riley adds.
“Embedded, regular clinical (reflective) supervision contributes to positive practice environments. If you have it in small groups, achievements and challenges in the workplace are shared. We learn new perspectives on how other nurses and midwives respond to a situation, which develops compassion, cohesiveness, and team work. It also can help nurses and midwives recognise when they need to step away from the workplace because they aren’t managing their relationships at work so well. People become more aware and responsible for how they act in the work environment.”
In its position statement, the ANMF recommends there should be further research undertaken to examine the role of clinical (reflective) supervision in nursing and midwifery, and the impact on individuals, organisational culture, risk management, and consumers of healthcare.
“It’s about being the best health practitioner you can be,” Ms Bryce says.
“We need employers that value and recognise their staff enough to offer these programs.”
- Australian College of Midwives, Australian College of Nursing, the Australian College of Mental Health Nurses Inc. (2019) Position Statement: Clinical Supervision for Nurses and Midwives 2022