Season 2: Episode 2: Dr. Renee Thompson - Reducing Workplace Bullying & Incivility

Thank you for joining me for another episode of the Nursing Strategies for Success podcast with this week's guest, Dr. Renee Thompson. Dr. Thompson is the CEO and founder of the Healthy Workforce Institute and works with healthcare organizations to cultivate a professional workforce by addressing workplace bullying and incivility. So let's welcome Dr. Renee Thompson to the show. Welcome to the Nursing Strategies for Success podcast, brought to you by The Nurse Speak, a show where we rally some of our nation's greatest nurse leaders, educators, experts, and advocates to tackle some of our greatest challenges that the nursing profession faces. My name is Damion Jenkins, and I'm your host for this show. So sit back, relax, and get ready to learn that nurses can do anything. Okay, Dr. Renee Thompson, thank you so much for being on the Nursing Strategies for Success podcast. Why don't you just take a moment and introduce yourself to the listeners? Let them know a little bit about who you are, where you started in nursing, and where you are today.

Yes. Well, thank you so much, Damion, for inviting me to your show. I'm really excited to be here today. And, you know, I know you introduced me already, but yeah, I've been a nurse for a really long time, a little over 30 years, and I've pretty much done everything that you can do as a nurse, you know, inpatient, outpatient. I was an educator. I worked for a managed care company. I've been a frontline nurse manager, of course, at the bedside. And then I was in an executive role. And you know what? I realized that it didn't matter where I worked or what role I had, there was always a group of, at the time, other nurses who I swear made it their mission to make my life difficult. And I just thought, working in healthcare, you know, especially now, is hard enough. Without your coworkers making it harder. And we've all heard, you know, nurses eat their young, and well, that's just the way it is in nursing. And I had a moment where I just said, enough is enough. Someone has to do something about it. And I thought, you know what? Looks like that someone will be me. And I quit a really great job that I love to start my own company with the intention to really eradicate bullying and incivility in nursing. And then I realized it wasn't just nurses, it's all of us. And now, 10 years later, uh, I am the CEO and founder of the Healthy Workforce Institute. We're actually the only company in the world dedicated to eradicating bad behavior in healthcare alone. Damion, we don't have to go outside of healthcare. We are plenty busy right here in healthcare. And so it's just such a problem, and it's actually gotten worse over the last couple of years, right?

Well, I mean, and we have good reason for tensions to be high. I think the general public has a much better understanding of the craziness that we have to deal with on a day-to-day basis, and then seeing the sheer lack of support when it came down to crisis mode, right? And then, you know, who is in the fire the entire time but the nursing staff? You know, yes, doctors were there too, but, you know, really all of the tragedies and you know, MacGyvering and figuring out how to do things with limited resources always has fallen on the nurse. And so I'm sure, uh, your business has been booming with the increased, um, tensions that are going along. And so, you know, so you, you talked about you've been a nurse for a long time and you identified this. I'm sure you identified this pretty soon in your career, probably almost in your new grad training, right?

Absolutely. Student nurse.

Right. So what point did you decide enough is enough? I have to do something about this. How many years in were you?

I was in about 20 years. And this is when I was in an executive role. And I was tasked with the challenge of developing a homegrown nurse residency program. And now we have these certified programs that people sort of purchase.

Sure.

But I was responsible basically for professional development for an entire health care system. There was about 10,000 nurses. Developing a residency program was one of my responsibilities. So I did a lot of focus groups. I talked to student nurses, new nurses, preceptors. I talked to a lot of nurses in that early stages of their careers because even though we started having some of those studies that looked at, you know, transitioning nurses into professional practice, I wanted to hear from our nurses in our communities. And I thought they would talk about how they needed to be oriented and the clinical tasks that they needed more help with and all of that. And Damion, all they wanted to talk about was how badly the other nurses treated them.

Mm-hmm.

That's all they wanted to talk about, whether they were a student nurse, a brand new nurse, a nurse who had been practicing for 2 years. That's all they wanted to talk about. And as I listened to their stories, It reminded me of my own stories. And it didn't matter, as I said, what role I was in, even at the executive level, there was always someone who was trying to set me up to fail. And we don't have time for that anymore. We have no extra time and energy when we come into work to worry about someone who we're working with making things difficult. So I decided that was it. No more was I going to accept nurses eat their young, although now we eat our young, our old, and everything in between.

Anything we can get our hands on.

I know. Wow.

