Respectful Relationships in the Maternity Service Maggie O ’ Brien Maggie O ’ Brien Midwifery Director Midwifery Director Auckland District Health Board Auckland District Health Board

Defining Attributes of Bullying Repeated nature of the behaviour Repeated nature of the behaviour Negative effect of behaviour on the victim Negative effect of behaviour on the victim The victim finds it difficult to defend themselves (power imbalance) The victim finds it difficult to defend themselves (power imbalance) The intent of the bully The intent of the bully Gillen et al 2004

Signs of an Intimidating Culture Anything different is automatically wrong and ‘ unsafe ’ Anything different is automatically wrong and ‘ unsafe ’ Those who do not conform are automatically wrong Those who do not conform are automatically wrong Hierarchical ‘ pecking order ’ Hierarchical ‘ pecking order ’ Poor decision making Poor decision making

Effects of Intimidating Culture High turnover of staff High turnover of staff High level of complaints High level of complaints De-skilled workforce De-skilled workforce Low morale and self esteem amongst staff Low morale and self esteem amongst staff

Forms of Intimidating Behaviour The use of terror tactics, open aggression, threats, shouting abuse and/or obscenities towards their target. The use of terror tactics, open aggression, threats, shouting abuse and/or obscenities towards their target. Subjected to constant humiliation or ridicule, belittling their efforts, often in front of others. Subjected to constant humiliation or ridicule, belittling their efforts, often in front of others.

Cont…. Removing whole areas of work responsibility from the person, reducing their job to routine tasks which are well below their skills and capabilities. Removing whole areas of work responsibility from the person, reducing their job to routine tasks which are well below their skills and capabilities. Deliberately withholding information which the person requires to do their job effectively. Deliberately withholding information which the person requires to do their job effectively. Refusing reasonable requests for leave, training, etc., or blocking a persons promotion. Refusing reasonable requests for leave, training, etc., or blocking a persons promotion.

Cont…. Ostracizing and marginalizing their target, dealing with the person only through a third party, excluding the person from discussions, decisions, etc. Ostracizing and marginalizing their target, dealing with the person only through a third party, excluding the person from discussions, decisions, etc. Setting the person what they know are impossible objectives, or constantly changing the work remit without telling the person and then criticize or reprimand them for not meeting their demands. Setting the person what they know are impossible objectives, or constantly changing the work remit without telling the person and then criticize or reprimand them for not meeting their demands.

Cont…. Subjecting their targets to excessive supervision, monitoring everything they do and being excessively critical about minor things. Subjecting their targets to excessive supervision, monitoring everything they do and being excessively critical about minor things. Constantly taking credit for the other person ’ s work but never taking the blame when things go wrong. Constantly taking credit for the other person ’ s work but never taking the blame when things go wrong. Spreading malicious rumours about them and making personal remarks Spreading malicious rumours about them and making personal remarks

Physiological Effects of Intimidating Behaviour Headaches/Migraine Headaches/Migraine Sweating/Shaking Sweating/Shaking Feeling/Being sick Feeling/Being sick Irritable bowel Irritable bowel Raised blood pressure Raised blood pressure Inability to sleep Inability to sleep

Psychological Effects of Intimidating Behaviour Anxiety Anxiety Panic attacks Panic attacks Depression Depression Feeling of dread Feeling of dread Tearfulness Tearfulness

Behavioural Effects of Intimidating Behaviour Becoming irritable Becoming irritable Becoming withdrawn Becoming withdrawn Becoming aggressive Becoming aggressive Increased consumption of tobacco/alcohol Increased consumption of tobacco/alcohol Obsessive dwelling on the bully and seeking justice or revenge Obsessive dwelling on the bully and seeking justice or revenge

Personal Strategies for Dealing with Intimidating Behaviour Support any member of staff that you believe is being intimidated. Support any member of staff that you believe is being intimidated. Discuss with colleagues and make intimidation unacceptable Discuss with colleagues and make intimidation unacceptable Make it clear to anyone who displays intimidating behaviour to you that you will not accept it. Make it clear to anyone who displays intimidating behaviour to you that you will not accept it.

Organizational Strategies for Dealing with Intimidating Behaviour All managers at every level must make it clear that intimidation will not be tolerated. All managers at every level must make it clear that intimidation will not be tolerated. All allegations should be taken seriously and every effort made to resolve issues informally All allegations should be taken seriously and every effort made to resolve issues informally All staff should be made aware of the support of HR and the counseling service All staff should be made aware of the support of HR and the counseling service