6. Stop abuse

The behaviours listed below are unlawful. They can cause compensable physical and mental injury, drive clinicians out of the workforce, undermine safe patient care, and expose employers to significant legal, financial and reputational penalties.

Unlawful behaviours include:

1. Bullying
2. Harassment, including sexual harassment
3. Discrimination
4. Sex discrimination
5. Racism
6. Verbal and physical violence

These behaviours may be overt - such as name-calling, racist or sexual jokes, vilification, crude language or threats. They are also commonly low-grade, repetitive, coercive and cumulative, making them harder to identify and prove, particularly when incidents occur without witnesses. 

To respond effectively:

• Know the legal definitions of 1-6 to avoid under or over reporting (see below)
• Document incidents over time to identify the repetitive nature of the abuse
• Ensure you can produce evidence (eg. SMS and voice messages, emails, witnesses' accounts, your diary documenting incidents) before making a complaint

Where evidence is substantiated, outcomes may include a formal apology (which does not need to be face to face), disciplinary action, or termination of the perpetrator’s employment. In some circumstances, anonymity for the complainant may be appropriate. Employers are legally responsible for preventing and proactively addressing unlawful behaviour, ensuring safe workplaces, and fostering cultures that clearly discourage abuse.

Vicarious liability means an employer may be held legally responsible for the actions of employees, contractors, visitors, or patients. 

1. Bullying

Workplace bullying is repeated, unreasonable behaviour directed at a worker that creates a risk to health and safety. When repeated or patterned, bullying may include:

• verbal abuse

• constant or unfair criticism

• exclusion or isolation

• psychological harassment

• intimidation

• derogatory comments

• meaningless or demeaning tasks

• impossible assignments

• roster manipulation designed to disadvantage individuals

• suppression of ideas

• deliberate withholding of essential information

• spreading rumours

Bullies often target selectively and may appear charming or competent on the surface. Targets are frequently disbelieved or labelled as “difficult”, while witnesses may remain silent to avoid becoming targets themselves.

Employer inaction causes serious harm - to individuals, teams, and organisations. 

If you are experiencing bullying, it may help to:

• seek regular confidential debriefing with an independent GP, psychologist, or psychiatrist;

• limit contact with the bully where possible and keep interactions brief and professional;

• build alliances with trusted colleagues and address “splitting” behaviours early;

• focus on doing your best work and avoid seeking approval or disclosing vulnerabilities;

• prioritise self-care and connection outside work;

• do not internalise the bully’s behaviour;

• obtain and follow your workplace anti-bullying policy;

• document objective evidence contemporaneously;

• insist on confidential complaint meetings without the bully present;

• maintain professionalism in all written communications;

• escalate concerns if management is involved or ineffective; and

• seek advice from your indemnity provider.

For more information on bullying and where to seek help:

Fair Work Ombudsman – Bullying in the workplace
https://www.fairwork.gov.au/employment-conditions/bullying-sexual-harassment-and-discrimination-at-work/bullying-in-the-workplace

Fair Work Commission – What to do if you’re bullied at work
https://www.fwc.gov.au/issues-we-help/bullying/what-do-if-youre-bullied-work

Safe Work Australia – Preventing and responding to workplace bullying
https://www.safeworkaustralia.gov.au/doc/guide-preventing-and-responding-workplace-bullying

Australian Human Rights Commission – Cyberbullying
https://humanrights.gov.au/our-work/commission-general/cyberbullying

eSafety Commissioner – Cyberbullying
https://www.esafety.gov.au/key-topics/cyberbullying

Australian Human Rights Commission – Be a supportive bystander
https://humanrights.gov.au/our-work/commission-general/be-supportive-bystander

2. Discrimination

The Fair Work Act prohibits adverse action against an employee or prospective employee because of protected attributes, including:

• race or colour;

• sex or sexual orientation;

• age;

• physical or mental disability;

• marital status;

• family or carer responsibilities;

• pregnancy or breastfeeding;

• religion;

• political opinion;

• national extraction or social origin;

• gender identity or intersex status; and

• experiencing family or domestic violence.

Adverse actions may include dismissal, denial of entitlements, disadvantageous job changes, differential treatment, refusal to hire, or unfair contract terms.

Discrimination can occur:

• when applying for a job;

• before employment commences; and

• at any time during employment.

Discrimination – further resources

Fair Work Ombudsman – Protected attributes
https://www.fairwork.gov.au/employment-conditions/protections-at-work/protection-from-discrimination-at-work#protected-attributes

Fair Work Ombudsman – What is adverse action?
https://www.fairwork.gov.au/employment-conditions/protections-at-work/protection-from-discrimination-at-work#adverse-action

Fair Work Ombudsman – Resolving general protections disputes
https://www.fairwork.gov.au/employment-conditions/protections-at-work/protection-from-discrimination-at-work#help

Australian Human Rights Commission – Sex discrimination and positive duty
https://humanrights.gov.au/our-work/sex-discrimination/positive-duty-sex-discrimination-act

Fair Work Commission – Gender identity and sexual orientation
https://www.fwc.gov.au/gender-identity-sexual-orientation

3. Sex discrimination and harassment

Amendments to the Sex Discrimination Act now impose a positive duty on employers to actively eliminate sex discrimination, sexual harassment, and hostile workplace environments - even where no complaint has been made.

Sex discrimination is the unfair or unequal treatment of an individual based on their sex, gender identity, or sexual orientation.

Sexual harassment is any unwelcome sexual behaviour that a reasonable person would expect might offend, humiliate, or intimidate.

Examples include:

• unwanted touching or staring;

• repeated unwanted invitations;

• sexual jokes or comments about appearance;

• sexually explicit materials or messages;

• sex-based insults, taunts, or rumours;

• unwelcome physical contact;

• sexually explicit conversations; and

• threatening or promising employment outcomes in exchange for sexual favours.

