Managing challenging behaviours

The stressful nature of a healthcare environment can result in difficult behaviours and may lead to workplace conflict.

By approaching challenging behaviours in the workplace with some tools, as well as a positive attitude and assertiveness you can reduce the risk of conflict occurring.

Nurse & Midwife Support Stakeholder Engagement Officer Mark Aitken says when you drill it down, workplace conflict is often related to stress.

“Workloads, lack of staffing or adequate staffing such as the use of agency or grads who are hitting the ground running.”

Sadly but not surprising bullying and harassment in the workplace, which we have long known about, are major issues, says Aitken.

“We have heard on masse for a profession that at its core is caring, nurses and midwives are often not very good at caring for each other or even caring for themselves.”

“There may be an element of not feeling cared for or asking why should I care about anyone else? With burnout there is an element of compassion fatigue which is multifaceted.”

There is also frustration for some people who have worked in an area for too long or for those who are no longer functioning in their job, says Aitken.

There are tools to equip nurses and midwives, in particular students and early career nurses to deal with challenging behaviours, he says.

“We have an opportunity to empower our younger, newer nurses, by providing student and graduate nurses with the tools, for example to have assertive conversations and negotiation skills in interactions with difficult people whether that be a patient, patient’s relative or work colleague.”

Educating nurses and midwives on how to call out inappropriate behaviour and to know its ok to do so, is a start.

“To call people on their behaviour, put it out there ‘let’s discuss it’,” says Aitken.

‘I’m not sure if you know it but you are talking to me in a way that’s not in line with our organisation’s vision’ or simply ‘stop talking to me this way’. Most bullies when confronted will back down. It’s often when you call it they realise the gravitos of the situation.”

Some other tips on dealing with challenging behaviours include:

  • Be respectful when approaching people with challenging behaviours.
  • Be assertive and honest – ask the person if they are ok (they are probably not).
  • Talk to your manager or team leader.
  • Contact Nurse & Midwife Support or the employee assistance program if this behaviour is affecting you.
  • Do not use personal attacks, instead describe how the behaviour makes you feel.
  • Don’t raise your voice or use closed body language – this may escalate conflict.

Nurse & Midwife Support provides free and confidential support 24/7 to nurses, midwives and students Australia wide. If you’re struggling with conflict and need some support you can call the NMSupport confidential support line 24/7 on 1800 667 877 or visit

Although it sounds “preachy”, Aitken also suggests to try to eat and sleep well and maintain a work/life balance.

“It’s important to focus on your health and wellbeing before you reach the point where you are phoning in with a crisis. That’s often hard when nurses and midwives are often juggling work, family and other responsibilities.”

One Response

  1. This is a well written article with good general advice if you are dealing with people who are receptive to improving workplace culture.
    Collected data from the OCPE workforce surveys in this area has shown that most healthcare cases of bullying & harrassment comes from middle & senior management in the healthcare setting with HR/ Workforce services departments being implicit in their behaviours in supporting the inappropriate behaviours of managers towards employees.
    When employees refer to policies & procedural guidelines to assist with addressing these issues ie zero tolerance to bullying, etc,
    Unless there are strong advocates within the organisation standing behind these pieces of documentation then that is all they are.
    It is very sad that it appears to take a Coronial investigation into a bullied employees suicide
    to bring into the light these ongoing problems which then once again with time become forgotten until the next sad event.
    Hindsight gives us the opportunity to improve our organisational commitment to addressing these events better but sadly we do not and are not legally forced to do this effectively to make any beneficial long lasting changes only recommendations.
    * 2017- Coronial investigation into the death of Paula Schubert
    A 24hr nurse/ midwife helpline is helpful but not the answer. Trusted Nurse & Midwife mentors within organisations are needed to support students, junior staff & those dealing with difficult workplace behaviours as well as a commitment from those above to have a known open door policy, listen & intervene where required.

Leave a Reply

Your email address will not be published. Required fields are marked *

Want more? Read the latest issue of ANMJ



Advertise with ANMJ

The ANMJ provides a range of advertising opportunities within our printed monthly journal and via our digital platforms.