Strategies for Managing Disruptive Behavior, Bullying, and Constructive Conflict in Healthcare
Bullying weakens teams, but well-handled conflict can transform them. Protect your well-being, reach for support, and honor the humanity in every interaction.
Bullying, incivility, and interpersonal conflict are challenges that many healthcare professionals face, often in silence. These experiences can be painful on a personal level and warrant attention on that basis alone. Yet they also carry real clinical consequences. In a 2023 survey, 71% of physicians and nurses reported that disruptive behaviors contribute to medical error, and 27% linked these behaviors to patient harm or death. The toll is both human and systemic.
Although conflict is an inevitable part of human interaction, bullying and incivility are not merely “conflicts,” nor are they harmless professional friction. They are harmful behaviors that interfere with communication, compromise teamwork, and place clinicians and patients at risk. It is essential to distinguish between conflict, which can be constructive, and bullying, which is inherently destructive. Conflict is not, in itself, a sign of a toxic work environment, but persistent bullying and incivility are.
Responding to Incivility and Disruptive Behavior
When all parties are committed to mutual understanding, effective conflict-resolution skills can create meaningful, collaborative solutions. However, when you are being treated rudely or disrespectfully, the first priority is addressing the incivility itself. You cannot resolve a conflict that the other party is escalating or weaponizing.
A reliable process for managing these moments helps you regulate your emotions, maintain professionalism, and aim for the best possible outcome.
- Practice Emotional Self-Regulation
Emotional regulation is not the suppression of emotion. Rather, it is the intentional calming of emotional intensity to an adaptive, workable level. It is foundational to managing difficult interpersonal interactions.
You might consider:
- Deep breathing, used subtly so it does not appear dismissive (e.g., heavy sighing).
- Calming imagery, such as a person, place, or memory that evokes ease. With repetition, this becomes a rapid cue for relaxation.
These small tools protect your ability to think clearly and respond intentionally rather than reactively.
- Have a Plan for What to Say
Renee Thompson and the Healthy Workforce Institute (HWI) offer excellent scripts to use in moments of incivility. These scripts work because they focus on behaviors, not character judgments.
Examples include:
- “You are yelling and screaming at me in front of patients and their families.”
- “I’m willing to discuss this with you as long as you’re willing to speak to me in a respectful manner.”
Notice that these statements describe the observable behavior and set a clear boundary for continued communication. They do not insult, escalate, or diagnose the other person’s intentions. This is the essence of professional boundary-setting: defining what behavior is acceptable and what is not.
When disruptive behaviors are chronic, HWI suggests scripts such as:
- “I’m not sure you realize this, but sometimes you can come across as being ___ (intimidating, aggressive, unapproachable, etc.).”
Again, this names the impact of the behavior without attributing motive or character flaws.
- Remember: You Are Not to Blame
It is critically important to emphasize that you did not cause the bullying or incivility directed at you. Strategies and scripts exist to give you tools, not responsibility.
It is also crucial to acknowledge the very real roles of racism, intolerance, gender bias, and anti-LGBTQ+ prejudice in workplace mistreatment. These patterns are often accompanied by gaslighting, leaving individuals questioning whether their perceptions are valid. Institutional support is crucial in addressing these issues, but not all organizations offer it reliably.
When internal support is unavailable, external resources may help.
Allow yourself to feel what you feel. Bullying and incivility are painful, regardless of your age, training, authority, or accomplishments. Being hurt by hurtful behavior is not a weakness.
Understanding Conflict—and Using It Wisely
While bullying is unacceptable, conflict itself is not inherently negative. Conflicts arise in every human relationship, both personal and professional. When addressed thoughtfully, conflict can become a pathway to clarity, learning, and growth.
So how do we resolve conflicts adaptively?
If your immediate response is “compromise,” that’s sometimes right. But often if we approach conflict resolution with intentionality, we can do better than what Merriam-Webster defines as “settlement of differences by arbitration or by consent reached by mutual concessions.”
Consider the story of the orange.
Two people are arguing over an orange. Each person comes to the dispute with rigid ideas about their entitlement to the orange.
The conflict intensifies.
Finally, they decide to compromise and split the orange in half.
At that point, one individual squeezes the juice from their half to have a drink.
The other person zests the rind of their half into the batter they are mixing.
They compromised by splitting the orange evenly and fairly, but neither understood what the other wanted. If they had, they could have reached a resolution that was better for both of them.
Win-win solutions feel better than “mutual concessions,” but are only possible when we understand both what we want and what the other person wants.
Finding Shared Humanity
A foundational step toward effective conflict resolution is recognizing our shared emotional experience. One tool that can help is the “just like me” technique. When your self-talk reflects frustration, thinking “this person is being really difficult, you add “just like me.”
- “They’re getting upset… just like me.”
- “They’re convinced they’re right… just like me.”
This shift does not excuse harmful behavior. Rather, it helps ground you in mutual humanity and opens the door to empathy, which is essential for collaborative solutions.
Identifying Goals
To pursue a productive resolution, you must first understand your own goals. Be detailed. For example, if you feel you’ve been carrying more than your share of the workload, ask yourself:
- Do I want equal workload moving forward?
- Do I want them to compensate for past imbalance?
- Do I want acknowledgement or an apology?
- Do I just want relief from the workload, regardless of how it’s redistributed?
Being clear with yourself makes it more likely that you will communicate effectively.
But resolution also requires understanding what the other person wants. Without that knowledge, both parties risk settling for a “split the orange” compromise.
Knowing one another’s goals does not guarantee agreement, but it creates the foundation on which creative, mutually beneficial solutions can emerge.
In Closing
Bullying and incivility undermine psychological safety, teamwork, and patient care. Conflict, when handled skillfully, can strengthen relationships and systems. Both realities can be true.
As you navigate the challenges of healthcare environments, we encourage you to protect your own well-being, use tools that support you, seek support when needed, and acknowledge the humanity, your own and that of others, that underlies every interaction.
References:
Lewis, C. (2023). The impact of interprofessional incivility on medical performance, service, and patient care: A systematic review. Future Healthcare Journal, 10(1), 69–77.