perspectives
perspectives
By Susanne Meninger, MS, BSN, RN, CPPS, CIC
Bullying and Gaslighting in Infection Prevention
Microbiology cultures are important to the success of an infection prevention and control( IPC) program but so are the workplace cultures of the organizations in which they function.
Infection preventionists( IPs) are vulnerable to workplace incivility
IPs play a crucial role in safeguarding healthcare environments. They are highly skilled professionals who are trained to analyze situations for risk, implement evidence-based protocols, monitor compliance and educate through training and data presentation. The role demands expertise, resilience, and meticulous attention to detail, often under high pressure conditions. Yet this critical work does not shield IPs from workplace hostility. Bullying and gaslighting can create environments where IPs feel undervalued, undermined, and burned out.
Bullying versus Gaslighting
Workplace bullying manifests in various forms: overtly such as verbal abuse or belittling comments, and more subtly as exclusion from decision-making, or being assigned unrealistic workloads( Joint Commission, 2016). For IPs, bullying often stems from hierarchical dynamics or resistance to infection control measures. Clinicians or administrators may dismiss IPs’ recommendations, perceiving them as overly cautious or restrictive. This may result in their expertise questioned or even mocked. Excluding IPs from decision-making meetings and micromanaging can cross the line into bullying. Gaslighting is more subtle such that those committing it might not even be aware. It’ s a form of psychological manipulation where victims are made to doubt their perceptions or competence.
IPs may encounter gaslighting when their concerns about infection risks are downplayed or dismissed as overreactions or high-risk situations are hidden from them. An IP might flag an environmental risk, only to receive the response,“ You’ re making a big deal out of nothing,” or“ everyone does it this way.” Over time, this lack of deference to their expertise erodes their trust in their own judgment and research. If you have ever heard the words from colleagues“ don’ t tell IP” or“ IP is just a consultant,” gaslighting might be in play.
The Effect on IPs
The cumulative impact of bullying and gaslighting takes a severe toll on IPs’ mental health. Chronic stress, anxiety, and burnout are common, with many reporting feelings of inadequacy or hopelessness. Almost 80 percent of the reasons for IPs leaving an organization are related to role challenges, work life balance, stress and coworker relationships. A quote from a former IP is illustrative:“ IPs need to feel psychologically safe with their boss and leaders need to back IP and provide them with support – otherwise attacks happen”( Reece, et al, 2025). The emotional exhaustion from navigating overt or subtle hostile work environments is compounded by the high-stakes nature of the job. When their efforts are met with hostility or manipulation, many question whether the personal cost is worth it.
The Ripple Effect on Healthcare
The departure of IPs has far-reaching consequences. IPs are highly educated, with advanced degrees or certifications. Hospitals with understaffed infection prevention programs undermine their IP team and are at higher risk of healthcare-associated infections, which affect millions of patients annually and cost the U. S. healthcare system billions of dollars( Bartles, Reece and Gumbar, 2024). The loss of experienced IPs also disrupts mentorship and training for new professionals entering the field, creating a vicious cycle of shortages. It takes several years to reach full competency and by 2030 approximately 40 percent of today’ s workforce will be retired( Reece, et al. 2025).
Healthcare Administrators Must Act Now Five things to do now:
➊ Zero-tolerance policies: Institutions should implement and enforce strict policies against bullying and gaslighting, with clear definitions, training, and consequences for perpetrators, regardless of their position. Many people are unaware they are participating in these negative behaviors.
➋ Leadership support: Hospital leadership must champion IPs, ensuring their recommendations are respected and acted upon. Administrators often hire outside consultants for regulatory readiness assessments, who identify issues that are no surprise to your own internal IP staff. If these issues are a surprise to administrators, IP is undervalued in your organization.
➌ Professional development: Offering opportunities for career growth, such as journal review days and conferences or funds for advanced certifications, can boost morale, expertise and confidence and demonstrate that IPs are valued.
➍ Workload management: Centers for Medicaid and Medicare Services( CMS) requires IPC programs and some may interpret that to mean programs need only address the minimum CMS metrics. IPC programs need to be broad and encompassing, addressing many areas from Healthcare Associated Infections( HAIs) to construction risks, as well as procedure safety in both inpatient and ambulatory settings( Garcia, 2022). Inadequate resources to meet the promise of a comprehensive IP program is a form of gaslighting as it can lead to IPs doubting their competence. Beware of using IPC staffing models that are not based on IPC professional literature. Alternative schedules such as remote workdays have also been shown to support workload satisfaction( Reece, et al, 2025).
➎ C-suite representation: As stated by Ellis in the July-August 2025 edition of this publication, IPs belong in the C-suite. They have the problem-solving skills, teamwork ability and knowledge of healthcare to guide patient safety initiatives in a specialized manner. IP is a close-knit community and an organization that elevates IP in this manner will surely find that vacant positions fill quickly.
Final Thoughts
Infection preventionists are the backbone of hospital safety, yet many former IPs describe situations that would qualify as workplace bullying and gaslighting. The time to act is now— before the silent crisis of IP turnover becomes a deafening blow to healthcare systems ability to ensure safe patient care.
Susanne Meninger, MS, BSN, RN, CPPS, CIC, is an infection preventionist and member of the Quality and Patient Safety Department at Tufts Medical Center in Boston. With an MS in industrial organizational psychology and a graduate certificate in patient safety, error science and full disclosure, she adds a different lens to nursing and infection prevention. She is passionate about understanding how workplace culture, psychology and relationships influence the prevention of healthcare-associated infections.
References:
Joint Commission( 2016). Bullying has no place in healthcare. Quick Safety. Issue 24.
Reece, et. al.( 2025). Why do infection preventionists leave a job? A qualitative evaluation of infection preventionist attrition in health care. American Journal of Infection Control. 53( 9), 919 – 924.
Bartles, Reece and Gumbar( 2024). Closing the gap on infection prevention staffing recommendations: Results from the beta version of the APIC staffing calculator. American Journal of Infection Control. 53( 12), 1345-1350.
Garcia, et. al.( 2022). Recommendations for change in infection prevention programs and practice. American Journal of Infection Control. 50( 12), 1281−1295.
Gilmartin, Reece, and Smathers( 2021). Recruitment and Hiring Practices in United States Infection Prevention and Control Departments: Results of a National Survey. American Journal of Infection Control. 49( 1), 70-74.
6 • www. healthcarehygienemagazine. com • sept-oct 2025