I was early in my bedside nursing career when I found myself taking a five to wipe tears off my scrubs uniform in the staff bathroom over something a doctor yelled at me. It was my first experience with nurse bullying and I can’t remember the words he said, but I remember feeling humiliated in front of my colleagues.
“Oh, Dr. So-and-so? Don’t worry about him. He does that to all the newer nurses. It’s just how he welcomes nurses to the unit and asserts his dominance”, my co-worker attempts to reassure me by minimizing my feelings.
Assuming I was perhaps acting a bit over-emotional, I took a breath and proceeded to my next patient’s room moments later as if nothing happened. But I still carry that with me.
Nurse bullying does not just come from other nurses, but also medical assistants, providers, nurse practitioners, management, nursing students, or other healthcare professionals we work with. The worst part about bullying in nursing is the fact that this behavior is continually enabled by our peers, management, and the healthcare system as a whole. No one should be “initiated” into a unit, or have someone “assert dominance” over them. Healthcare workers signed up to do a job, not join a fraternity or a zoo.
Why Bullying in Nursing?
Despite nursing being voted the most trustworthy career for over 2 decades, being a career in the STEM field, and comprising of college-educated professionals, nurses continue to suffer from bullying and workplace violence.
A 2013 analysis revealed that about half of nurses have experienced lateral violence (workplace bullying) at some point in their careers, and 93% of nurses have witnessed lateral violence at some point in their profession.
There are several reasons why bullying in nursing is so prevalent:
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Bullying behavior is deeply ingrained into healthcare in general
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Nursing is a traditionally female-dominated field, and women tend to participate in gossip and verbal bullying
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Nurses are placed consistently into high-stress, fast-paced environments
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High turnover rates force nurses to always be training newcomers
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There is less time for team-building activities or workplace camaraderie due to the state of healthcare
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Healthcare management is lax in taking action against bullying and changing the bullying culture
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We spend 12-hour shifts with a small group of people, where social structures and cultures begin to form, and gossip and incivility can take root
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Types of Nurse Bullying
There are two main types of nurse bullying: overt bullying and covert bullying .
Overt Bullying
1. Yelling. Raising your voice against a colleague in public or in private in non-emergent situations.
2. Name-calling. Referring to someone as “the newbie”, “sweetie” (in a condescending tone), or any other derogatory shorthand in reference to a coworker.
3. Belittling. Giving criticism that is unfounded, unfair, or overdramatized to a colleague, especially in front of others.
Covert Bullying
1. Gossiping. Saying something about someone else that you wouldn’t want them to hear, about their personal life, what they ate for lunch, how they prioritize their nursing care, etc.
2. Cliquing. Making an effort to exclude other nurses from conversations or the general group as a way to “other” them.
3. Ignoring. Not answering the questions of another nurse, not engaging in friendly workplace conversation, or refusing to help them when they need it.
Patient, Staff, and Healthcare Impact
Nurse bullying is much more than a few hurt feelings that can be smoothed over. Fostering a culture of bullying has real and dangerous implications, including:
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Nurse burnout
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Decreased job satisfaction
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Physical health disorders, like insomnia, palpitations, or GI upset
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High turnover rates
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Mental health disorders ( PTSD , depression, anxiety, and even suicide in nursing)
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Impact on patient care due to distraction, poor mental health, and lack of teamwork
Ideas for Change
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Zero-tolerance policies. Perhaps the most effective way to stop incivility in nursing would be to enact zero-tolerance policies for nurse bullying. This means that offenders will be given discipline. This should be the norm starting in nursing school.
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Diverse hiring. Having diversity in the staff, including diversity of thought, culture, race, religion, and appearance can help mitigate bullying in nursing. When the workplace is too homogenous, there is a higher likelihood that someone can be outcast or bullied due to their slight differences from the group. Exposing nurses to diversity in the workplace allows them to have more tolerance for other groups of people.
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Open door policies. Nurses should be welcome to report all types of incivility and bullying to their management. Management should always consider listening to a nurse's report of bullying as a top priority, and action should be taken after hearing the report.
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Reduced external stressors. Reducing some external stressors like poor staffing ratios and high turnover rates will mitigate some bullying behavior because nurses will have their basic needs met.
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Provide resources. Victims need to be provided with appropriate counseling and resources. Don’t Clock Out is an organization with a mission to prevent suicide in nursing by providing access to mental health resources.
Change From Within
You’re with the majority if you’ve experienced nurse bullying or incivility, but that doesn’t make it okay or normal. You have every right to be upset about the way you’ve been treated and you should be listened to and taken seriously by your management.
To start to change this culture, we need to listen to the stories of those who have been hurt. We need to report bullying when we see it and when it happens to us. And we need to reflect on our actions to see how we can root out our own bullying behaviors.
The Moxie Way
Moxie Scrubs is committed to supporting the mental health and well-being of all healthcare professionals. According to the Moxie Mission, “Moxie defines the 'force of character, determination, and resourcefulness,' of the nurses across our country on the frontlines today. More than a brand, this is a movement.”
Check out the super soft scrubs at Moxie Scrubs to rep the movement.
References
Nurs Adm Q. 2019 Jul: Our Own Worst Enemies
The Online Journal of Issues in Nursing: Lateral Violence in Nursing
Moxie Scrubs: Real Time Tools for Nurses to Cope With Their Own PTSD
