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The New Age of Bullying and Violence in Health Care: Part 3Managing the Bullying Boss and Leadership

Fink-Samnick, Ellen MSW, ACSW, LCSW, CCM, CRP

doi: 10.1097/NCM.0000000000000249

Purpose/Objectives: This article:

  1. Distinguishes among various types of bullying behaviors associated with leadership;
  2. Discusses abusive and vicarious abusive supervision;
  3. Discusses the influence of leadership styles and models on workplace bullying;
  4. Explores industry evidence surrounding workplace bullying and the abusive boss; and
  5. Provides strategic guidance on managing the bullying boss and leadership in health care.

Primary Practice Setting(s): Applicable to all health care sections where case management is practiced.

Findings/Conclusions: This article is the third of a 4-part series on the topic of bullying in the health care workplace. Part 3 addresses the dimensions of the bullying boss and leadership, posing major implications for patient safety plus the mental health of staff members. The complex constructs and dynamics broached by the bullying boss and department leadership are explored. These include the underlying forces at play such as power, gender, leadership styles, plus weaves in assessment models. Strategic and proactive management of bullying by leadership is vital to workforce retention and well-being.

Implications for Case Management Practice: The increasing incidence and impact of bullying across all sectors have made it a major workforce performance management challenge. Health care settings are especially tense environments, often making it difficult for individuals to distinguish between bullying behavior and high expectations for staff. Bullying impacts both direct targets and bystanders who witness the assaultive behaviors, with ethical implications as well.

Case management is poised to promote a safe health care workplace for patients and practitioners alike amid these intricate circumstances. Understanding types of bullying bosses and leadership styles is integral to a case manager's success in the workplace.

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, is an award-winning industry thought leader who empowers health care's transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. A subject matter expert on Ethics, Ellen is an esteemed author with more than 90 publications to her credit. She has authored content for many of the industry's knowledge projects for case managers, including chapters on the Ethical Use of Case Management Technology, Workplace Bullying, Collaborative Care, and the Social Determinants of Health. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations, including roles as subject matter expert, examination item writer, and leadership positions. She is a vibrant professional voice.

Address correspondence to Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, EFS Supervision Strategies, LLC, (

The author reports no conflicts of interest.

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