Joining the Mean Girls: On Fridays, We Wear Pink

The hardest part of being an adult is realizing that, in many ways, high school never ends. We all hope to escape the challenges of high school when we leave for college and/or our careers. In many ways, we do. I’m no longer burdened with hours of homework daily, the chronic stress of needing to be an “A” student, and the endless marching of time. I’m probably being a little dramatic, but high school was not the high point in my life.

We all know the mean girl or girls in high school. They’re not always the popular ones but they’re amazingly critical and detail-oriented, prepared to overlook no small opportunity to criticize your hair, grades, and generally just make you feel inferior. My mean girl was Katie D. Katie was a uniquely horrible individual a year older than me who seemed hell-bent on making people’s lives miserable. She even spent an extra year in high school which I’m convinced was an attempt to draw out the process. She didn’t need to bother. That behavior carries over into the workplace.

Hospital Mean Girls

Bullying unfortunately showed up in my first professional job. In a highly competitive healthcare field, bullying is displayed by people who want to be the smartest people in the room. My most vivid memory was an ICU pharmacist. During cardiac rounds, she informed us in a condescending tone that one of our patients was "very sick" in

a tone that implied we had personally caused his illness. It's unclear what she thought would be the result of this comment but she never left any opportunity to make a person seem small. I was far too shy at that point in my career to say anything to her directly but I had plenty of sarcastic responses after the fact. She was a uniquely unhappy person which probably contributed to her actions but her behaviors worsened patient care.

Workplace Behaviors

Errors in the medical field occur and they should be addressed. Often tempers run high and it’s challenging to hear criticism of your work. However, extreme or unwarranted criticism that’s given in a public forum among your peers can be paralyzing.

More than simply verbal abuse, bullying behaviors can be humiliating, intimidating, and even threatening. The best comparison I can think of is the character of House in the popular show of the same name. He’s amusing with his chronically acerbic nature. However, who could work with him being your boss or peer?

These behaviors negatively affect the healthcare market in the following ways:

• Poor communication

• Lack of accountability/questioning

• Lack of patient advocacy

• Employee retention

• Poor patient safety

When we consider medical errors, disruptive behaviors play a role and can be challenging to address. My current hospital spends a great deal of time and effort enforcing positive and respectful interactions in the workplace. It’s a top-down approach that I’ve noticed from our president to our surgeons, and even the CNAs. Obviously, we don’t have a perfect workplace, but I genuinely enjoy my colleagues and don’t feel under constant scrutiny.

Changing Cultures

My first job as a dietitian was an environment that was trying to change their culture and with limited success. While there were many people I genuinely enjoyed in that position, it was all too easy to get sucked into a negative mindset and even join into the bad behaviors happening there.

In fact, I didn’t realize that the workplace could be much better than when I changed hospitals. In my current job, our orientation ended by our hospital’s president giving a talk where he said we were expected to be friendly to staff and visitors and even made each person pledge to have a positive attitude at work. The emphasis of our leadership on a welcoming culture impacts every level of staff. I remember cringing the first time I had to call a surgeon only to be pleasantly surprised when our conversation went well. Even in situations where the dietitians disagree with our colleagues, there is an overall lack of bullying or intimidating behavior displayed.

As a dietitian, you have a limited ability to change the culture of the workplace. In general, I recommend these steps:

• Don’t bully, intimidate, or belittle in the workplace

• Try adopt a non-judgmental attitude as much as possible

• This does NOT mean lowering your standards or allowing poor patient care to exist. You’re not a doormat but try to engage people productively when problems exist

• Address and discourage intimidating or bullying behaviors as much as possible

• At the very least, do not participate

• When appropriate, encourage and bring up positive attributes or actions of your colleagues even without reciprocation

Although we can’t change our workplace culture by ourselves, we all play a role in our environment. Start by doing your part. We’re all going to have bad days, but focus on improving these behaviors and you may notice a beneficial change. I love where I work for many reasons but the people and my workplace culture make it a world-class environment.