Management and administration and non-clinical services staff experiences of co-worker unprofessional behaviour and their reported speaking-up skills: a survey across seven Australian hospitals

Purpose – Unprofessional behaviour is highly prevalent among hospital staff and negatively impacts staff wellbeing and patient care. Little is known about the experiences of non-clinical staff. We aimed to examine the types and prevalence of unprofessional behaviour experienced by management/administration staff and non-clinical services staff and their self-reported speaking-up skills. Design/methodology/approach – A survey was distributed to staff across seven hospitals. Staff were surveyed about their experiences of 21 incivility/bullying behaviours and 5 extreme unprofessional behaviours and about their speaking-up skills. Management/administration staff and non-clinical services staff responses were included in our analysis. We used multivariable logistic regression to examine the associations between unprofessional behaviour, respondent characteristics and speaking-up. Findings – The response rate for management/administration staff was 48.2% (N = 804) and 19.0% for non-clinical services staff (N = 525). Approximately 89% (N = 712; 95% CI, 86.6–90.7%) of management/administration and 80% (N = 422; 95% CI, 77.1–83.6%) of non-clinical services’ respondents experienced incivility/bullying at least once in the preceding 12 months. Management/administration respondents who reported having speaking-up skills experienced frequent incivility/bullying less often (odds ratio [OR], 0.63; 95% CI, 0.44–0.91). This relationship was not found for non-clinical services’ respondents (OR, 0.82; 95% CI, 0.51–1.32). There were no differences in the experience of extreme unprofessional behaviour for respondents who reported having speaking-up skills versus those that did not. Originality/value – Our results provide new evidence about the experiences of previously neglected groups of hospital staff about unprofessional behaviour, their confidence in speaking-up about it, and possible barriers and enablers for this, to inform practice. Highlights – Non-clinical hospital staff are at high risk of experiencing unprofessional behaviour. Management/administration respondents who reported having speaking-up skills experienced frequent incivility/bullying less often. Speaking-up programs may be one strategy to assist in reducing unprofessional behaviour. Speaking-up training must be supported by organisational systems in which concerns are listened to and action is taken to address unprofessional behaviour amongst all hospital staff.