Healthy Workforce

Bullying and Retaliation

Taking action when you’re scared to speak up

Illustration of a nurse yelling at another nurse that has her hand covering her face

No matter how hard she tries, new nurse Tameka can’t do anything right for Becky, one of the older, more experienced nurses. Becky constantly picks on Tameka during report and always gives her the worst assignments when in charge. Twice, Becky has told Tameka, “Maybe you’re just not cut out to be a nurse.”

It’s gotten to the point where Tameka gets sick to her stomach when she knows she must work with Becky. Tameka confides to a coworker that she is going to report the bullying nurse. The coworker warns her that others have tried, but Becky just made their lives even more miserable.


Bullying and incivility are familiar problems in healthcare, and yet the bad behavior continues. Part of the reason is that dealing with human behavior is more complicated and less intuitive than dealing with clinical performance. It’s much easier to tell a coworker he needs to work on his IV insertion skills than that he needs to treat you with respect.

However, the biggest obstacle to ending bullying in healthcare isn’t the complexity of human behavior— it’s the victims not speaking up because they fear retaliation.

“She’ll Make Our Lives a Living Hell”

In my experience, this is a more widespread problem than you might realize. At the Healthy Workforce Institute, we’ve talked to thousands of employees about their perceptions of workplace culture.

Here’s just a sampling of comments employees have shared with us regarding bullying in their workplaces:

  • “If we say anything, he’ll find out and make our lives a living hell.”
  • “We’ve referred to the new nurses as the ‘sacrificial lambs’ when it’s their turn to give report to the mean nurses, but there’s nothing we can do about it.”
  • “We don’t want to get her in trouble. We just want her to stop.”

One nurse shared a story that brought me to tears. She had spoken up about a workplace bully who would threaten other employees and whose behavior also made the nurse concerned about the patients.

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The bully was fired after a lengthy investigation that validated the nurse’s concerns, but once the bully was gone, her “buddies” would periodically leave toy rats in the nurse’s chair and on her locker. The nurse told me, “I spoke up and got bit. I’ll never speak up again.”

That’s so, so wrong.

Five Strategies to Protect Yourself

1. Document everything.

I talk a lot about documentation, but it’s really your greatest weapon for ending workplace bullying. Start creating a paper trail as soon as you sense a problem. If the bully or their allies try to retaliate against you for standing up to them, document that too.

Let’s say that after you confront a bully for openly criticizing you in front of others, she gives you the worst assignment. Write this down, including as many details as possible: the date, time, and who was present.

Remember, without evidence, it’s your word against hers, and some bullies are quick to play the victim if there’s any chance of getting in real trouble. Being able to demonstrate a pattern of objectively bad behavior will make it harder for her to turn the tables on you.

2. Link bullying to patient safety.

Any time you can link the bully’s behavior to patient safety, do so! Now, you have some really useful ammunition. Patient safety is on the administration’s radar, which makes it more likely the bully’s behavior will be addressed than if just involved you.

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One nurse told me that a bully took away her trach patient’s call bell and then wrote her up for “not having the call bell close to her patient.” What the bully didn’t realize was that the patient had witnessed the bully moving his call bell and reported it to the manager.

My jaw dropped when I heard this story — what a huge patient safety issue! If I were the bully’s boss, I’d have fired her on the spot.

3. Gather your posse.

There is strength in numbers. Chances are that you are not the only person the bully is targeting. Find others like you and start joining forces: Protect each other, watch each other’s backs and act as scouts for one another.

4. Report the behavior.

The word “retaliation” is hardly ever spoken, which makes it that much less likely anything will be done about it. Tell someone, whether it’s your manager, educator or HR representative. Explain that you are experiencing a bullying situation, but you’ve kept silent for fear of retaliation. Say the word: “RETALIATION.”

This might not help immediately, but it’s a step in the right direction. Imagine if 10 employees approached the manager on separate occasions and shared their concerns about bullying and fears of retaliation. That would get someone’s attention.

5. Speak up anyway.

You might be tempted to say it’s not worth it, but remember that the bully is relying on you and her other targets to think this way. That’s how bullies exert their power over you; fear of retaliation is their most powerful weapon.

Don’t give in to that fear. Tap into your moral courage and speak up. It’s okay to be afraid, but speak up anyway.

As a last resort, if you are working in a toxic environment where you can’t even imagine taking any action against a bully, or if you’ve tried to take action and it didn’t help — GET OUT! Leave. No one should have to work in fear.

RENEE THOMPSON, RN, DNP, CMSRN, is the CEO and founder of the Healthy Workforce Institute. As a speaker, author and consultant, her goal is to eradicate nurse bullying and incivility.


JASMIN MORA is a Los Angeles-based illustrator. Reach her at

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