Sexual harassment does not require deliberate intent. Impact matters.

Further resources:

Respect@Work – What you need to know (Safe Work Australia factsheet)
https://www.respectatwork.gov.au/sites/default/files/2022-10/Rec%239_FACTSHEET_WSH_What%20you%20need%20to%20know.pdf

Fair Work Ombudsman – Respect at Work reforms
https://www.fairwork.gov.au/about-us/workplace-laws/legislation-changes/respect-at-work

Australian Human Rights Commission – Positive duty under the Sex Discrimination Act
https://humanrights.gov.au/our-work/sex-discrimination/projects/positive-duty-under-sex-discrimination-act

4.  Racism

Racism is often under-recognised, under-reported, and normalised within workplaces and professional cultures. It includes behaviours, attitudes, policies, practices, or systems that offend, humiliate, exclude, stereotype, marginalise, or disadvantage individuals or groups based on race, ethnicity, cultural background, nationality, descent, language, skin colour, religion, Aboriginal and Torres Strait Islander status, or migrant status.

Racism can occur in many forms. Interpersonal racism occurs between individuals and may include:

• Racial slurs, jokes, insults, or  derogatory comments
• Stereotyping or making assumptions about competence, intelligence, or behaviour
• Excluding people from workplace conversations, opportunities, or social interactions
• Dismissing concerns about racism or cultural identity
• Microaggressions, such as repeatedly mispronouncing names, questioning a person's belonging, or making comments that imply they are "different" or "less capable".

Racism can also be embedded within organisational structures, policies, procedures, and cultures that create unequal opportunities or outcomes for certain groups. Examples may include:

• Barriers to recruitment, promotion, leadership, or professional development
• Inadequate support for internationally trained professionals
• Failure to provide culturally safe care
• Lack of representation in leadership and decision-making roles
• Policies or workplace practices that unintentionally disadvantage particular cultural groups

Racism in healthcare can affect staff, students, trainees, patients, families, and carers. It may occur between colleagues, from patients toward healthcare workers, from staff toward patients, or through organisational systems.

Like other forms of abuse, racism in healthcare can affect staff, students, trainees, patients, families, and carers. It may occur between colleagues, from patients toward healthcare workers, from staff toward patients, or through organisational systems.

Racism undermines psychological safety, team cohesion and workplace culture, professional performance and career progression, patient trust and engagement ant the quality and safety of healthcare delivery.

Witnesses of racism may also experience distress, moral injury, and reduced confidence in organisational culture and leadership. Bystanders play an important role in creating safe and respectful workplaces. Silence may be interpreted as acceptance of discriminatory behaviour.

Culturally safe workplaces are environments where people feel respected, valued, and able to contribute without fear. Organisations can promote cultural safety through visible leadership commitment, anti-racism policies and education, fair recruitment and promotion processes and meaningful inclusion of diverse voices in decision-making

Racism – further resources

Safe Work Australia – Racism as a workplace hazard
https://www.safeworkaustralia.gov.au/safety-topic/hazards/racism

Australian Human Rights Commission – What is racism?
https://humanrights.gov.au/our-work/race-discrimination/what-racism

It Stops with Me campaign
https://itstopswithme.humanrights.gov.au/

Australian Human Rights Commission – Race discrimination
https://humanrights.gov.au/our-work/race-discrimination

5. Physical and verbal violence

Violence and aggression towards healthcare workers are serious work health and safety hazards and must never be accepted as “part of the job”. Every healthcare worker has the right to a safe workplace.

Violence may be physical, verbal, psychological, sexual, written, online, or technology-enabled. It can be perpetrated by patients, family members, carers, visitors, colleagues, or others in the workplace.

Examples include:

• Physical assault or attempted assault
• Threats of harm
• Intimidation, coercion, or aggressive behaviour
• Verbal abuse, yelling, swearing, or discriminatory abuse
• Sexual harassment or sexual assault
• Property damage
• Stalking, cyberstalking, or persistent unwanted contact

Importantly, assault does not require physical contact. Threats that cause a person to fear for their safety may constitute assault and should always be taken seriously.

All incidents, threats, and near misses should be documented and reported through appropriate workplace reporting systems as soon as practicable. Early reporting enables organisations to identify risks, implement controls, and prevent recurrence.

Following an incident, teams should consider:

• Are staff safe now and in the future?
• What support is required for those affected?
• Were there warning signs or contributing factors?
• Could this incident have been prevented?
• What risk controls need to be strengthened?

Management strategies should focus on protecting staff while maintaining appropriate patient care wherever possible. Depending on the circumstances, responses may include:

• Behavioural expectations or behavioural agreements
• Increased security measures
• Modification of appointment or consultation arrangements
• Documentation and clinical record alerts where appropriate
• Restriction of access to premises
• Formal warnings regarding unacceptable behaviour
• Police involvement where threats, stalking, assault, or criminal conduct have occurred
• Medicolegal advice

Stalking and cyberstalking are significant safety concerns that may be perpetrated by patients, relatives, colleagues, or others. Behaviours may include repeated unwanted contact, monitoring, following, harassment through social media, or misuse of personal information.

Early intervention is essential. Maintain detailed documentation, report concerns promptly, develop a personal safety plan, and seek assistance from workplace leaders, security personnel, police, and medicolegal advisers as appropriate.

In some circumstances, ongoing threats, aggression, or violence may make continuation of the therapeutic relationship unsafe. Ending a clinician–patient relationship may become necessary, but this must be carefully planned to ensure continuity of care and compliance with professional obligations. Medicolegal advice should always be sought before taking this step.