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I recently wrote about bullying in healthcare, when healthcare providers bully patients. A similar problem has existed for a long time within healthcare itself: professionals bullying each other. I’ve seen it in action as some physicians bullied nurses, and some nurses bullied other healthcare providers and other nurses. Unfortunately, it’s still happening.
According to the Harvard Business Review, about 30% of people in the U.S. general workforce are bullied. For comparison, the authors mention India as having at-work bullying rates from 46% to 55%, and Germany at 17%. One would think that a caring, empathetic profession like nursing would be different. Sadly it’s not.
Nurses eat their young
When I first entered nursing school, I heard the saying that nurses ate their young. This was considered acceptable, that students and new nurses would be subjected to harsh treatment to toughen them up or help improve their performance. I saw it first-hand in nursing school when certain students would be targeted by some professors and clinical instructors. It was obvious to us that these students were being bullied, and yet, we felt powerless.
…about 30% of people in the U.S. general workforce are bullied.
Here is one example. A pair of first-year nursing instructors were known for picking on older students who had life experience, compared to us 17-year-old new high school graduates. We could see how aggressively the teachers approached these students. Their mistakes were broadcast to the class in a more aggressive manner than for other students. If they had any conflicts (daycare for children, work, etc.), they were constantly told that nursing had to be their priority and they were not indicating that it was. Instead of trying to help these students manage work and family issues along with school, the teachers tried to make them feel terrible about their choice to return to school. Most of the older students dropped out by the end of the second semester.
These instructors were equally as harsh on LPNs who enrolled in the program to get their RN license. The instructors constantly told them, aloud for all to hear, things like they had to adjust their ways of thinking, that being an RN was much different than being an LPN, and if they couldn’t grasp that, then maybe they should stay as LPNs. I remember one instructor telling me that I was too task-oriented and that if I remained this way, I should save time and money and just go and become an LPN. (For any LPNs reading this - I’m sorry that some RNs feel this way. Your contribution to patient care is invaluable and I know LPNs who can run rings around some RNs.)
We also saw bullying behavior in the hospital, right from our student nurse days and onward. I would argue that some of the nursing supervisors I worked with were bullies too. We were allowed 9 sick days per year. But if we tried to take a sick day, the supervisors would do everything they could to not allow us that day. They would ask what was wrong, how sick we really were, point out if we had recently taken a day, and insinuate that we only called because we didn’t feel like working. If we woke up at 5 a.m. for a 7 a.m. shift and realized we were too sick to work, we’d be berated for calling so late. Calling in sick was very stressful because we knew that we would be subjected to that treatment. When I was a supervisor, if a staff member called sick, I said, “Thanks for letting me know. I hope you feel better soon.”
Statistics back up the bullying claims
Some may argue that it was our perception, but statistics say otherwise. The American Nurses Association says that between 18% and 31% of nurses have been bullied by colleagues. But others say it is even worse. According to an article in Nursing Administration Quarterly, “The nurse bullying phenomenon is well-documented in the clinical and leadership literature. It starts early and is present from the classroom to the bedside to the boardroom. One study showed that over a 6-month period, 78% of students experienced bullying in nursing school. In another study, over half of nursing students reported seeing or experiencing nurse-on-nurse bullying during their clinical rotations. Within the first 6 months, 60% of nurses leave their first job due to the behavior of their coworkers.”
Some may argue that it was our perception, but statistics say otherwise.
The authors wrote that it happened at all levels of nursing, in all types of units, ranging from the patient floor to the executive suite. It’s not just one group that bullies. Please note that this is SOME, not all nurses:
Older nurses might bully younger ones
Younger nurses might bully older ones
More educated nurses might bully less educated nurses
Established staff might bully travel or agency nurses
Females might bully males or the other way around (This study shows men were more likely to be victims in nurse bullying)
Specialty nurses might bully general floor nurses
Becker’s Hospital Review published an article on nurse bullying a couple of weeks ago. The authors wrote that workplace shortages and the higher stress levels at work contribute to an increase in nurse bullying. Hospitals are hiring more inexperienced nurses or those who work for private nursing agencies – a red flag for some nurses who resent the agency employees.
So what constitutes bullying in nursing?
There are two types of bullying: covert and overt.
Covert bullying is not as in-your-face as overt bullying. It includes leaving someone out of important interactions. It can make you question yourself - are you being bullied, or are you imagining it? The bullying can be continuous eye rolling or nasty looks when the victim speaks up, deliberately turning away when the victim is speaking or reaching out, that sort of thing.
There’s gaslighting too. In a nursing setting, it could be “forgetting” to tell a colleague about a task that needs to be done or a meeting. It could be making yourself unfindable when your colleague needs you to cover so they can take a quick break. It could be spreading rumors or being dismissive.
Overt bullying is much easier to identify. This is berating the victim, minimizing a nurse’s struggle, shouting, shaming, sending angry messages, and using hostile body language. And I think all nurses have seen examples of this at one time or another.
It’s not a good look
People turn to us for help when they are at their most vulnerable. But if there is bullying going on, patients can and do notice. Bullies aren’t always subtle, or they think they are, but patients see and hear things.
Bullying also increases worker shortages. I worked in one facility where the bullying was so bad that new nurses after the new nurses left, and those left behind, were complaining that we couldn’t keep any staff. Word spread too. I met a nurse who had considered applying to work in the facility but decided against it when she heard about the bullying.
It has to stop
One simple way to stop bullying in nursing is to stop it when it first starts. We need to take a step back and acknowledge that nursing is a tough job and we all need to learn. Teaching by intimidation and anger is not effective, so it has to start in the very beginning, in nursing school. Therefore, the instructors who take the “we must be tough on them approach” need to rethink their teaching methods, as do preceptors who think that way.
I had a clinical instructor tell me that I was not smart enough to be a nurse. She failed me for my peds clinical rotation. Now, maybe my work wasn’t up to par and maybe I did deserve to fail it – but to say to me, “You’re not smart enough to be a nurse”? She encouraged me to drop out. So I did. (Obviously, I ended up going back to school, graduating and getting my license.)
Starting with the instructors is a good thing, but that doesn’t help the nurses in the workforce now. And we need to do that. Here are some links to articles on how to stop workplace bullying.
We also need to start standing up for ourselves. I wish I had when I was in that situation. I wish I’d stood up for the other nurses too.
What do you think? Have you been a victim of workplace bullying? Leave your comment below. Let’s get a conversation started.
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Oh, that part of about sick leave brought back memories! (not good ones)