Incivility and bullying in rural and remote health workplace culture in Australia – Through the lens of appreciative inquiry

Ms Therese Forbes1,2, Dr Yoni Luxford2, Dr Annmaree Wilson1,2

1Cranaplus, Broome, WA

2University of New England, Armidale, NSW


Workplace ostracism, incivility and bullying have been increasing in incidence and concern in Australian health workplaces despite concerted efforts to address it on a range of organizational levels and professional approaches. Most policy and professional development strategies have been developed in centralized health departments and rolled out with little attention to specific contexts of practice.

This paper examines remote and rural health workplaces in Australia, giving special attention to research investigating factors that have been contextualized, or emphasized localized solutions to the wicked problem of workplace bullying and its antecedents. Factors that impact on collaboration, engagement and connectedness in the workplace are particularly relevant.

An integrated literature review was undertaken and found that incivility, ostracism and bullying can thrive in highly stressful and small inter-dependent team work environments. Ignoring these factors can be perilous for teams. Remote health professionals were also more concerned about bullying by colleagues than they were about physical violence from community members – another significant issue in remote practice.

Stressful working environments are fertile ground for ostracism and incivility and management may feel ill equipped to respond and resolve conflict within teams. If this is poorly handled it can result in the use of behaviours that are passive and even more difficult to detect.

Strong support for implementing values based practice strategies to mitigate the wicked problem of ostracism, incivility and bullying has been found. Using an Appreciative inquiry approach to engage with remote and rural health professionals to improve workplace culture has been useful.


Therese Forbes is an experienced psychologist who has lived and worked in remote areas in Western Australia and Queensland. She has worked in primary health care settings and in private practice and is currently Bush Support Line Psychologist with CRANAplus. Therese is currently a candidature in the Masters of Philosophy (Research) program at UNE.
Therese provides counselling and mentoring services to rural and remote health workers and delivers workshops on resilience, mindfulness and connected, engaged and collaborative workplaces.

Therese is passionate about improving workplace culture in rural and remote health care settings.