So, you know, I find it so surprising knowing you, you know, and working closely with you that it took you 20 years to be like, okay, this is enough. And I think a lot of it is because, you know, when we're in the trenches and doing the work, we're focusing on just, you know, getting the job done. And sometimes when it comes to those essential skills like effective communication or how to disrupt, you know, bad behavior and those types of things, um, you know, that's not the priority when we have to meet patient care needs or when we have to, you know, balance a budget or when we have to hire or fire and things like that. Um, but yeah, nursing school, same for me. I identified these bad behaviors. I came into nursing as a second career, uh, nurse, and so I already had 15 years of hospitality, you know, industry experience at the manager corporate level. So I already knew a lot of these essential skills and how to disrupt bad behaviors and how to hold people accountable when they're misbehaving, when they're being a bully, or when they are trying to intimidate others for no good reason. And there's really no good reason. Um, and so when I came into nursing, I got met with a lot of resistance because people were like, who are you? You're just a new nurse. What do you know? This is the way it's always been. And I'm like, well, the way it's always been is wrong. So let me, let me inspire and educate and role model how it should be done. And when I met resistance by leaders who refused to change, then I left. And that's what happens. And this is what's continuing to happen is when we're faced with, you know, an uphill battle and we're not getting the support we need, we're leaving. And you know, the pandemic has cost healthcare institutions so much money because we're losing nurses. And I have colleagues who are in great positions, even executive positions, who left those positions to go do travel nursing because they're paying 3 times the amount in salary, right?

No, you're absolutely right. And, and although some of those travel nurses are getting beaten up, beaten up by the people who are there who are angry that they're— the travel nurses are making so much money and, um, they're not. And so it's such a complicated problem, it really is. There's no linear solution to any of this. I just try to remind people that you can be angry, frustrated, stressed out, all of those things, but it's still no excuse to be cruel to another human being.

Yes.

You know, it's still not an excuse to be cruel to people. And so I also hold out hope that we've seen— not to this level though, so I don't want to minimize, you know, what's happening right now— but we've seen these ebbs and flows in our profession over the years. And then there's a shortage and people going to travel, and then they come back because— and then there's no travel jobs, and then there are issues, and then they travel. It, it's the ebbs and flows of our, our profession, although it's never— we've never seen it at this point where we're in— we're definitely in crisis mode.

Yeah. So, okay, so we know that workplace bullying and civility has always been a problem. That's what has gotten you into a very successful business, and, you know, your focus on how you can use your nursing expertise to help, you know, create nicer work environments, because really that's, that's where we are right now. A lot of us have received some reprieve from toxic, toxic work environments because we're working remotely now because of the pandemic. But many of us are starting to go back. We're starting to be called back into the office. And with tensions high, there has to be strategies that we can implement to mitigate workplace bullying and incivility, because we all have the capacity to do it, right? And one thing that I want to point out to the listeners as they learn more about you is that you don't just point out the bad behaviors, you help people to identify when they are also, you know, being the bully, or when they are potentially, you know, treading that line of being uncivil in the workplace. And so I really like the work that you, you do and the strategies that you have in place. So let's talk about how did you develop these strategies to help other organizations, you know, improve their workplaces so that they can have happier staff, don't see so much turnover. And so that, you know, that's not the number one thing people are talking about when you're trying to put together a residency program.

Well, exactly. And so 10 years I've been doing this work. I will try to condense and just give you a couple of core foundational strategies. However, I do want to first just have a short conversation about my transition when I started this work. My focus was nurse to nurse. How does one coworker address being bullied by another coworker? And I had nurses reaching out to me every single day asking for help. And in many of the conversations, it ended up centering on, I've already complained to my manager and my manager has done nothing about it.

Mm-hmm.

And I kept hearing this over and over again. And truth be told, Damion, I was a frontline manager once. I was new to an organization, new to leadership. And within 2 weeks, I found out that my department was the worst, had the worst reputation of any department in the entire 700-bed hospital. And I was the 6th manager in 6 years. You know, did they tell me that when they interviewed?

Of course not.

