Intro

In Orthopaedics, we often work in high-pressure environments. Sometimes I might see a colleague being mistreated, spoken to disrespectfully, or excluded because of their gender, ethnicity, age, or other characteristics.

When this happens, I have a choice. If I stay silent, the behaviour may continue, and the person being targeted may feel even more isolated. If I step in safely and appropriately, I can help protect them, reduce harm, and send a clear message that discrimination is not acceptable in our workplace.

Have I witnessed discrimination, bullying, or undermining?

I ask myself:

• Is the behaviour repeated, hostile, or humiliating?
• Does it focus on someone’s personal characteristics (e.g. gender, race, accent, disability)?
• Would most people consider the behaviour disrespectful or unfair?
• How did the person on the receiving end look or react — did they seem uncomfortable, upset, or excluded?

Examples in orthopaedics:

• I hear a senior surgeon make repeated jokes about a female trainee’s strength or ability to handle trauma lists.
• A colleague is repeatedly ignored during the MDT meeting, even when they raise important clinical points.
• A scrub nurse is spoken to in a rude and belittling way in front of the team.

What should I do if I feel I have witnessed discrimination?

I can use Active Bystander Frameworks.

The 5Ds of Bystander Intervention https://righttobe.org/guides/bystander-intervention-training/

• Distract – change the subject, interrupt, or find a way to diffuse the situation without direct confrontation.
• Delegate – involve another colleague, senior, or manager to help.
• Document – make a clear, factual note of what I saw and when.
• Delay – if I can’t act in the moment, I check in with the person afterwards.
• Direct – if it feels safe, I calmly name the behaviour, confronting the person harming. (“That comment felt inappropriate. Let’s keep this professional”).

When and how to intervene safely

• I think first: Am I safe? Is this the right time?
• If the person is senior to me, I may choose to delegate or delay rather than direct confrontation.
• If I intervene, I keep my tone calm and professional.

What can I do to support the person being bullied or undermined?

• I check in with them privately afterwards: “I noticed what happened in theatre earlier, are you okay?”
• I listen without judgment.
• I offer options: “Do you want me to come with you to speak to someone?”
• I let them know about support routes: Freedom to Speak Up Guardian, Clinical Director / Training Programme Director, BOA/RCSEd resources, NHS Support helpline or the GMC confidential helpline.

What can I do to improve my wellbeing?

Witnessing discrimination can also affect me. I may feel guilty, angry, or unsure if I did enough.

• I remind myself that doing something is always better than doing nothing.
• I reflect on what went well and what I could do differently next time.
• I talk it through with a trusted colleague, mentor, or support service.
• I look after myself, stepping up as a bystander should not come at the cost of my own wellbeing.