Nurse Bully, please protect your young: "Don't eat them"

[Leonardo Del Toro]

I believe nurses are very special individuals. Think about it. They are professionals who take care of others in their dire moments. They patiently heal the putrid wounds of some; calm the fear and hopelessness of others; tolerate ingratitude and hostility daily; endure day after day of toiling around the sick and dying. Is only natural you'll find compassionate and warm hearted beings among nurses. I have been in other professions and the contrast is clear to me.

But because nursing is a tough job; some of us develop a thick skin. In a way, is a protection mechanism some develop to survive - you either get tough or you die. Although there is nothing wrong with being tough, some nurses can become quite aggressive and hostile to other nurses. We all have met them at some point, I surely did. But even being aggressive and assertive, nurses cannot match the aggressiveness of some bosses. Oh yes, let's talk about them bosses.

But bosses are people too. Yes, there are reasons why nurse bosses are sometimes so bossy. But bosses also have their though fights to fight. They too must develop an even tougher skin to survive the trials and tribulations of health care. Sometimes bosses are just nurses who left the floor because they simply couldn't take it anymore. Then to find even more stress in management.

Nurses are usually between a rock and a hard place. They have lots of responsibility, but lack the power to make decisions on their own. Doctors have much more say so in regards to their professional lay out. They call the shots, they can fire patients and are respected by most. Nurses on the other hand need to make decisions but always filtered by a set of rules created by others. Nurses must endure whatever BS is thrown at them. If you have an abusive patient, all you can do is to write a note and hope for the best. Most nurses can't simply fire a patient or they'll get fired.

Nurses run the show but are told how things should run. Often by someone who is deciding for them from an office chair; people who never worked on a floor or have not worked in years and can't remember anything. So, nurses are in a pressure cooker situation. Pressure from all sides and not an outlet in sight.

Well actually there is: and that is to relief the pressure on the least dangerous and inconsequential outlet - the young and vulnerable ones. The perplexed and scared nurslings are the recipient of a lot of pent-up anger. But why older nurses engage in this predatory and coward behavior?

It must be their inability to change the system and claim their power. Their extreme frustration lead them to eat their young. The ones they should be nourishing, protecting and grooming to take nursing to the next level just got eaten for lunch. Just like scared animals - they step on their own eggs. This is unfortunate.

If young nurses were well groomed and nurtured they would be the ones able to take nursing to the next level. Instead nurses create a culture of perpetuating the errors inflicted in them by transferring it to the young.

Protecting the young

Again, if you want to bully someone bully the oppressor and not the oppressed. Bully your problems and not the people who are here to learn. The bully energy is good energy but wasted and pointed in the wrong direction.

The alternative to bullying is to preserve and protect the young: because teaching the young the right ways is the only viable way to change nursing culture. It changes things because the young always will change the world. But instead we teach them the culture of bullying. We create perfect students in the art of bullying others. Nothing changes.

So, Mr. Bully next time you decide to torture the young, think of why you went into nursing back in the day. Bullying the young will only perpetuate the culture of abusiveness you were ounce, and continues to be a victim of.

[Ruby Vee, BSN]

Not_A_Hat_Person said:

When older nurses say they have been bullied by their younger and or less-experienced colleagues, they are generally believed. No one suggests the poster might be the problem. No one says "Grow a thicker skin, snowflake!" No one tells them bullying doesn't exist.

Here's the thing: Older nurses are unlikely to complain about being bullied by their younger and less experienced colleagues because they've developed thick skins and know when to take things in stride. Young nurses are quite apt to complain about being "bullied" because someone didn't want to sit next to them at lunch. (No, I'm not exaggerating. We've seen threads where this is the complaint.)

[Ruby Vee, BSN]

SmilingBluEyes said:

Not true. The opposite is true, actually in many cases. I had a preceptee eating me for lunch. This person learned almost nothing, nearly killed a patient during my preceptorship with them---- and I was blamed for being "mean" when trying to take this person to task and correct them (in private I might add). A bad outcome did occur once this person was on their own after our hellish preceptorship was over. Every time I tried to teach this arrogant person anything, I got the eye-roll and attitude. I could teach them nothing, and I ended the preceptorship with notes outlining my concerns. And again, I was blamed for giving a "bad orientation" after the bad outcome , by this poor "picked-on" nurse. Management did not listen to my concerns but sure listened to theirs.

But still---- The poor young nurse was the "victim" once again of a mean old preceptor nurse----- and despite the bad outcome. So nope, the older nurse is NOT always believed when they report the younger one is the problem. Believe that.

Yea the young do eat the old. Often.

I, too have been accused of being mean to a poor, helpless orientee when I attempted to correct them. I got the same eye rolls, This person even threatened to "take you to management" whenever I attempted to take them to task. I wound up with her as an orientee because her previous preceptors (four or five of them) couldn't deal with her. "She needs someone who will be direct with her and who will give her negative feedback when she needs it." I tried. She'd tell me that she knew what she was doing and if I didn't like it, I could go speak to the manager and the manager would set me straight. We spent many the hour after our shift in the preceptor office discussing some of her choices, the possible consequences and how she could have made better choices. She made it off orientation over the protests of six senior preceptors, two nurse managers and a few physicians. Fortunately, she quit shortly thereafter. She's in anesthesia school. Isn't that a scary thought?

