Bullying, incivility, and disruptive behaviors in the healthcare setting: identification, impact, and intervention.

Bullying, incivility, and their associated disruptive behaviors are insidious and destructive forces with negative consequences that require identification and intervention at the individual and organizational level. Costs incurred secondary to these insensitive behaviors are substantial and involve matters of patient safety, absenteeism, turnover, turnover intentions, organizational commitment, and employee healthcare. Factors that increase the risk of hostile behaviors include changing hierarchies, conflicting loyalties, stress, and the state of the science. Each organization has the responsibility to develop processes for managing threatening and intimidating actions. New criteria are proposed to guide the implementation of successful programs.