Well isn’t it just sad I have to write a post about this topic. Nursing might consistently rank the most trusted profession by the community year after year, however – it is also considered extremely high risk for lateral violence. For those of you who haven’t heard the term “lateral violence” before, it’s basically nurse to nurse bullying. You always hear the term “nurses eat their young” thrown around, and unfortunately this phrase continues to be mentioned, acted upon, and passed down through the generations.
I posted a poll on my instagram asking how many of you have experienced nurse bullying – 78% of you said yes.
Recently, nurse bullying has been a topic of focus in the social media world and for good reason. This year, Becker’s Hospital Study determined that 43% of nurses were considered high risk for suicide, with 7% of nurses reporting self-harm and 11% reporting attempted suicide attempts. I’m sorry WHAT. That is just AWFUL, for a profession that is supposed to promote well-being and saving lives.
I experienced nurse bullying right from the start. Nursing school clinical rotations. Of course I’d have some awesome nurses that loved to teach students. And other days I’d have the nurse that would roll their eyes right in front of me as I introduced myself. Trust me lady, I don’t want to be here either after not sleeping last night, but here we are. And after the introductions were forced I’d run around trailing my nurse all day, staying quiet and out of the way so I didn’t annoy her more than she was already. Too scared to ask questions and actually take advantage of my precious clinical time. Which of course leads to lesser educated nursing students graduating with a predispositioned fear to ask questions as a new graduate RN… leading to unsafe practices and decreased job satisfaction r/t fear and anxiety…. AND possibly resulting in higher nurse turnover for hospitals because of it. Dramatic? Maybe. Accurate? Absolutely. Horizontal violence can cost a hospital anywhere from $30-100K per nurse (Jennifer Becher, MSN, APRN, and Constance Visovsky, PhD, RN, ACNP-BC). Per nurse! And close to $150K for a trained critical care nurse.
Being a new grad in the ICU was better than being a student I’ll give you that. But I still would get the occasional snarky correction while giving report, or even just body language that was so obviously degrading. Sometimes it was just the simple motion of being actively ignored. It’s terrible. And I get it, we all have strong personalities in the ICU. We’re all awesome in our own eyes. But it doesn’t mean we have to treat other nurses like they’re lesser than us.
And it’s not only confined to your home unit. Nurse bullying happens giving report to other floors, between nurse practitioners and the bedside nurse, between preceptors and preceptees. How many times have you heard someone complain about a report from another floor? “How did they not know that? They’ve been taking care of them all night…” Or, “those damn ED nurses bringing up this hot mess.” Now whether or not the comment was warranted is situational lolz. BUT. The fact that it was mentioned in front of other coworkers is nurse bullying. It creates a non-productive environment for everyone, even those who just hear the comment passing by. It promotes that behavior and deems it acceptable if it continues without consequence. New grads are listening – watching experienced nurses as an example to them. Other nurses are listening. People feed off of other people’s energies. Let’s keep it positive energy ya?
Lateral violence can lead to decreased well-being and depressive symptoms in nurses. Sleep disturbances, anxiety, PTSD…the list goes on. Why would we want other nurses just like ourselves to feel that way? And these symptoms not only affect the nurse, they can affect patient care and outcomes. A happy nurse is much more able and willing to provide excellent care than an anxious or intimidated nurse. Right?
So the reason you’re all here. What can we do about this? How can we change this culture that’s been around for so long? Now obviously I don’t have a mind-blowing solution to this issue that’s been a problem for so long. But we can start with acceptance and communication. Acceptance meaning, acknowledging that this IS an issue in the nursing field. A lot of people think that just dealing with nurse bullying “toughens you up for the job,” or prepares you for being a nurse. No. We need to accept that lateral violence in nursing is still an ongoing and unresolved issue in order to fix it. Those snarky comments are not a normal part of the job. It’s bullying. And it stops with communication and advocacy for yourself and others.
So DUH. The easiest answer in response to a nurse bully is to confront them, right? That’s what your charge or supervisor might say when you’ve made them aware of a nurse who was rude to you. “Why don’t you just tell them how you feel?” Of course they’re correct here – you should. But it’s not always that easy! Is it worth talking to that person knowing that if you make this an issue then you’ll have even more problems with them in the future? Better off to just take it you say. Bringing up a bullying situation is really hard! I mean that shit is awkward! But if you can scramble up some nerve to do it, most of the time it is well worth it. These people will be caught so off guard that you actually said something about it, that they may even respect you for it. Cause guess what? You’re probably not the only one they’re picking on. And most people probably aren’t saying something to them, thus they continue the behavior. There have been plenty of instances were I was just fed up and finally said something to someone. And since it was discussed, they were super nice to me afterwards – respecting that I had the balls to stand up to them.
