Healthy Workforce

The Case of the Bad Day Bully

An isolated harsh incident should be judged in context

Illustration of a nurse being grabbed by the wrist by another nurse, and throwing her clipboard in the air

Staff nurses Camilla and Bridget usually get along. However, today, they got into a heated argument about assignments. Bridget, who was in charge, decided to assign Camilla a complicated new patient. Bridget made the decision based on what she thought was best for the patient, but Camilla didn’t see it that way, accusing Bridget of babying the newer nurses and dumping on her. The argument escalated until Camilla grabbed Bridget by the arm and yelled, “I’m so tired of this crap!” before storming out.


We all know that bullying and incivility are persistent and serious problems for the nursing profession. On the other hand, we also know that even the most competent, highly professional nurse can get testy with his or her coworkers when having a bad day.

Nurses work in stressful environments and we are not always on our best behavior. Sometimes, that can be a sign of a larger problem. However, we are not all bullies! Where does the occasional harsh word or rude exchange like the one between Camilla and Bridget cross the line into bullying? Let’s take look at what bullying is and what it is not.

Bullying Defined

Although there’s no uniform legal definition of bullying in the United States, most experts define it as a repeated pattern of disruptive behavior with the intent — conscious or unconscious — to do harm. In my own work, I’ve developed a three-point definition. I define bullying as disruptive behavior with the following three characteristics:

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For behavior to qualify as bullying, it has to have a specific target, whether it’s a single person or a group of people, such as nurses on the opposite shift (day shift versus night shift), new nurses or those of a different racial or ethnic background. Nurses who are sour to everyone may be uncivil and disruptive, but they aren’t necessarily bullies. On the other hand, a nurse who is nasty to certain people and nice to everyone else might be.


Behavior doesn’t rise to the level of bullying unless it is harmful in some way, whether to the target or to someone else (like the target’s patients!). Some forms of uncivil behavior, like eye-rolling, are not really harmful in any specific way, at least not by themselves. On the other hand, spreading false rumors, undermining a colleague’s credibility and physical assault are definitely harmful.


To constitute bullying, the behavior has to be repeated over time, not just a one-time event. Yelling at a colleague in the midst of a single crisis isn’t bullying, but yelling every time he or she does something wrong might be.

Camilla vs. Bridget

The confrontation between Camilla and Bridget was certainly unpleasant, but does it mean Camilla is a bully? Let’s evaluate the situation based on the three-point definition:

  1. Was there a target? Yes — Camilla’s behavior was directed specifically at Bridget.
  2. Was the behavior harmful? Yes! Camilla physically assaulted Bridget.
  3. Has the behavior been repeated over time? No. They usually get along.

Based on the above definition, this single act of aggression does not constitute bullying. Of course, that doesn’t mean it was okay! Obviously, an argument that results in physical violence absolutely needs to be addressed and should lead to disciplinary action.

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As it turned out, Camilla, who usually behaves in a professional manner, had barely gotten any sleep the night before because her 2-year-old son had spent half the night in the emergency department. She should have called off, but, ironically, she didn’t want to dump on her coworkers. Camilla was just having a really bad day and this was fortunately a one-time occurrence.

I’m not condoning Camilla’s behavior. However, I challenge any one of us to claim that we’ve never done or said something unprofessional when under stress at work. Our responses, both individual and in the context of institutional policy, need to bear that in mind.

Are You Being Bullied?

If you have an unpleasant relationship or nasty confrontation with a coworker, ask yourself these questions:

  1. Am I the only person he or she treats this way?
  2. Is this behavior harmful to me or in some way harmful to patients?
  3. Has he or she treated me this way repeatedly over time, and, if so, for how long?

If you answered yes to all three questions, then you are being bullied! You should document this behavior and seek support from your manager or human resources. If we are going to decrease the prevalence of bullying in healthcare, we have to be very clear about defining what bullying is so we can do our part to stop it.

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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