Bullying, Culture, and Climate in Health care Organizations: A theoretical Framework

Culture and climate — two distinct but inexorably linked terms, as many of the chapters in this book illustrate. In this chapter we focus on a compelling topic — bullying. In keeping with the theme of the book, we explore bullying in health care in terms of its links to culture and its relationship to climate and ultimately implications for patient and service user outcomes. This chapter arises from theoretical analyses, and studies relating to climate carried out by the authors in two large public health care organizations in Ireland where the issue of bullying arose not only in terms of its effect on individuals who experienced bullying, but also the effect of bullying on the collective perception of the organization and variables that are associated with climate. We are aiming in this chapter therefore to — perhaps tentatively — explore the culture-bullying-climate nexus and to provide a conceptual framework for further research. To this end the chapter examines first the ‘meaning’ of bullying and the incidence and extent of bullying. A conceptual model is then presented which links antecedents of a bullying culture to both individual outcomes and organization climate. This is followed by a discussion of the key variables presented in the model.