So escalation of the issue. If saying something to them got you more grief that you bargained for, or if you’re just too scared of that specific nurse, bring up the issue to your manager or supervisor. These people are trained to deal with these issues and can address them in a way that hopefully resolves the problem. DO NOT be scared to bring up nurse bullies to your manager!! And DO NOT worry about the aftermath of the bully being called into the office, potentially knowing it was you that said something. Cause guess what. If they do anything post-you bringing this to a manager’s attention that is still bullying, just smile at them, and bring it up AGAIN to your manager and if necessary, HR. Smiling at those people kills them inside I swear.
I’ve heard from some of you that you have brought up issues of bullying to your managers with no resolution. Either they make it seem like it’s your fault somehow, or that they just simply don’t address the concern in a way that solves the problem. Don’t let this stop you. HR is there for a reason. I know a lot of people that are scared to go up the chain of command to get what they need. They can help you. Mention being bullied to HR in person or even in an email. Keep a log of days and situations if this person continually picks on you and have it to show them.
AND IF you get nowhere after discussing with your manager and HR, and you still feel uncomfortable in your work environment, get outta there. Haha sorry… maybe not the answer I should be giving but in my opinion, there are SO MANY hospitals out there with zero tolerance for bullying/harassment, and you should be working there instead. Feeling bullied and broken at work is not a safe working environment – especially when you’re dealing with sick patients. It is not worth your emotional well-being at work, and the burden you carry with you home. Nursing is supposed to be a rewarding career choice, take your talents elsewhere if your facility can’t figure out how to treat their employees properly.
And what can hospitals do? There should always be someone you’re comfortable with talking to about work-related issues. My last facility had a voluntary mentorship program available to all new hires. I thought this was such an awesome program as it required 5 outside-of-work meetings that were paid for by the hospital. These meetings were simply to support the new hire socially doing whatever you wanted (going out for dinner & drinks, going on a hike, etc). When I was a mentor, I always asked my mentee if anyone was giving them a hard time at work. I was able to be that voice for them and bring it up to their supervisor since I was more familiar with them and it was easy for me to do so. Cause everyone I mentored had always replied with no… I didn’t say anything about it… which is to be expected when you’re new! It’s rough! So I truly believe that having a mentor program like this can help support those new staff by having at least one buddy at work, and someone to advocate for them if they are being bullied.
A glimpse into the future… I read a study called “Nurse Bullying: A Review and A Proposed Solution” (Castronovo, M., et al). They had a very interesting perspective and possible solution for nurse bullying. Basically they concluded that hospitals could have some sort of HCAHPS inspired survey for nurses to complete regarding bullying and their work environment. They believe that there needs to be some sort of incentive for hospitals in order to fix the problem. So, if surveys resulted in high levels of bullying, reimbursement would be reduced. Hmmm…
Nervous to confront a bully? Scrubs Mag has an anonymous form on their website that allows you to report them. They will follow up with your hospital and you can provide as little to as much information as you would like. How awesome. Link is below.
And lastly, sign the pledge here to help spread awareness of nurse bullying on the #Nursessupporttheiryoung campaign on Nurse.org.
We are all in this together. Nursing is a profession rooted in compassion, and fueled by teamwork, communication, and empathy. We can never pretend to know what another person is going through in life, so be kind to one another. We’ve all had shifts that make our heads spin, where we forgot something, where we gave a shitty report. It’s okay. It’s never excusable to be a bully, or to be bullied. Talk to someone, support each other. Let’s end the culture of nurse bullying.
One comment on “Stop Nurse Bullying”
Great article! I’ve been an RN for over 24 yrs now, and I have seen the best and the worst. I still encounter new nurses all the time who are actually shaking with trepidation while beginning to give me report. My response: I usually touch them in a reassuring way and say “Its okay, I’m one of the nice ones, :-)” I actually really get a lot of satisfaction out of being kind and supportive to new nurses. …And let me tell you, two years later, they [usually] still remember it (and they might just end-up being your new boss…).
When I first started ICU, I was often overwhelmed when giving a report in the morning to the “OG” day nurses. The death stare, no smiling, no blinking, no “good morning,” picking apart everything you say you did, or didn’t do while digging for errors. With the VAST majority of cases, I have handled this by calling them out on it. Letting them no how uncomfortable and how unsupported it makes me feel. Not only do they usually stop doing it, but they have frequently ended-up being some of my best relationships. Honestly, most of these type A nurses (despite female stereotypes), are usually horrified over the idea of ever having to “have a talk” about feelings with you ever again! They will avoid being unpleasant to you just KNOWING that you might actually confront them about it.
The other practical thing I learned to do early in my career, was to always try and set-up the next shift as nicely as you can. Fresh IV bags/tubing, fresh linen, well cleaned patient, etc… The nurse most likely to write you up is the one to whom you have left the biggest mess…