Tuesday, 16 June, 2020

Dear INGID members

We have been living through unprecedented times. Most of us will never have seen anything like this before in our lifetimes. I imagine many of us hope we never will again. In some countries around the globe, COVID restrictions are lifting and a shift is occurring. In others, the isolation and restrictions continue. This has prompted some of us to reflect on life that was and life that is and will be in the future. To that end, I  have been interested in the clever and insightful observations and reflections that are currently in circulation and wanted to share them here. Although this is not a topic specific to Immunodeficiency, it is a topic that affects us as human beings, as nurses who care for other human beings and as people who co exist with others. Please share your thoughts on this post with the INGID community. 

I  have been enjoying reading an amazing book that many of you may be familiar with: ‘Becoming’ Michelle Obama. I have been so in awe of her integrity, her humility and her honesty. She quotes a line from her husband which states …”Do we settle for the world as it is or do we work for the world as it should be”.




Things have been hard for many of us – make that all of us. The world has entirely been put on its heavy hairy head – and – now we have a choice to make. Yes – we could go on like nothing had happened and get back on that hamster wheel running ourselves in endless circles to nowhere – or – we could decide that – no – that life is not good enough for us anymore. I think that we are all going to have to work a lot harder now for our keep, that we will appreciate what we had but also know more keenly what matters. There is so much comfort to be had that when the world had to choose between money and life, it chose life. The truth is – and, I can speak to this first hand from staring right into Death’s sharp and beady eyes – that life has to come first. Of course there will be a few more gnarly summersaults ahead of us because that is how stories must go … But right now, I am going to celebrate the good!

Martine Alars

Here we can gain some reflections from a yogi:

As yogis, we know that our practices – both individually and collectively – are so much more than the physical postures of Asana. It’s a way we process life and life experiences. 
The Yamas, or moral observances, is the first of the eight limbs of yoga. Ahimsa, translated as “non-violence” or “non-harming” is the first of those Yamas. It means “the intent to not harm, in thought, word, or action.” 
The “good intent” phrase isn’t intended as a loophole to absolve us of negative outcomes.  It takes mistakes, consistent effort, and repeated actions. It is not a one-time commitment.  Shrugging our shoulders and accepting that we have hurt others despite our intentions is not Ahimsa; it is apathy.
Yoga Vibes 

During this time of reflecting and reading, I  have been pondering on how fortunate I am to work with a great team of people who respect each other, who listen to each others suggestions, who collaborate and who respect all  input. As a result, each team member feels valued for their contributions and perspectives. I am aware that not everyone is so fortunate.  Sadly, some of us work within teams or orgnisations with a culture of bullying.

Bullying can involve verbal attacks, other forms of intimidation, and deliberate exclusion from activities. 



Some very specific ways in which you may be bullied in work are:

  • excluding you or stopping you from working with people or taking part in activities that relates to your work
  • playing mind games, ganging up on you, or other types of psychological harassment 
  • treating you differently to other staff or being given less rights than other staff
  • intimidation (making you feel less important and undervalued)  
  • giving you pointless tasks that have nothing to do with your job  
  • giving you impossible jobs that can’t be done in the given time or with the resources provided  
  • deliberately changing your work hours or schedule to make it difficult for you 
  • deliberately holding back information you need for getting your work done properly
  • Freezing you out/ ignoring you or excluding you



This paper, which describes a study of bullying among nurses, outlines the type of person who is likely to bully, the type of behavior and also, the devastating effects it may have on the nurses’ performance and personal well being.



Table 3. Differences between nurses and other staff for each type and category of bullying Nurses Other staff
% n = 396 % n = 704 χ2
Threat to professional status† 19 (76) 16 (109) 2.5 NS
1. Persistent attempts to belittle and undermine your work 15 (57) 10 (67) 6.0 **
2. Persistent unjustified criticism and monitoring of your work 11 (41) 10 (68) 0.2 NS
3. Persistent attempts to humiliate you in front of colleagues 10 (37) 8 (53) 1.2 NS
4. Intimidatory use of discipline/competence procedures 7 (26) 4 (31) 2.5 NS Threat to personal standing† 22 (88) 18 (129) 2.4 NS
5. Undermining your personal integrity 14 (53) 9 (61) 6.1 **
6. Destructive innuendo and sarcasm 14 (54) 10 (69) 3.8 *
7. Verbal and non-verbal threats 7 (26) 5 (37) 0.8 NS
8. Making inappropriate jokes about you 6 (25) 3 (24) 5.1 *
9. Persistent teasing 4 (15) 2 (17) 1.7 NS
10. Physical violence 2 (7) 2 (11) 0.1 NS
11. Violence to property 1 (4) 2 (12) 0.8 NS Isolation† 27 (107) 21 (148) 5.1 *
12. Withholding necessary information from you 20 (78) 14 (100) 5.8 **
13. Freezing out/ignoring/excluding 15 (58) 12 (85) 1.5 NS
14. Unreasonable refusal of applications for leave, training 12 (47) 5 (31) 21.7 ***
or promotion
Overwork† 19 (74) 13 (92) 6.2 **
15. Undue pressure to produce work 17 (66) 11 (73) 9.2 **
16. Setting of impossible deadlines 10 (39) 7 (50) 2.5 NS
Destabilization† 33 (132) 23 (162) 13.8 ***
17. Shifting goalposts without telling you 27 (105) 14 (99) 26.1 ***
18. Constant undervaluing of your efforts 14 (56) 10 (70) 4.5 *
19. Persistent attempts to demoralize you 13 (49) 9 (65) 2.7 NS
20. Removal of areas of responsibility without consultation 10 (40) 6 (44) 5.4 *





The possible effects of bullying resulting in stress: If a colleague is experiencing these symptoms, check if they are OK or the source of their distress




What are you rights as a worker ? Although this will vary greatly across the globe, some suggest that in order to undertake work, the following are required :

  • Right to Know. …
  • Right to Participate. …
  • Right to Refuse Unsafe Work









Why do people bully ?

Most frequently, those who bully others are looking to gain a feeling of power, purpose and control over you. 



Dr Fatumina is a woman’s rights activist and all round talent who i admire. She recently stated the following :


When it comes to a toxic environment, the most toxic people are not only those doing the bullying but those that allow them to perpetrate that type of behavior and stand there watching. Their silence is worse than any horrible word thrown at us. Dealing




Dealing with a bully can be difficult, stressful, confronting and consuming. If the bully is in a position of power, it can make the task even more difficult or even impossible. Do remember though, that the bully will be bullying others too, so reach out to those you feel you can trust. it’s important you get support as bullying can significantly affect your well being and mental health.






Getting through tough times

Kirsten Bradbury describes some simple tips that may assist in getting through those tough times  and may include some of the following:

 Faith and Spirituality

Community and Connection

Creativity and the Arts

Adaptation and Change

Self-Care and Self-Compassion

details may be found here :


And finally, a few words about self care from the Sydney Children’s Hospital Network where I am fortunate to work with a dynamic and caring team. This is important for nurses at all times, but even more important in recent times of this global pandemic and also if you are currently experiencing bullying behaviour; 

It’s important to remember that caring for yourself doesn’t show a lack of love or care for others. Instead, taking measures to look after your own psychological wellbeing enables you to provide better care for those around you – whether they are patients, colleagues, family or friends.


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