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Good Practice: Psychological Hazards in the Workplace

The term psychological hazard may be unfamiliar, but the synonyms abuse and bullying are all too familiar these days. It may surprise you to realize that bullying isn’t limited to the school yard and that a significant number of adults encounter bullying in the workplace. Importantly, bullying and co-worker abuse in healthcare settings can have a serious impact on patient safety as well as staff well-being.

What constitutes a workplace psychological hazard?

The behaviours in question can be subtle or overt, but include:

  • Raised eyebrows or eye rolling
  • Verbal affront i.e., bossy, rude or snide comments
  • Intimidating or threatening behavior
  • Undermining others
  • Withholding information
  • Sabotage
  • Infighting (bickering, rivalry)
  • Scapegoating
  • Backstabbing
  • Failing to respect privacy
  • Broken confidences1,2

If you were surprised by that list, you are not alone. In 2015, the College of Physiotherapists of Alberta and four partner Colleges undertook a survey to gain greater understanding of psychological hazards in healthcare settings. 36% of survey respondents noted that they were surprised by some of the behaviors that constitute a psychological hazard. Of course, context and relationship matter too for some of these. In a generally good relationship, the occasional eye-roll or sarcastic comment may be part of how you relate with each other and be accepted by all parties. But, if the relationship is strained or poor to begin with, or just in the process of forming, then these behaviors can have a negative impact, not only on the people directly involved but also on those who are observing the interaction.

While it would be nice to think that this isn’t an issue among physiotherapists, the survey results suggest that the problem is widespread:

  • 82.7% reported witnessing or personally experiencing some form of co-worker abuse.
  • 48.1% reported that they had experienced abuse themselves within the last year.
  • More than 50% reported experiencing abusive behavior while they were students.3

What are the consequences? Ask yourself these questions:

  • How likely are you to want to go to work if you are experiencing bullying, and what will that absenteeism mean for patient safety and quality care?
  • How does patient-related communication occur properly when you are being bullied by the same person you need to communicate with?
  • How likely are you to walk up to the person you just witnessed bullying a colleague to tell them about a concern you have about their patient, and what could that mean for the safety and care of that patient?

The Joint Commission on Accreditation has found that co-worker abuse contributes to poor patient satisfaction, increases the cost of care, leads to staff turnover, and impairs how health-care teams function.2 The statistics from the patient safety world suggest that communication breakdown is the top contributing factor to patient safety incidents.1,4 While that communication breakdown isn’t limited to psychological hazards, it is easy to see how workplace bullying impacts patient care and safety, with serious consequences for the patient.

If you are a team leader or manager, it would be nice to believe that this behavior wasn’t happening in your office, but with more than 80% of respondents reporting experiencing or witnessing abuse in the workplace, that seems pretty unlikely.3 In fact, 58.9% of respondents stated that they did not report co-worker abuse to their supervisor,3 meaning it probably is happening; you just aren’t hearing about it. The statistics on reporting abuse aren’t very optimistic either, as 67.5% of those who did tell their supervisor reported that it was not successful in stopping the abuse.3

Occupational Health and Safety legislation identifies psychological hazards as hazards that must be addressed in the workplace. Both workers and employers have responsibilities under OHS legislation to address hazards in the workplace.

Unfortunately, just because you are aware of abuse doesn’t mean you have the tools to improve the situation--until now., the website dedicated to this project, provides information about co-worker abuse and offers resources and suggestions for how to address workplace bullying. Ideas include developing a team charter, instituting zero-tolerance for bullying and taking part in the “One Good Thing a Day” initiative.

The first step is awareness, and the video vignettes of workplace bullying help to underscore what co-worker abuse looks like. We suggest you watch them with your teammates in the hopes of improving awareness and sparking a discussion.

It’s time for honest conversation and serious self-reflection about workplace bullying. The repercussions from bullying affect patient care and have the potential to put patients at risk. Let’s get serious about making things better at work. Check out, watch the videos and ask yourself if any of the scenarios look familiar. Take action to make things better for everyone!

That’s Good Practice and it begins with you!

  1. College of Licensed Practical Nurses of Alberta. Practice Guideline: addressing Co-worker Abuse in the Workplace.
  2. The Joint Commission. Sentinel event alert #40: Behaviors that undermine a culture of safety. July 09, 2008. Available from Accessed on December 14, 2015.
  3. Watts Communications. Co-worker abuse member survey: Increasing awareness, recognition, and prevention of psychological hazards-A joint strategy to promote a health work environment for health care practitioners. Edmonton; 2015 (Unpublished report).
  4. Popovich D. Cultivating Safety in Handoff Communication. Pediatric Nurse. 2011; 37(2): 55-60. Available from  Accessed on December 14, 2015.

Page updated: 25/04/2022