Sometimes, workplace bullying isn’t obvious. It can be subtle, disguised as leadership, or hidden within the culture of a hospital or clinic. Over time, however, its effects become painfully clear, chipping away at confidence and well-being, and posing serious risks to the mental and physical health of healthcare professionals. Nurses, doctors, and allied health staff often face bullying not only from colleagues or managers but, at times, from patients and their families—an added layer of complexity in an already high-pressure environment.
Last year, a study by the University of the Free State found that nearly 30% of South African employees reported feeling bullied at work. In healthcare, where emotional resilience is constantly tested, these numbers may be even higher. Workplace bullying is defined as the repeated, unreasonable actions of individuals or groups directed toward an employee or group of employees, with the intent to intimidate, humiliate, or harm. Bullying often involves an abuse of power, a behaviour most organisations officially condemn. Many hospitals and clinics have policies and training to prevent bullying, yet the problem persists because the solution is far more complex than drafting rules.
In healthcare settings, the bully may be a supervisor, senior nurse, physician, or even a department manager who presents as competent and professional to their superiors but behaves aggressively toward subordinates. They often mask intimidation behind the guise of leadership while using tactics to assert dominance. Common behaviours include refusing to take responsibility for mistakes, shifting blame onto junior staff, withholding critical patient information, or creating unnecessary stress by setting impossible deadlines. At times, patients’ aggressive behaviour, when left unchecked by management, adds to the pressure on staff, reinforcing the feeling of vulnerability.
The result is a toxic environment where healthcare workers feel they must constantly “walk on eggshells,” suppressing their voice to avoid confrontation or reprimand. Policies and grievance procedures exist, but addressing bullying in practice—especially when the perpetrator holds authority—is rarely straightforward.
Most institutional policies require staff to formally report bullying incidents, documenting occurrences and gathering evidence or witnesses. In reality, bullying is often invisible on paper. Bullies rarely document their actions, and colleagues may fear retaliation if they speak up. Without tangible proof, management may side with the employee who has a polished reputation, leaving the target discredited as “difficult” or “overly sensitive.” For healthcare professionals, this imbalance can be particularly damaging: when staff morale falters, patient care may inadvertently suffer.
The legal landscape in South Africa
The Labour Relations Act (1995) provides protection against unfair dismissal and certain labour practices, but bullying occupies a grey area not explicitly defined in legislation. The Basic Conditions of Employment Act and the Employment Equity Act (EEA) similarly do not reference “bullying” directly. However, Section 6(1) of the EEA prohibits unfair discrimination on numerous grounds, and Section 6(2) explicitly recognizes harassment as a form of unfair discrimination. While not every bullying incident falls under these categories, sustained, targeted, and damaging behaviour can legally be considered harassment.
Still, proving harassment remains difficult. Fear of retaliation often leads to silence, yet inaction has consequences. Workplace bullying deteriorates mental and physical health, diminishes performance, and perpetuates a toxic culture. In healthcare, burnout, absenteeism, and reduced patient care quality are common outcomes when bullying goes unchecked.
Bullying affects all levels
Bullying in healthcare is not limited to junior staff. Experienced nurses, senior doctors, and department heads can also become targets of manipulative managers. Raising a grievance at higher levels may strain relationships, increase tension, and make the environment even more toxic. When the situation becomes unbearable, resignations may appear as the only solution. Without proactive HR intervention, proper exit interviews, and pattern tracking, workplace bullies continue their behaviour unchecked, causing long-term damage to both staff and patient outcomes.
Workplace bullying is pervasive and damaging, extending far beyond policy manuals. While laws and internal procedures exist, the burden on victims to provide proof, combined with fear of retaliation, often renders these mechanisms ineffective. In healthcare, where professionals are responsible for the lives and wellbeing of others, organisations cannot afford to let bullying go unaddressed.
A proactive approach requires transparent reporting mechanisms, supportive leadership, ongoing staff training, and a culture that prioritises psychological safety. Charisma, as a recruitment partner, understands the importance of placing nurses in environments where they are respected, supported, and empowered. By highlighting workplace culture in recruitment, Charisma helps healthcare organisations attract and retain professionals who thrive, ensuring that teams can focus on delivering excellent patient care.
Until these steps are widely adopted, countless healthcare professionals will continue to suffer in silence, and organisations will continue to lose invaluable talent. Charisma’s focus on matching nurses with supportive workplaces ensures teams are resilient, valued, and equipped to deliver the best care possible.