Friday, November 14, 2008

"Tell Everyone!" (Part 3 of Workplace Psychological Abuse)

( I recommend reading Part 1 at http://leonardnolt.blogspot.com/2008/04/looking-at-work-abuse.html and Part 2 at http://leonardnolt.blogspot.com/2008/08/gap-part-2-of-workplace-psychological.html before reading Part 3.)

This is the third in a series on the experiences I had at my previous employer, Saint Alphonsus Regional Medical Center in Boise Idaho, where for the last app. two and a half years I worked there (Jan. 2004 until Aug. 2006), I was the consistent target of a bully, the "adult" workplace version of what many of us had to endure, or witnessed in grade school or junior high. Saint Alphonsus (often called St Als) is a part of Trinity Health, headquartered in Novi, Michigan. In this part of the series I will encourage those who are being, or have been, the target of bullies in the workplace to speak out and tell others. I will also address the part denial plays in this kind of situation. Often management simply refuses to acknowledge the problem exists, even when, as in my case, there is documentation that someone is being injured, and patient care compromised as a result of the bully's behavior. In addition I want to introduce a few of the findings of the 2007 WBI-Zogby Survey on Workplace Bullying.

This "adult" bully was a woman who I was responsible for supervising in the Respiratory Care Department where we both worked. Our respective job descriptions made it necessary for us to communicate with each other. She consistently targeted me with psychological abuse in various ways, including by making derogatory comments about me to others, making false accusations against me, refusing to communicate with me, pretending I didn't exist, and withholding information I needed to do my job. Her behavior daily jeopardized patient care.

I first reported the bullying to management in the spring of 2004, and when nothing was done to address the problem, kept reporting it repeatedly throughout the rest of that year. I sought help from an Employee Assistance Program counselor who diagnosed me with Post Traumatic Stress Disorder (PTSD) as a result of the bully's harassment. In January of 2005 I began a series of reports, first to the Human Resource Department, and later (in August) to Senior Management. In May of 2005 a manager from Human Resources requested the names of co-workers who might know about the conflict, so he could conduct an investigation. I gave him the names of approximately twenty people. Later in the middle of the investigation he sent me an urgent "high priority" e-mail asking me to not ask those twenty people if they had been contacted, or if they participated in the investigation. I followed that request. However when, weeks later, I was ordered to never talk to anyone about the investigation, I began to get suspicious. How does talking about an investigation in August change results obtained three months earlier in May?

As I did more research into the problem of bullying and the way businesses respond to it, I became aware of a couple new (for me) discoveries. I found out that investigations are conducted, not necessarily to find out the truth about what happened, but to protect senior management and the company from blame, liability, or any exorbitant expense associated with the conflict. It's clear that the investigation conducted into the conflict I was having fell into that category. No sincere attempt was made to find the cause of the problem. It's my impression that the investigation was manipulated to get pre-determined results. After the investigation, several people came to me and reported what they told the manager. Their reports contrasted drastically with what the manager told me in a very sparse verbal report I received at a meeting, scheduled by me, before the investigation was over. I was promised a written report of the investigation as well as a chance to discuss it with the department manager, but the written report never arrived, and when I requested it, the request was emphatically denied. The meeting to discuss the investigation with the department manager was never scheduled and didn't happen.

The part denial plays in this kind of situation is the second discovery from my research. Many companies, for a variety of reasons, try to deny that they have a bullying problem. That's certainly one reason why I never received a report of the investigation. Since then a member of senior management told me that I never should have been promised a report of the investigation, or expected one. But if the investigation is being done to get to the root of the problem, how can withholding the findings of the investigation contribute to solving the problem? The Workplace Bullying Institute (http://www.bullyinginstitute.org/) under 2007 WBI-Zogby Survey states: "Bullying is a Public Health Hazard." If that's true then the more everyone knows, the safer everyone will be. To protect the public, public health hazards have to be publicized.

Several times I was ordered to not talk about the conflict. This was part of management's attempts to enforce their policy of denial. On Oct. 4, 2005 in a meeting with him, the manager from Human Resources ordered me to lie about my PTSD injury if asked. Denial also seems to be a factor in the willingness of managers to even listen to someone who is reporting the problem of bullying. I think denial was a factor in the department manager claiming that the PTSD injury I was diagnosed with as a result of the bullying, was "petty." Surely he knew better. Before he met with me the first time on Jan 14, 2005 the manager from Human Resources refused to listen to my side of the story, and before our third and last meeting on Oct 4, 2005, he let me know ahead of time that I would not have any opportunity to respond to the information given at that meeting.