No. And when we were talking, you mentioned earlier about we don't train people in how to do this. We train all these other things in nursing, but we don't teach people what to say to somebody who's being incredibly disrespectful to you in the moment, you know, in front of other people. Right. And what I realized was Nobody helped me as a leader be able to address the disruptive behaviors of my employees. And after 14 months, I became manager number 7, and I quit. I couldn't handle it. I had no idea how to address behaviors, and I don't use this word frequently, but toxic behaviors, like impacting patient care toxic behaviors. And for years, I felt like a failure until I got older and wiser and realized, nope, I'm not a failure. I just wasn't equipped. And so I transitioned from helping that nurse to nurse to really making sure that their leaders are equipped with the skills and tools that they need to address disruptive behaviors of the healthcare professionals. It's not just nurses, it's everyone. Because I don't know about you, but I worked with a nursing assistant, and let me tell you, she ruled the roost, and you did not get on her bad side, or you were, you know, made to suffer.

Definitely.

And so it's the entire healthcare team. So I work primarily with leaders who can then empower their employees to be part of the solution. Everywhere I go, and when people ask me, what can we do about it? What do I do at 2 o'clock in the morning when I'm being treated in a way that's, you know, I consider bullying? Or, um, you know, how do I deal with a leader who's the bully? And I always get asked these questions. It all boils down to One primary issue and one of the number one reasons why bullying and incivility continue in our healthcare systems, and it's because we've normalized bad behavior to the point where we just accept it as the norm. Oh, that's just the way she is. Or, oh, that's just my personality. You know, I'm not puppies and flowers like you. I'm— I've had people say, I'm direct. I just tell people the way it is. Like, oh my God, you're abrasive and everybody's afraid of you. This isn't being direct. This is aggressive.

Right.

And, you know, I try to remind people that if any one of us on the healthcare team isn't comfortable communicating with anyone else on the healthcare team, it stops the flow of information.

Absolutely.

And when we stop the flow of information, that affects someone's mom or spouse, partner, child, or precious grandbaby. And, you know, going back to the whole, you know, the way we treat each other is just as important as the care that we provide. So we have to start unnormalizing deviant behaviors and start paying attention to that clinically competent, brilliant nurse who's meaner than a junkyard dog and stop accepting that and justifying and rationalizing that behavior. But what do you do? So that's what we work on, okay? But what do you do when someone say is yelling at you, pointing their finger at you in the middle of the nurse's station, calling you an idiot, or, you know, oh, the stories I could tell. The first and the easiest strategy is just to name the behavior. That's it. You're screaming at me in front of everyone else. You just called me an idiot. Especially if you're in a patient care room, you're yelling, you're criticizing me in front of our patients. Can we step out?

Right.

But it's just naming the behavior. And you know what's even more powerful, Damion Jenkins, than— let's say I'm working with you and you, you know, criticize me when I'm giving you report, you know, you're such an idiot, you know, you're never going to last here, what were you thinking, you know, becoming a nurse. What's more powerful than me naming your behavior— is for the witness. Yeah. The most powerful intervention to stop the cycle of bullying is for the witness to speak out on your behalf. And I do this technique. It's very powerful. It's based on brain science. And when you said, how did you learn all of this? I have been studying human behavior for decades. There wasn't a class that I went to, to learn this. It's just from a collection of understanding the way humans behave and how it shows up and what do you do about it. But when we look at addressing someone's behavior, it can be as simple as, well, there's two things that you do. First, you wanna give a visual cue. So I like to do the timeout symbol, like timeout, because it catches their attention. Grabs their attention because it's a visual interruption. So timeout. And then you can say something like, you can name it or say, the way you're talking to me right now is really rude and disrespectful and you need to stop it.

Right.

And do the same thing if somebody, especially this is really powerful. I've seen physicians, nurse practitioners, charge nurses, leaders, anyone, okay, fill in the blank. Be really rude to someone who's sitting at that desk, the unit clerk, okay, somebody in a supportive role, yelling at them, it's for you to do the exact same thing. Time out. The way you're talking to— and here's the key, Damion Jenkins, say the person's name. The way you're talking to Susan right now is rude and unprofessional, and you need to stop. And then go and support Susan. So it is the number one most powerful, simplest thing to do. You're not counseling them, right? You're not getting into some, you know, dissertation with them. You're just naming their behavior. So you got to identify what the behavior is and then just name it.

Wow. That's so effective. And I know that's effective because I've learned that that's the way to deal with these types of behaviors myself. And then, you know, learning the work that you do and following, you know, your advice, You validated what I've learned along the way. And I, you know, I deal with a lot of nursing students. And so, you know, we're really focusing on these essential skills that they need to be successful as they transition into practice. And it's so easy for us to focus on how we feel about the behavior. And that often leads you nowhere, right, when you're focusing on your feelings of the behavior. But by naming the behavior, That's focusing on the actual problem, which is staying within our role as nurses, remaining objective, and just kind of staying in that lane. Because if you use too much subjectivity, then you really can't measure that, and it gets really muddy. So yeah, naming the behavior, that's really, really powerful. Thanks for sharing that.

