There are social cliques at every stage in life and you may experience close-knit and exclusive groups within your job at a hospital or clinic. You may work on a shift at a hospital and feel there is a clique and that you don’t fit in easily. It may result in one or more of the nurses exerting behavior toward you that is considered bullying. The intent is to socially isolate a co-worker, which can impact teamwork and safe patient care. This is a rare occurrence, but it does happen. In fact, the Joint Commission addresses social cliques and bullying and provides the following examples:

• Unwarranted or invalid criticism
• Blame without factual justification
• Being treated differently than the rest of your group
• Being sworn at
• Exclusion or social isolation
• Being shouted at or being humiliated
• Excessive monitoring or micromanaging
• Being given unrealistic work deadlines

Aggression normally involves a single act and bullying is an ongoing pattern of behavior from an individual or group. Bullying can cause significant physical and mental problems. Common issues include lowered self-esteem, work withdrawal and sickness, absence, depression, and family tension and stress. The organization suffers also. The hospital has to replace the worker who leaves and absorb the cost of training the replacement. Bullying normally impacts a group of people and the turmoil results in a disruption of the workflow and lower morale and productivity among the staff. Medical errors and adverse outcomes may occur. There are costs to investigate the bullying, and it will likely have a cost to the reputation of the organization. Social cliques that contain bullies can create unwanted consequences for the staff and the entire organization.