At no time was I given an opportunity to defend myself against the false accusations of the bully, not in front of the bully nor in front of any member of management. Although I requested the information, I was never told exactly what her accusations against me were. In fact I got the impression that management didn't even know for sure what the problem was. The Human Resource manager told me a couple times that there was "some ambiguity" about the bully's charges. Of course! Anyone who has done their homework on bullying in the workplace knows that ambiguity is a typical characteristic of a workplace bully's abusive behavior. The whole point of a bully's behavior is to be a bully. The bully will not provide management with precise information because that would make it easier to resolve the conflict. Then the bully will have to find another target. One of the chief characteristics of a workplace bully's behavior is "the refusal to be specific about criticisms" (from "Bully in Sight" by Tim Field, Page 41).

The writings of Marie-France Hirigoyen in her book "Stalking the Soul: Emotional Abuse and the Erosion of Identity," emphasize the fact that bullies refuse to be specific about criticism and also refuse to talk about the problem:

"Emotional abuse in the workplace goes through different stages, all of which have the
refusal to communicate as a common theme."...."By refusing to label and therefore discuss
the conflict, the abuser obstructs finding a solution."..... "Withdrawal from discussion is an
effective means of aggravating the conflict..." (Page 62).
"Abuse is perpetrated by the refusal to acknowledge what is happening, discuss the
situation, or jointly find solutions. If the conflict were out in the open, discussion would be
possible and a solution might be forged."........ "An effective way of aggravating the conflict is
avoiding dialogue, which silently imputes blame on the other person. The victim is
refused the right to be heard.".... "This refusal of dialogue is a way of saying, without directly
expressing it in words, that the other person.....doesn't even exist" (Page 96).

Hirigoyen make it clear that in any bullying situation, the person who refuses to be specific about criticism, and who refuses to participate in a resolution process should be assigned the responsibility for the unresolved conflict. Also note that when things are out in the open, a solution is more likely, so prescribing censorship is unwise and harmful. When someone suffers a psychiatric injury, such as PTSD, as a result of bullying, a responsible resolution will include the needed mediated dialogue between bully, target, and management, even if the injury occurred years before. Psychiatric injuries require a much different treatment than physical injuries. Unlike most physical injuries, treatment for psychiatric injuries have to take the cause of the injury into consideration.

On Aug. 29, 2005 I received an e-mail from a member of senior management ordering me to not talk about this issue with other employees. She was the third member of management to order me to not talk about this potentially disabling on-the-job injury. Managers claimed that information about the bullying was "confidential," but the truth is that their efforts to silence me were acts of censorship. It was, and still is part of their denial of the problem. Talking about the problem is necessary to raise awareness and prevent others from being injured. Managers of a medical center ordering employees to not talk about a PTSD injury that occurred on the job at their institution are acting as irresponsible as public officials prescribing censorship about mosquitoes and West Nile Virus, or about cases of mumps or measles in the neighborhood. Communication raises awareness and protects people while censorship endangers the public. With such overwhelming evidence, why would management deny that there was (and still is) a bullying problem at St. Alphonsus Regional Medical Center? Here are a couple possible reasons. Perhaps because they are not interested in, and have no training, skills or experience at addressing the problem. One reason is because some managers are bullies and they see bullying by them, or by others as a way of using fear to help keep employees "in line." Certainly a manager threatening an employee with termination for reporting a serious and potentially disabling injury, as the manager from Human Relations did to me on July 18, 2005 when I reported the PTSD to him, is guilty of a severe act of bullying.

What does it mean when management imposes censorship on employees concerning a public health menace like bullying? It means that managers are acting exactly as child molesters and pedophiles act when they tell their victims to not talk about the harmful and abusive treatment they are experiencing. Workplace psychological abuse is at the same place now that child abuse was fifty years ago. Half a century ago child abuse was hidden, denied, not talked about, and the victims who reported it were not believed. Now targets of bullies in the workplace face the same dilemma. Despite more than two dozen reports to them that I was being seriously injured on the job by a psychologically abusive co-worker, at no time to this day (Nov. 18, 2008) has any member of any level of management at St. Alphonsus responded, addressing that problem. Their "response," if you can call it that, is one of complete denial. What's the solution to this denial? The solution is to defy the censorship orders and "tell everyone!" You keep telling and telling until people wake up and address the problem. The solution is the same as the solution for child abuse. In her book for children "Something Happened and I'm Scared to Tell: A Book for Young Victims of Abuse," Patricia Kehoe writes on Page 11; "You tell and tell until somebody listens." Other authors on child sexual abuse echo Kehoe. In "Everything You Need to Know About Sexual Abuse," Evan Stark writes "Tell someone who can help you about the abuse," and also "Keep speaking up until you get the help you need to stop the abuse" (Page 7). Stark also writes, "Keep telling people you trust about sexual abuse until someone listens" (Page 24), and "...if you have been sexually abused, speak up" (Page 40). A pedophile tells his victim to not talk about it so the molester can continue to abuse his victim. A manager at St Alphonsus who tells an employee injured by a bully to not talk about it, as I was told at least half a dozen times by management at St Als, is doing exactly the same thing to the victim of bullying, as the pedophile does to his victim. Such orders have the effect of giving the abuser permission to continue to abuse his/her victim. In situations of sexual, physical, or psychological abuse, ordering the victims to be quiet about the abuse is medically inappropriate. Silence always supports and encourages the abuser.

