Dr. Heather Cooke has more than 20 years of experience working in dementia care in both a front-line and research capacity. Her current research focuses on the workplace relationships of front-line care staff, including workplace incivility and bullying. Heather’s work is supported by the Alzheimer Society of Canada, the Michael Smith Foundation for Health Research, and WorkSafeBC.

Q: What led you to begin researching workplace incivility in long-term care?
A:  During a previous research project, I witnessed a staff member verbally abuse a resident while providing care. There was another staff member in the room at the time, and when I spoke with her after the incident, she was extremely reluctant to report the abuse. She told me that if she reported what she saw, her colleague (who carried a lot of informal power in the care home) would ‘make her life hell.’ For this staff member, the workplace repercussions for reporting her colleague’s abusive behaviour outweighed resident safety. That had a profound effect on me. I started to look into workplace incivility and bullying in long-term care and discovered that very little research has been done in this area.

Q: What have you learned so far from your research?
A: While bullying does exist, it’s the workplace incivility that’s more common. With incivility, the intent to harm is much more ambiguous than with bullying. Incivility can include refusing to acknowledge a colleague’s requests for help, giving a colleague the silent treatment, or putting someone down in front of another colleague or resident. Dynamics of power and control underpin both both bullying and incivility.

Q: How do workplace bullying and incivility impact health and safety?
A: If relationships between co-workers are strained, it significantly impacts their ability to work as a team. Either due to incivility or an attempt to avoid it, people resort to working alone. Given the complex needs of today’s care home residents, this potentially puts the residents and staff at risk of injury.  Residents aren’t immune to the tensions that exist among staff, and their behaviour may at times reflect such tensions. As such, workplace relationships get in the way of safe care.

Q: Why do we need to address issues of workplace civility and bullying?
A: There are only a handful of professions where your own safety is so dependent upon your colleagues, and healthcare is one of them. When you show up for work, you need to know that your co-workers have your back so that you can provide quality care, both safely and effectively. Incivility can disrupt workplace culture, affecting staff morale and retention. Given the challenges in finding and hiring qualified care staff, we must ensure that newly hired staff are welcomed and supported. Left unaddressed, incivility significantly impacts the quality of life of staff and residents, ultimately impacting the quality of care being delivered.