Yeah, and you brought up the feelings thing. I don't disagree with this. When you do this, I feel that. It's not that I disagree with it. That. But if you're dealing with somebody who's either, let's just say, unprofessional, may not be mentally healthy, they don't care how you feel, right? And therefore, being that objective, it's, it's not so much about how you feel about it, it's their behavior and how inappropriate it is. Like, this is what you're doing, you need to stop it, right? And be clear about it, you know. And I think sometimes that's a better approach.

Yeah, absolutely. You know, I agree that when you share your feelings with your colleagues and friends, family, that, that that, you know, again validates kind of the relationship or the synergy between you. But again, when we're in, uh, an objective environment— and as you said before, you've been a manager and you've had nurses come to you with problems— but if your nurses aren't coming to you with facts or data that you can measure, there's not much you can do about it despite how awful they feel about a certain thing. So I just found that we all have our emotions, our emotions are valid, But if we don't offer measurable solutions or identify the actual problem in a measurable and objective way, then we just wind up running in circles.

Right, right. And I think it's a more— and it's a clear message to the person who's behaving in a way that's disruptive that, you know what, we're not going to play this game. Uh-uh, we're not doing it. Yeah, this gives you the upper hand, right?

This isn't about Damion not liking someone, right? This is about Damion acting unprofessionally.

Bingo. Period.

Exactly. So awesome. That's a wonderful strategy. Um, and I know you offer so many more. And for everyone listening, Dr. Renee Thompson has incredible videos on YouTube, very much free for your consumption. Um, lots of resources on the website. So, you know, let's talk about how people can learn more about you, your services, and the resources that you've created surrounding this very important work.

Well, thank you. Thank you for asking that. This has been a 10-year journey, and we're always looking at adding support, services, resources to the people who need them based on the current, you know, environment. And so we've really grown into an entire institute. As you mentioned, one of the first places I would go would be my YouTube channel. And all of this you can find on my website is healthyworkforceinstitute.com. And we do, we call it a Coffee and Conversations video twice a month. And it's really geared to that coworker to coworker situation where I'm just sitting in my loft having a cup of coffee, talking about bad behavior, but giving really practical strategies. We also have a community of healthcare professionals that we send additional tips and resources out to either every Tuesday or Thursday, depending on if you're at the bedside or if you're in a leadership role. And that's all free. You know, the YouTube is all free. All my social media platforms obviously are free. And then we have some other ways if somebody wants to, to go a little deeper. The easiest and probably the best thing to do is I written a few books on, you know, bullying and incivility. My first one was called Do No Harm Applies to Nurses Too, and this is strategies to protect and bully-proof yourself at work. The person who I wrote that book for is that brand new nurse.

Yeah.

Who was starting their first job and might not feel comfortable or prepared if they encounter any type of hostility from the existing, you know, their colleagues. And so I wrote that book for them. But then I've evolved and I wrote a book just for frontline leaders because it's both. It's the people at the bedside and it's their leaders who, who need to learn the strategies. And then I have a whole online academy. We do a lot of consulting, speaking, training. It goes up from there. So anything you're looking for, chances are we have it. So I'd love for you to just come over to the website and check it out and let us know what we can do to support you.

Awesome. Thank you so much for sharing all of those valuable resources. I will have all of the ways that people can connect with you in the show notes of this episode, including links, um, to your books, your YouTube channel, your website, all of that good stuff. So, um, thank you so much for being on the Nursing Strategies for Success podcast today. I really appreciate the work that you're doing, the strategies that you've shared.. And I cannot wait to get to hang with you in person again in the near future. Thank you so much for being on the show.

Oh my gosh. Thank you for having me, Damion Jenkins. It's really been an honor just spending some time with you and your listeners. And just as a reminder to everyone, the way we treat each other is just as important as the care that we provide. Thanks so much.

Awesome. Thank you so much. We'll talk soon. And that concludes episode 2 of season 2 of the Nursing Strategies for Success podcast with this week's special guest, Dr. Renee Thompson. I will have all of the ways that you connect with Dr. Renee Thompson in the show notes of this episode. And as always, if you have any questions about anything we covered, you can go to thenursespeak.com/contact and get in touch with me. I would love to have a conversation with you. So until next episode, take care, be well, and remember that nurses can do anything.