ARNBC does not generally print blogposts from anonymous sources. Ideally nurses could state their opinion on virtually any topic, without repercussions. However, the following blog was submitted by a nurse who feels so threatened in her workplace that she does not feel it would be safe to identify herself publicly. Bullying is a topic that we know impacts many nurses and we feel strongly that it is important to publish this piece in its entirety.
Nurses are frequently named by the public as one of the most trusted professions, second only to firefighters. Our inherent compassion, professionalism, and dedication to our patients is the root of this. While we seem to have mastered our interactions with our patients, why is nurse on nurse bullying so common? Why can’t we show compassion and respect for each other in addition to our patients? Why does the body of literature on horizontal bullying have to be so vast as part of the accepted language of nursing? Why do instances of nurse on nurse bullying continue to grow? And maybe most importantly, why do we allow bullying to continue in our workplaces?
Seattle nurse and consultant Kathleen Bartholomew has explored the challenge of nurse bullying and notes that “because nursing has its fundamental roots in caring, it’s often hard for nurses to admit that they could be hurting one another. But studies show that 60 percent of new nurses leave their first position within six months because of some form of verbal abuse or harsh treatment from a colleague.”[1. Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young, HCPro, 2006]
You know what I’m talking about. The snide comment about you behind your back that you hear when you’re walking by the nurses’ station. The whispered tones, the smiles to your face and the lies that live underneath fake smiles. We’ve all seen senior nurses do this to younger nurses. They chalk it up to learning the ropes, or growing pains that are necessary to experience. They have to ‘toughen up’. Or, ‘my nurse manager did this to me when I was a new grad’. I’ve also seen younger nurses act like their seasoned colleagues are out of touch dinosaurs for not adopting new looks, methods or body art. Many of our younger colleagues simply don’t respect that experience is a great teacher.
What if it’s your manager or supervisor who is doing this to you? Every time that person calls into question your practice, he or she destroys a little piece of your confidence and makes you question your ability. Constructive criticism provided in a supportive and open environment articulated with respect for the individual is absolutely necessary. The problem comes when there is a lack of regard for opposing opinions and perspectives, and the blatant lack of respect that rears its ugly head when an idea is dismissed, when a person is belittled, or when someone acts like you don’t get to count. Literally and figuratively they may turn their back on you.
I know. Sticks and stones may break my bones but names will never hurt me. Sorry, Mom but that’s just wrong. Names do hurt and they do inflict damage. Damage can be inflicted quickly and painfully by bullying managers and colleagues. As professionals we cover up the damage done as not to let it show in our professional lives, but in private the toll is very real. Anyone who has ever felt sick about having to go to work, afraid of what the day might bring about, knows how this feels. A job you love can quickly become a frightening and difficult place to be.
Stand up to the person. The bully is afraid. The bully is threatened by you. Don’t let anyone push you around. That all sounds great, but what if I lose my job because I was the lone person who made the choice to stand up to the bully? What will I do when a power-wielding bully takes me away from a job that I can’t afford to lose?
The literature tell us that that the roots of horizontal violence often come from workload stress, shiftwork and the emotional toll nursing care takes on people. I get it. We have stressful jobs, we work in high pressure situations and we literally have lives in our hands. Violence begets violence – if you learn it, you do it. And if someone does it to you, you will likely do it to someone else. But is that really our best excuse? If these issues are the roots of violence, then it seems to me that the better response would be to show some empathy to our fellow nurses. The better response would be to recognize that for the most part, we all do the best we can. Don’t we all want healthy and supportive work environments where our patients get the best care possible?
This seemingly too usual response of bullying and putting each other down isn’t working. Perhaps it’s time we all take a long look at our own behaviour and ask ourselves the hard questions. Are you the bully? Did you leave your work today having been a positive force for your colleagues? Or, did you let your bad day, bad mood, or just the fact that you don’t like someone allow you to be a negative force for someone today? Is it such a stressful time for you that it really justifies bad behaviour against a fellow nurse? Should your bad mood and insecurities get to dictate the well-being of those around you?
