Tackling bullying within the healthcare profession is a major priority considering the costs and risks associated with it, and a full understanding of what behaviours constitute bullying is crucial (Allen, 2015). This mixed-methods study’s QUAL/Quant aims were, firstly, to establish what ALT staff considered to be their experiences of bullying (QUAL) and, secondly, to consider the prevalence of negative acts and their potential relationships to levels of reported depression (Hypothesis 1), stress (Hypothesis 2) and anxiety (Hypothesis 3) (Quant). A pragmatic epistemological framework was utilised for this study with a qualitative focus. Employees from five divisions of ALT were invited to participate in this study, and 303 (response rate 27.5%) took part in the quantitative questionnaire-based study. Eight participants who had described experiences of being bullied were interviewed qualitatively. Prevalent negative behaviours, as reported were: being exposed to an unmanageable workload, having your opinions and views ignored, excessive monitoring of work, being ordered to do work below your level of competence, and being ignored or facing a hostile reaction when you approach. All three hypotheses were strongly supported, in that there was a significant positive relationship between reported experiences of negative acts and levels of depression, anxiety and stress. A constructivist grounded theory approach was adopted for the analysis of the qualitative data. The findings suggested that the experience of bullying was far more complex than the reporting of negative acts and included a stealth-like nature prior to individuals recognising a bullying event. The integration of both methods during the analysis enabled a more thorough exploration of the experience of bullying behaviours than either a qualitative or quantitative approach would have achieved in isolation.

This research hones in on the differing stress levels between blue and white-collar employees. The research looked at the particular reasons for developing stress in the workplace of blue and white-collar workers, as the author found an opening for such research. Previous research states that it is the white-collar industry that has to endure the higher levels of stress, however further research states that blue-collar workers have to put up with similar and even more stress than those in the white-collar industry. Therefore this study will attempt to explore the different reasons for stress in both industries and see which sector has to deal with the most stress. The individuals who participated in this quantitative study participated in an online survey, which was comprised of 10 demographic questions, and a 35-question questionnaire developed by the Health Service Executive (HSE) put together to calculate participants stress level. The results showed that the only significant result displayed a negative correlation between work being brought home and stress. All the other correlations were not statistically significant.

Much has been written in recent years of a ‘crisis’ in the recruitment and retention of midwives in the NHS. The crisis has been attributed variously to burnout, a lack of professional autonomy, a bullying culture, and an ideological conflict between the way in which midwives wish to practise and the way they are required to practise within large bureaucratic institutions, such as NHS Trusts. Negotiating these experiences requires a significant amount of emotional labour by midwives, which they may find intolerable. This thesis explores the strategies NHS midwives deploy in order to continue working in NHS maternity services when many of their colleagues are leaving. It examines the extent to which working in a midwife-led service rather than a consultant-led service helps or hinders midwives’ capacity to manage the emotional and ideological demands of their practice. Ethnographic fieldwork was carried out in a consultant unit and an Alongside Midwife-led Unit (AMU) in two NHS Trusts in England. The findings from negotiated interactive observation and in-depth unstructured interviews with eighteen midwives were analysed using inductive ethnographic principles. In order to ameliorate the emotional distress they experienced, the midwives used coping strategies to organise the people and spaces around them. These strategies of organisation and control were part of a personal and professional project which they found almost impossible to articulate because it ran contrary to the ideals of the midwifery discourse. Midwives explained these coping strategies as firstly, necessary in order to deal with institutional constraints and regulations; secondly, out of their control and thirdly, destructive and bad for midwifery. In practice it appeared that the midwives played a role in sustaining these strategies because they formed part of a wider professional project to promote their personal and professional autonomy. These coping strategies were very similar in the Consultant Unit and the Midwifery Unit. A midwife-led service provided the midwives with a space within which to nurture their philosophy of practice. This provided some significant benefits for their emotional wellbeing, but it also polarised them against the neighbouring Delivery Suite. The resulting poor relationships profoundly affected their capacity to provide a service congruent with their professional ideals. This suggests that whilst Alongside Midwife-led Units may attempt to promote a midwifery model of care and a good working environment for midwives, their proximity to consultant-led services compounds the ideological conflict the midwives experience. The strength of their philosophy may have the unintended consequence of silencing open discussion about the negative influence on women of the strategies the midwives use to compensate for ideological conflict and a lack of institutional and professional support.