Disruptive behavior, bullying, incivility, disrespectful behavior, etc. all describe basically the same thing – bad behaviors that should never occur in healthcare. Although similar, there are subtle but clear differences.

Disruptive behavior

Disruption means to separate or create a divide. Common words used alongside disruption are “wild, unruly, or undisciplined”. When we think of disruption in healthcare, we tend to think of someone or something that is stopping the flow of care. This disruption can be a person (patient or coworker) or a situation (unexpected admission or additional duty). However, in the context of disruptive BEHAVIORS, we can easily see how frequent disruptions (and disrupters) can impact work relationships and lead to negative work environments.

According to the Joint Commission, the following represents disruptive behaviors:

• Reluctance or refusal to answer questions, return phone calls, or respond to pages
• Physical threats
• Verbal outbursts
• Impatience with questions
• Refusing assigned tasks
• Uncooperative attitudes during routine activities
• Condescending language


Being uncivil basically means you are being rude, inconsiderate, and generally have bad manners. A teenager occupying a seat on the bus who doesn’t give up his seat for an oncoming elderly female; a coworker who interrupts you mid sentence to interject her opinion; or a friend who is consistently late for dinner or other events (my personal pet peeve), etc. The term incivility is generally the term we use to describe bullying in the academic environment too. However, using the term in this way isn’t really accurate.

Common behaviors in the workplace that can be considered uncivil:

• Condescending body language
• Texting or talking during someone else’s presentation
• Mocking a co-worker
• Jamming the copier
• Gossiping
• Treating someone like a child

Note: The American Nurses Association does a really nice job defining incivility and bullying.

Incivility is one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them.

Bullying is repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient.

Bullying behaviors

Bullying is the repeated patterns of destructive (disruptive, uncivil) behavior with the conscious or unconscious attempt to do harm.
When you look at the list of the disruptive and uncivil behaviors, they can all be considered bullying IF repeated, there is an intent to do harm (conscious or unconscious), and there is an intended target.

Why is this important to understand?

Many nurses refer to their coworkers as bullies or say that they are being bullied when the reality is; they are working with a coworker who is being uncivil or disruptive in the moment. Not everything is bullying and when we call everything bullying, we lessen our chances of addressing true bullying.

The next time your coworker behaves in a way that you believe is rude, inconsiderate, or offensive. Pay attention and ask yourself these questions:

Do they behave this way frequently?

Do they only behave this way towards select people (maybe you and not anyone else)?

Is there an underlying intent to do harm (remember, conscious/deliberate or unconscious/unaware)?

If you answered yes to all 3, then you are experiencing a bullying situation. If not, it might be that your coworker is just rude and needs a good dose of good manners!

Bottom line:

I’m not saying that being disruptive or uncivil is okay – no way! These behaviors need to be addressed because they impact relationships and the work environment. However, bullying takes these behaviors to a whole other level and the strategies to address bullying are a bit different.
We all have to do our part to stop the cycle of nurse bullying, disruptive and uncivil behaviors in healthcare. After all, aren’t nurses supposed to “Do No Harm”?

I have many multiple anti-bullying strategies available to those in need.

Renee ThompsonTake care and stay connected,

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