The comparison between child abuse and psychological abuse in the workplace is a valid one. Numerous titles on bullying compare the emotional harm done to the victim of a bully with the emotional harm done to a rape or torture victim. (For one example check "Bully in Sight" by Tim Field, pages 6, 50, 317-318, 323-324). Judith Wyatt and Chauncey Hare in "Work Abuse: How to Recognize and Survive it," write that bullying in the workplace is "one of the most severe forms of emotional abuse anyone can experience" (page 13), and they also tell us that anyone bullied at work has experienced it as "a life-threatening event" (Page 158). They write that the experience of being bullied at work "is very similar to the impact on a child who is beaten every day" (Page 68). Wyatt and Hare also emphasize the destructive impact that a policy of denial, such as the one that exists at St. Als, has on the victim of bullying. They write, "Living under continual attack in an everyday setting and having it denied is a nightmare. It is a horrifying experience that depletes trust in the world and in one's perceptions of reality..." (page 68).

Psychological abuse is as serious as sexual and physical abuse. Bullying is a personal attack on another person's health, safety, and professional integrity. Bullying is an act of violence. Talking about it is necessary to raise awareness of the problem. However the target of bullying in the workplace who talks about it will probably lose his job as a result. It's important for any victim of bullying to realize that before he/she speaks up. An employer will not long tolerate an honest employee who is exposing the employer's dirty secrets. An employer who tolerates bullies is a bully. The Zogby Survey reported that "in 62% of cases, when employers are made aware of bullying, they escalate the problem for the target or simply do nothing." The report goes on to say; "It must be said that doing nothing is not a neutral act. When a person asks for relief and nothing is done, the employer becomes the bully's accomplice, whether deliberately or inadvertently, by allowing it to continue." My experience at Saint Als confirms those findings. Although I was initially targeted by a co-worker, it wasn't long before management became a part of the problem. I reported the problem to management numerous times but nothing was done to stop the bully. It seemed as if management consistently tried to support the bully. I requested a professionally mediated conflict resolution process with the bully to try to resolve the problem. It was denied by management because the bully "didn't think it was necessary." I have an e-mail I received from the Respiratory Care Department manager which states, and this is an exact quote; "If she (the bully) can accept your presence on her shift, then there is no issue other than for you to do your job" (Italics mine). He sent that to me more than six months after it had been documented that I was suffering from Post Traumatic Stress Disorder (PTSD) as a result of the bully's harassment. To management the fact that one employee was intentionally causing a serious injury to a co-worker was "no issue." Is it surprising that bullying is such a problem at St. Alphonsus? I'm no longer working there, having been forced to leave because I was gradually becoming disabled by the bullying, but the bully is still there, and is now on day instead of night shift, which many would see as a promotion. The department manager who wrote that the fact I was being injured on the job with PTSD was "no issue,' is still there, and has received a significant promotion. Upper level managers who knew I was being injured and did nothing, are still there. The Zogby Survey confirms my experience at Saint Alphonsus by reporting that targets leave, and bullies stay.

