Workplace bullying in Healthcare: Why it’s not just “bad apples”
Workplace bullying in healthcare is often explained away as an issue with a few individuals:
Difficult personalities; poor behaviour; “bad apples.”
But when 70% of nurses report experiencing bullying, harassment or abuse, as highlighted in recent Nursing and Midwifery Council survey findings, that explanation does not hold.
That is not isolated behaviour.
That is a pattern.
And patterns point to something bigger.
The default response organisations take
When workplace bullying in healthcare is identified, organisations tend to respond in familiar ways:
Training programmes
Policies and procedures
Values statements
Behavioural frameworks
These actions feel logical. They are structured, visible and manageable. But they often fail to change what is actually happening in teams.
This is because they target individuals and not the system those individuals operate within.
What I see in healthcare teams
When I am brought in to work with teams, the issue is rarely about one or two people.
It is about what the team has learned.
Over time, teams develop shared expectations about:
Who gets challenged
Who does not
What happens when someone speaks up
These expectations shape behaviour far more than formal policies.
How culture shapes people's behaviour
In teams where workplace bullying in healthcare is present, people are constantly observing their environment.
They notice:
Which behaviour is tolerated
Whose voice carries weight
What happens to people who raise concerns
These observations drive adaptation.
People adjust how they behave to stay safe.
How people adapt in unsafe cultures
When speaking up feels risky, people do not stop seeing problems. They stop raising them.
You often see:
Silence in meetings
Concerns shared informally rather than openly
Issues escalated through side conversations
Reliance on “safe” individuals or informal networks
People are not passive.
They are managing risk.
Why harmful behaviour continues
Workplace bullying in healthcare is rarely sustained because people agree with it.
It is sustained because it goes unchallenged.
When behaviour is not addressed:
It becomes tolerated
Tolerance becomes expectation
Expectation becomes normal
This shift happens gradually.
Often without being explicitly acknowledged.
How patterns become normalised
Over time, unchallenged behaviour shapes team norms.
People begin to assume:
“This is just how things are done here”
“It’s not worth raising”
“Nothing will change”
At this point, the culture reinforces itself.
New staff quickly learn what is safe.
And the cycle continues.
Why the NMC findings matter
The recent findings from the Nursing and Midwifery Council highlight:
Workforce pressure
Unsafe staffing
High levels of bullying, harassment and abuse
These issues are often discussed separately, but they are connected. Because culture shapes how pressure is experienced and managed.
In environments where:
Behaviour is not challenged
Influence sits in the wrong places
Speaking up carries risk
Problems do not stay contained.
They spread.
This is not just a behaviour issue
Organisations often treat workplace bullying in healthcare as a behavioural issue.
That leads to solutions focused on:
Individual accountability
Training interventions
Formal processes
These have a place, but they do not address the underlying drivers.
Because behaviour does not happen in isolation.
It is shaped by the system around it.
The systemic nature of the problem
When bullying, harassment and abuse reach high levels, the issue is no longer individual. It is systemic.
It is embedded in:
Team norms
Power dynamics
Informal networks
Psychological safety
At this point, addressing individuals alone will not shift the pattern.
What organisations need to pay attention to
If you want to understand workplace bullying in healthcare, look beyond incidents.
Look at patterns.
Ask:
What behaviour is consistently tolerated?
Who is able to challenge, and who is not?
What happens when concerns are raised?
Where does real influence sit?
These questions reveal how the system is operating.
Shifting the focus from behaviour to culture
Reducing workplace bullying in healthcare requires a shift in approach.
From:
Managing individual behaviour
To:
Understanding and changing team culture
This means addressing:
Informal power
Unspoken rules
Psychological safety
Team norms
Because these factors determine what is reinforced.
Final thought
When 70% of staff report bullying, harassment or abuse, the issue is not a few individuals.
It is what the system allows.
What is tolerated becomes normal.
What is normal becomes embedded.
And once that happens, organisations are no longer dealing with behaviour.
They are dealing with culture.
Nicole Williams is an occupational and coaching psychologist specialising in culture repair, team dynamics and psychologically safe workplaces.
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