I write this blog to ARNBC’s members anonymously because I feel so fundamentally unsafe in my working environment that I don’t want any of you to know who I am. Some of you will shake your heads and say what a shame, not realizing that perhaps YOU are the bully in my workplace. Others will understand the feeling, and share my despair - because you also can’t afford to be the one to stand up and say you won’t take it anymore.
In her article Addressing Nurse-to-Nurse Bullying to Promote Nurse Retention, Carol F. Rocker identifies a number of strategies that can prevent workplace bullying:
1) Education – teaching nurses how to decrease bullying by helping them understand what to do and not do when confronted by a bully.
2) Policy – involving nurses in policy development to give them ownership and responsibility for their own workplace environment.
3) Celebration – celebrating positive, bully-free work environments
This is a start, but do we not have some responsibility for our own actions? We’re the second most trusted profession – but only if you ask non-nurses. Within our ranks, we know there’s good reason for the expression “nurses eat their own”.
It’s time to figure out how to end bullying, for the good of our colleagues, our patients and ourselves!
Canadian Centre for Occupational Health and Safety:
BC Research - Houshmand, M; O’Reilly, J; Robinson, S, Wolff, A, “Escaping bullying: The simultaneous impact of individual and unit-level bullying on turnover intentions”. Human RelationsJuly 2012 vol. 65 no. 7 901-918. (ABSTRACT - http://hum.sagepub.com/content/65/7/901.abstract)
Stokowski L., "A Matter of Respect and Dignity: Bullying in the Nursing Profession". Medscape Nurses, September 2010.
Johnson S., Rea R., "Workplace Bullying: Concerns for Nurse Leaders". Journal of Nursing Administration, 2009; 39(2):84-90. (ABSTRACT - http://journals.lww.com/jonajournal/Abstract/2009/02000/Workplace_Bullying__Concerns_for_Nurse_Leaders.9.aspx)
Griffen M., “Teaching Cognitive Rehearsal as a Shield for Lateral Violence: An Intervention for Newly Licensed Nurses.” Journal of Continuing Education in Nursing, 2004;35 (6):257-63.
Nurses shouldn't eat anything but a healthy lunch and some delicious individually-wrapped chocolates in the breakroom - most CERTAINLY not "their young". It makes me so sad that this is a piece of our professional culture!
Kudos to the author for tackling the subject, and thank you for your bravery!
I know that we've struggled with this a long time, and I think that compassion and involvement will go a long way to help! Ensuring that staff are empowered to work with one another instead of against, and to help foster a safe space for people to speak up if the need arises will be important parts of that too!
I agree it's time that we started living up to the high ideals that we strive for - not just in patient care but in care of the profession and everyone else around us!
These are painful issues brought to the forefront in this important blog piece. We all understand that any nurse who demonstrates the kinds of behaviors that are depicted in this article has violated CRNBC Professional Practice Standard 4 (Ethical Behavior) – standards that cross all practice contexts for nursing, including health care administration https://crnbc.ca/Standards/ProfessionalStandards/Pages/EthicalPractice.aspx .
Those professional practice standards, against which we should all be held to account as a condition of membership in this profession, represent our collective agreed-upon core values about what nursing stands for. They reflect the commitment we have to the public trust, and to the integrity of the systems we work in, which require that the relational practice context is as healthy as possible to ensure the most effective delivery of health care. They bind us to such responsibilities as these:
• Treat colleagues, students and other health care workers in a respectful manner
• Address concerns related to disrespectful behavior in the workplace.
• Promote and maintain respectful communication in all professional interactions, and guides others to do the same.
• Recognize and respect the contribution of others on the health care team.
Although I don’t mean to oversimplify the problem, I honestly believe that an important contributor to the current health care climate is the trend in recent years toward the interdisciplinarity and program management philosophies that try to extract us from our professional identities and obligations and turn our administrative sector into a corporate mentality. Without that strong professional orientation and standards framework, we are at the mercy of the managerial imperative, and so many of our leaders struggle with the impossible demands of corporate effectiveness and adhering to the professional ideals that brought them into their leadership roles. It seems high time for us to surface these problems – not to simply point blame at individuals for their behavior and brand them as bullies, which can be quite counterproductive in the end – but to begin to understand our collective responsibility in presenting an alternative model for how we might organize and deliver health care. Nursing systems led by nurses and supported by nursing philosophies, values and standards can make a world of difference in the world. They are caring and compassionate systems that attend to the individualized needs of patients, families and providers. When we sell ourselves short and allow nursing systems to be co-opted for a corporate managerial motivation, we tend to hate what we do and take that discomfort out on others.