The 2007 WBI-Zogby Survey is a valuable source of current information about workplace bullying. It can be found at http://bullyinginstitute.org/zogby2007/wbi-zogby2007.html. There are numerous interesting findings of the Zogby Survey, and most of the findings confirm my experiences at Saint Alphonsus. Thirty-seven percent of American workers have been bullied at work according to the poll. Being the target of a bully is an eye-opening experience. Although I knew little or nothing about workplace bullying before I became a victim of it, I was forced to learn rapidly and, in a few months, read eight or ten texts and scores of articles on the topic. That new information made me aware of how common the problem is at St Als. By the time I left Saint Alphonsus, I knew of half a dozen other employees who were having the same experience, or who had just left for the same reason I was leaving. I only knew approximately 250 employees at St. Alphonsus and most of them superficially. So with 37% of Americans workers having experienced the violence of being bullied and with app. 3,000 employees at Saint Alphonsus, you can calculate how big the problem is at St. Alphonsus. The Zogby Poll found out that 40% of the targets of bullying never complain. At St. Alphonsus undoubtedly that percentage is higher, perhaps much higher, especially if employees know what happened to me, as many do since I reported it to hundreds of them after I left Saint Alphonsus. Reporting it was the responsible action to take since, as the Zogby Poll reports; "Bullying is a public health hazard," Forty-five percent of the targets had detrimental health effects from the bullying. The number of days I missed work annually for health reasons doubled after I became the target of a bully. By reporting it, at least I helped to raise awareness, which will make it easier for others to defend themselves if targeted by a bully, and hopefully avoid a serious injury like PTSD. Unfortunately they still cannot safely report it since management at St. Alphonsus Regional Medical Center has yet to demonstrate any commitment to addressing the problem.

There is no question that management at Saint Alphonsus is capable of acting responsibly with regard to the problem of bullying. They have the ability to learn how to recognize bullying and help eliminate it from their workplaces. They can develop the skills needed to properly help victims of bullying, including protecting them from additional injury, and providing the kind of treatment that detoxifies the hostile workplace and creates a safe working environment for the injured employee. It's likely that high quality, experienced employees are being lost to bullying, probably by the dozens, each year. It's a matter of choice. Will they choose to address the problem, or will they continue to be a part of the problem? This can and should be seen by management at Saint Alphonsus and Trinity Health as a great opportunity to take the lead in addressing the problem of bullying in the health care sector, which is one of the areas where bullying is most common.

When an employee at St. Alphonsus falls down the stairs and breaks his leg, the employer will offer the required treatment in the emergency department and, if necessary, also as an inpatient. The injured employee will be allowed enough time to recover, and will be given an opportunity to provide input on how the accident happened, and on what could be done to prevent a re-occurrance. But if an employee suffers a psychiatric injury like PTSD as a result of intentional mistreatment from a co-worker, the victim will still be scheduled to work with the abuser, the victim's request for a change of schedule and a resolution of the problem will be ignored, as will his request for time off to recover from the abuse. He won't be offered any treatment. From Jan, 14, 2005 when I first reported the PTSD injury to Human Resource Management at Saint Als, (which was 20 months before I left St. Als), until today, almost four years later, I have had to seek, obtain, and pay for all my treatment for PTSD myself with no help from St Alphonsus. In a meeting with him on May 19, 2005 I requested compensation from a Human Resource manager for the PTSD injury and the expense it was costing me. He promptly denied it. Later I requested, from a nursing official, the forms needed to complete and apply for compensation. She told me that the only forms they had were for patients and covered only physical injuries. That says something about how primitive the care for a relatively common psychiatric injury such as PTSD is at Saint Alphonsus Regional Medical Center, which advertises itself as the "Center For Advanced Healing." Management has completely refused to acknowledge that I was injured, even though the first diagnosis of PTSD was made by Saint Alphonsus, as occurring on the job at Saint Alphonsus! To draw a parallel, if St. Als treated the broken leg the way they treat PTSD, they would let the injured person lying at the foot of the stairs indefinitely, ignoring his cries for help. The injured employee would have to drag himself to the nearest "other" health care facility for help. He would be threatened with termination if he talked about his broken leg, and how it happened, to other employees. He would be ordered to not report the fracture, and fired if he reported it to management. He would receive no days off work. He would be expected to show up at work and continue to do the same quality and quantity of work as before, and even work with the person who pushed him down the stairs!

Why is the response to bullying and on-the-job psychiatric injury at Saint Alphonsus so primitive as well as hopelessly irresponsible? Because management at St. Alphonsus has yet to take the problem of bullying and workplace psychological abuse seriously. Recently a vice-president told me that management has a lot more awareness of the problem as a result of the information I sent them. That's nice, but actions speak much louder than words, and so far there has been no action to address the problem and no accountability from managment at Saint Alphonsus with regard to those who have been injured and are still dealing with PTSD and the accompaning issues. We can only hope and pray that the Center for Advanced Healing at Saint Alphonsus Regional Medical Center will soon live up to its name and begin to apply some healing to the serious problem of psychological abuse on their campus.


Leonard Nolt



Next: Part 4 - Find out what happens when a responsible health care professional and citizen reports a public health hazard to the public. The title is "A Knock at the Door"