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Improving workplace culture in maternity health care

Photo: Improving workplace culture important in midwifery
A toxic workplace negatively impacts the health and wellbeing of staff, but in a maternity health care setting, it also has the potential to impact on the experience of birthing women and babies.

The move to engage a consultant at Canberra Hospital to improve workplace culture in maternity services is evidence that public health decision-makers are taking workplace culture seriously.

A recent government contract revealed that the consultant would be tasked with helping to ease tensions between midwives and doctors with a focus on creating respectful and professional working relationships.

A Canberra Health Services spokesperson told Canberra News: “These issues are not unique to Canberra Health Services and are experienced by other organisations, including maternity services in other hospitals.
“Work undertaken as part of the plan will strengthen positive workplace behaviours with our maternity services workforce and assist staff in continuing to develop strong working relationships with each other in a supportive environment,” the spokesperson said. 

Further, a recent Independent Review into Workplace Culture within ACT Public Health Service revealed a need to improve workplace culture significantly. In fact, the review discovered that inappropriate behaviours, bullying and harassment are occurring in the workplace.

In a survey of staff across ACT’s Public Health System, it was revealed 61 per cent of respondents had witnessed bullying over the past twelve months, 35 per cent had experienced bullying personally, and 12 per cent of staff had endured physical harm, sexual harassment or abuse at work. Of this 12 per cent, almost half (46 per cent) indicated it was inflicted by someone they worked with.

Unfortunately, the majority (three in four) who experienced bullying or were subjected to harm did not submit a formal complaint, and only 22 per cent of staff had confidence in the way grievances were resolved once reported.

Trish Everett, a workplace culture expert, said how people deal with their anger can determine how they cope with a toxic workplace or colleague.

“It's natural to feel anger, and it's an important and powerful emotion when it comes to dealing with this type of workplace, said Ms Everett.

“Anger isn’t there just to challenge our self-mastery, although when out of check it can be great for that.

“What our anger is trying to tell us is usually that one of our boundaries has been crossed.  And when I say boundaries, I mean, crossed a line that isn’t ok with us.

“When our anger alert has sounded, we have an opportunity to do two things.

“The first is to question our boundary or line in the sand. So, whatever boundary has been crossed, ask:

Is this boundary reasonable?
What does this boundary protect/support/enable?
Am I willing to compromise this boundary?

“Once you are clear on that, the next step is to look at how are you going to defend that boundary.

“A bit of anger can come in handy as it helps you to speak up, but it’s important to choose constructive communication over gossip.

“It’s frustrating to be in a toxic environment, but blowing off steam is like adding fuel to the fire,” said Ms Everett.

Instead of discussing a litany of problems that adds to the toxicity, ask:

What can I do to make this better?
What are the positives I can see in this?
Where are they coming from?

In the workplace, it's essential to start the reconciliation process, which has three stages:

1. Understand the different viewpoints and what each group needs
2. Create a safe dialogue with a combined vision and action plan to move forward in a morally respectful way.
3. Build in processes so that all involved can heal starting with a strong circle of safety, a blame-free workplace culture and a strong support system.

People and Culture Consultant Kateena Mills, a former human resource team member in cancer care, said the high-stress health care sector could sometimes get the better of people.

“People handle stress in different ways, and it can manifest in people’s behaviours as aggression or disinterest.

“Unfortunately, you can’t control other people’s attitudes and behaviours, but you can control your own and how you respond.

"It's not a quick fix, and it takes self-awareness and self-control to step back and think before fuelling the toxicity with an immediate reaction," said Ms Mills.

A 'reality-based leadership' technique created by leadership researcher Cy Wakeman, who also has management experience in hospitals, is a useful strategy to shift people's thinking, according to Ms Mills.

The technique asks people to consider what they can do to help.

“If you perceive someone isn’t doing their job the way you would like them to, or they aren’t speaking to their colleagues in a way you deem appropriate, what can you do to help them?

“It might be to speak with them about how their behaviour is affecting others or suggesting a more effective way of completing a task.

“This is especially important when someone comes to you to complain or whine about someone else, instead of jumping in on their vent, challenge that person to think about how they, and you, could offer assistance,” said Ms Mills.

Procedural avenues for escalating complaints of toxicity in the workplace are also important.

“If you’re not sure, speak to human resources or a manager. Different facilities will have different processes around dealing with these kinds of issues which might range from one-on-one mediation, team mediation, and informal or formal investigations into behaviour and impacts.

“It can also be helpful to create a buffer between work and home.

“It could mean listening to a podcast or your favourite music on your commute to work to reflect on the day ahead.

“Taking some time for self-care and mindfulness can help people to be more resilient and not let toxic workplaces consume them,” said Ms Mills.

Ms Everett agrees: “Instead of becoming entrenched in a toxic environment, try to build a strong inner strength.”

Building this inner strength is a different process for everyone, explained Ms Everett, but can include starting the workday with a run or any form of exercise, meditation, visualisation or journaling.

“It’s important to find your own way to start your day on a high so that you can walk into work fully charged," said Ms Everett.

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Haley Williams

Haley Williams has a Bachelor of Communication in Journalism and over a decade of experience in the media, marketing and communications industries.

She is a widely published journalist with a particular interest in writing magazine features on parenting, health, fitness, nutrition and education.

Before becoming a freelance journalist, Haley worked as a writer for NeoLife (a worldwide nutrition company), News Limited and APN News & Media.

Haley also has extensive experience as an SEO Content Writer and Digital Marketing Strategist.