So lets keep our eye on the ultimate goal – regaining the capacity to enact a nursing angle of vision on how health care ought to be delivered and the role that nursing can play in making that happen. Bullying is a symptom of a system gone wrong, and we need to be astute at reading the signals as well as strategic in proposing system-level solutions!
I honestly want to reach out and pull you into me, talk to you and listen to you and tell you that it does not have to be this way. You are correct of course, it is historical and it is distressing that it still exists.
I also agree that constructive critique is important and all nurses need to be open to hearing it and engaging in discussion regarding practice and professionalism. But that is very different than criticizing someone's practice, behaviour or person.
There is so much to say but I think Sally says much of it so I won't repeat her words, there are also excellent resources included here and other great comments.
What I will say is find a mentor, find someone to talk to who can help you address this issue. Don't leave it and don't continue if you still feel compromised as it can affect your practice and as you say sour your whole nursing experience. If you can't find someone you trust? Then call me.
Wendy Bowles NP
I confess. That was me. Not the author or the victim. The bully. Me.
About ten years ago, I was let go from a job. Not for bullying of course, because despite the fact that the way I treated those around me certainly warranted that kind of action you really can't fire someone for bullying, but because when you're a bully you're also likely insecure, incompetent, self-conscious, lazy and in way over your head. I didn't do the work I needed to do - it was easier to yell and push and shove other people around, all while telling my managers that it certainly wasn't ME not doing the work. It wasn't until after I was fired (for incompetence), that I realized that my incompetence and my behaviour were all part of the same problem. I had lived my whole life feeling like I was somehow less than everyone else around me. So I tried to make them look bad, to make me feel better. I treated them poorly, because that made me feel powerful.
I don't think most bullies ever come to this realization, or ever see themselves in the behaviour. For me, I had to hit rock bottom - broke and bankrupt, jobless, no prospects, couch surfing because I had to home - before I sought professional help and started to learn how my lifelong perception of myself had made me want to put down everyone around me.
Most bullies will read this and never see themselves. I see what I used to be and it makes me ashamed, even all these years later.
Everyone is a victim in a bully situation. The person who is belittled and bullied, and the person who feels so badly about themselves that they think cruelty is more fun than kindness.
As a casualty of bullying, I'd like to thank the former bullying Nurse for her honesty. She is taking responsibility and ownership for what happened during her reign of terror. I found your honesty very meaningful. In my own situation, there was no ownership. When I filed a complaint, I was vilified, defamed and dehumanized even further. There was no willingness by the professionals that I sought out for help, to admit I had been a target of psychological violence. Actually, their attentions were aimed at protecting the bullies, and silencing me. To this day, there has been no resolution, and it has been over 4 years since I left the clinic and hospital that continues to harbor the bullies.
Ownership of destructive behaviors by bullies and corporate goes a long way to restoring the souls of damaged targets. It will also alleviate much of the suffering experienced by targets of bullies.
I think everyone is a victim in a bully situation.I also agree that constructive critique is important and all nurses need to be open to hearing it and engaging in discussion regarding practice and professionalism.we tend to hate what we do and take that discomfort out on others.
Real-life stories like this are always hard to read, especially when it happens to those that are dedicating their lives to helping others. One key aspect that many nurse bullying experts such as Dr. Renee Thompson discuss is the need to properly document all incidents of nurse bullying so that you have evidence should you decide to make a complaint or work with HR to find a solution.
At Forensic Notes, we offer targets of bullying a free resource to properly document all aspects of the bullying so that you can prove when you wrote the notes to show the natural progression that bullying often takes.
By working together, we can hopefully put an end to nurse bullying.