The era of the bully is over
i’ve always hated bullies
since being the uh the fat jewish kid at
school that never quite
fit in and then becoming the trainee who
realized i could do something about
these behaviors
i’ve always hated bullies and so i was
pretty lucky
when i got to be part of an organization
that meant we could do something about
it
now actually this organization is a
trainee organization and it was the
uh team before me when i was just vice
president who thought we should do a
census
we wanted to ask trainees how they felt
about things
kind of a state of the union type thing
so we asked them all the questions where
do you live where do you work
and one of the things that i really
wanted to look at were behaviors like
bullying undermining and harassment
now we’re not daft and so the reason we
got this data was because we said look
we also will have a price draw and give
you two grand
if you win it so we actually got a
pretty good amount of data out of it
now i knew what i thought would happen
i knew what i thought it would say it
would say that some people are unhappy
and some people were pretty happy
but i was shocked by some of the the
data we got
now one of the other reasons that we got
such good data was
that we’d actually said to these
trainees we’re gonna make you a pledge
number one
we’re gonna keep it anonymous so that no
one can go it’s you you said this
and number two we promise that whatever
we find we’ll do something about
if it says that we’re wasting our time
bark up the wrong tree we’ll just go to
the pub and say look okay fine it’s not
a problem
but if we find something something
meaningful something we can do something
about we’ll do it
and this data came back and it blew my
mind
but people use words like bullying and
harassment undermining and they’re
pretty emotive words and they mean very
different things
so uh they need to be defined and
bullying is where someone uses
power to make you feel frightened or
afraid and do something you don’t want
to do
okay i’m your boss and you’re not gonna
have lunch today
okay undermining is far more subversive
undermining
is where you make someone feel small
worthless
powerless like they have no value and
harassment
well harassment are those protected
characteristics we talk about age
gender sexuality and so on and we asked
two really powerful questions we asked
whether or not people had uh experienced
those things
in the month pre pre proceeding the the
census and if they’d ever perceive them
one of the other big challenges people
say is well perception
it’s all in the eye of the beholder but
but is it really i think that’s one of
the more powerful things because
actually and this is one of the things
that always
comes up when we talk about these
behaviors is uh
if i’m chatting to you and you’re my
trainee and
and we get on really well and i just
tell you just man up just man up
and we have a laugh and it’s great and
everyone laughs except for that one
medical student at the back of the room
that one nurse
in theater who goes i can’t believe he
spoke to that person that way
i can’t i can’t believe he made him feel
that way
and so actually perception is really
powerful and we had some data that
showed that there was
a problem with these behaviors but don’t
get me wrong this is not
a trainee problem there’s loads of other
surveys out there and i could if i want
to put loads of graphs up to show that
everyone experiences because this isn’t
a trainee problem this is a cultural
problem
and so to fix it we need to change
culture
now here’s the thing i believe that
training
should be like family so your mum and
dad
loved you i hope
and what that meant was that sometimes
they rewarded you
you’ve done really well good for you
here’s here’s a present
and sometimes they told you go to your
room and you
mum but the next day you knew that
they still loved you they knew what was
best for you and that’s kind of the
relationship you had with your parents
you would hope
but here’s the thing a couple of years
ago someone turned around to parents and
said um
don’t hit your kids not only don’t hit
your kids
if you hit your children that’s abuse
you’re a child abuser what
yeah it’s bad parenting to hit your kids
and so what happened well the parents
said well
my my parents hit me and their parents
hit them
so does that make me a bad parent and my
parents were bad parents
in fact were all parents preceding this
press release bad parents
and what we say is no it’s not like that
at all because if you make it a blame
thing
if you make it a them and us thing a
trainee and a trainer thing or a doctor
and a nurse thing
then instantly it becomes a blame thing
and so of course people are going to
take it personally
you’re a bad parent you’re a bad trainer
you’re a bad nurse or a bad
person what we’re saying is actually no
we just know that things have changed
it’s been a paradigm shift and we know
that there are better
ways of doing things there are better
ways of training than making someone
feel small and building them up again
there’s better ways of of educating
someone than
bashing the knowledge into their head
because actually that does work
there are just better ways of doing it
that means that everyone feels better
about it
but if you think about other campaigns
to change culture if you think about
smoking or seat belts
this is going to take a generation
because it’s not easy because you know
what
you have to reflect i’m an orthopedic
surgeon i’ve reflected
and when when you reflect
that always gets a laugh when when you
reflect you realize
oh i’ve done this too i’ve done this
too and and i try to be better at work
but you know what i i’ll share something
with you
i still do it sometimes sometimes i put
my foot in it
more often than not i put my foot in it
but the fact is
that the hardest bit is admitting that
you have to change
and that maybe even the best of you and
the worst of you
can do a bit better can change but big
changes
is nearly impossible everyone stop
smoking
problem solved it’s never going to
happen so what you have to do
is small changes tectonic
change no one here will know that the
tectonic plates under your feet are
moving but they are
and you have this slow movement and
without realizing it the world is
changing
under your feet and so that’s what you
need to do and the best way to do it
is to start with yourself so you say i’m
looking in the mirror next time i say
something stupid at work or something
hurtful or something spiteful or
something that isn’t helpful or
it’s the middle of the night and someone
calls me up and i say you know what did
you even go to medical school
i’m really sorry um i’m really sorry i
shouldn’t have said that how
how can i help you okay you change
yourself
and eventually if you change yourself
enough people will notice
they’ll notice that you’re changing and
so people will go why is it that people
prefer to work with
that person than that person or they
really like it when that person is on
call and not that person
and so what they do is they role model
off you and that’s not a hierarchical
thing
people role model in all directions so
suddenly you change yourself
and so the people you work with change
so you start to change your team
suddenly
maybe your boss or maybe your junior or
maybe your colleague goes i saw simon
after a really stressful case go
do you know what guys i’m really sorry i
raised my voice during that case but
thank you very much
i think i think i might do that because
people seem to respond really well to
that so so you start to change your team
and then you realize of course
why isn’t patience like going to that
operating theater or that clinic
why is it that the nursing staff always
try and swap and do this instead of that
and so you start to have a better team
and of course we’re all competitive so
when people go well that team
that team’s better than this team i want
to be that team
how do i make my team like their team
and so suddenly you start to change
your unit and if you change your unit
eventually people go why is that you’re
doing better than that unit
and so eventually you change your
hospital and as we’ve seen from other
speakers today
certain units certain hospitals get held
up look at what they’ve done look at
what they’ve achieved and if you can
change a hospital then you can start to
change
the health service the whole health
service
not just hospital not just gp practice
not just
primary care or secondary care or
paramedics or everyone and then
because we’re doctors and nurses and
health care givers we start to also
change the way we interact with our
patients so actually we literally
start to change the world
and it all started because i asked you
to
change yourself and i actually believe
that by doing that we can completely
change the culture we work in
and the place where we make people
better
will get better you