[DTWriter]

Ruby Vee said:

Most of those topics have been addressed in previous threads, with the exception of workplaces hiring nurses whose main purpose is to precept. How would that work? If your job isn't taking care of the patients, you lose perspective on what taking care of the patients actually entails.

I do not know about others but I will not mind new tips on how a preceptor and orientee should behave, expect, etc. Maybe it would be the same as that of previous threads from years past (maybe from a couple months ago, or less) - I still would not mind; I will treat it as a reminder.

As for nurses whose main purpose is to precept -

They would be taking care of patients along with the orientees, right? At least, they should as the nurse preceptors - with the orientees eventually taking over.

The "nurse preceptor" could be a role for nurses interested in getting education experience, nurses looking for a PRN position, seasoned nurses and soon-to-be retired nurses who want to lessen their workload (I.e. take a break from being the main nurse), etc.

The "nurse preceptor" could be someone trained to be a preceptor as opposed to a random nurse who may or may not have experience as a preceptor, let alone the nursing experience to even precept someone else.

[Ruas61, BSN, RN]

These types of posts would be better listed as 'commentary pieces'.

[Horseshoe, BSN, RN]

Ruas61 said:

These types of posts would be better listed as 'commentary pieces'.

I totally agree. Newspapers call them "editorials." There is nothing clinical or research-oriented about this "article." It's not vetted in any way, contains no verifiable facts, and was not properly edited. I'm not saying it has no value as a post or thread, but calling posts like this a "featured article," which will end up all over the internet, incorrectly representing to the public the kinds of "articles" generated by nursing professionals, baffles and disturbs me. I don't understand how questioning that is wrong.

Maybe the concern some of us have voiced about the recent slew of questionable "articles" is best addressed in a separate thread so as not to come off as a personal attack towards the OP. Would this be allowed?

[Ruby Vee, BSN]

DTWriter said:

I do not know about others but I will not mind new tips on how a preceptor and orientee should behave, expect, etc. Maybe it would be the same as that of previous threads from years past (maybe from a couple months ago, or less) - I still would not mind; I will treat it as a reminder.

As for nurses whose main purpose is to precept -

They would be taking care of patients along with the orientees, right? At least, they should as the nurse preceptors - with the orientees eventually taking over.

The "nurse preceptor" could be a role for nurses interested in getting education experience, nurses looking for a PRN position, seasoned nurses and soon-to-be retired nurses who want to lessen their workload (I.e. take a break from being the main nurse), etc.

The "nurse preceptor" could be someone trained to be a preceptor as opposed to a random nurse who may or may not have experience as a preceptor, let alone the nursing experience to even precept someone else.

Have you ever actually precepted? Precepting is a very difficult job; taking your own patients without an orientee is a far lighter workload.

Someone who is continually precepting is responsible for the patients the orientee is caring for, but tends to lose track of the shortcuts, tips and timesavers that they habitually apply in their own practice but cannot apply when orientees are present. I might be able to glance at the monitor and think (accurately) "Atrial fibrillation" and immediately recognize that we've been diuresing a bit too aggressively. But with an orientee present, I have to go through all of the steps -- print off the strip, analyze the intervals, determine the rates and then go through the steps of critical thinking with the orientee to determine the probable cause that this patient went into A fib at this time. Then we have to discuss what to do about it, which doctor we contact for this issue, what orders to anticipate . . . and on and on. Alone, I can do the steps pretty much in my head without pausing to think through the steps, notify the physician and have the orders in about 1/4 of the time it takes with an orientee. But if I never take care of patients without an orientee present, I tend to lose track of those shortcuts.

In all but one of the hospitals I've worked in, there's been training and support for preceptors. That isn't an issue. What is the issue is that precepting is exhausting. I love to teach and have been told over and over that I'm good at it -- by managers, nurse educators and orientees. (And by my clinical students.) Precepting, done right, is not "light duty". Someone looking for a PRN position isn't going to be a preceptor because they aren't on the unit enough to keep abreast of the changes in practice, the new policies and procedures coming down the pike and because management and educators aren't going to know and respect their practice. (Unless, of course, they are on the unit "PRN" 36 hours a week, and in that case, what's the point in being PRN?) As a "seasoned nurse" close to retirement, I can verify that precepting is not a lessening of the workload. Yes, you have that young, able bodied orientee to "help you", but everything takes longer. I'm holding that 200 pound patient on his side for a LONG time so that the orientee can listen to his lung sounds, and it takes her three times as long as it would take me or my experienced colleagues. Granted, there are two nurses going into the room when it's time to clean up poop, but I have to explain to her what she needs to bring into the room, what to assess and how to assess it, but again, it takes her longer so I'm left holding that patient on his side for a very long time, never mind that my 61 year old back is aching and my knees are acting up.

It's also a very nice idea that only those who want to precept are doing the precepting. Unfortunately, with 12 or 13 new orientees hitting our unit every six months (and orientation being 5-6 months) everyone who has ever had to renew their nursing license will be precepting. Whether they are burned out from continuously precepting for the past two years or whether they're fresh from that preceptor workshop. The nurse whose husband is in the CCU waiting for the heart transplant and whose son is in jail (again) and who just moved her aged mother into her home to keep a closer eye on her wandering has BEGGED not to be given an orientee this time around because she just doesn't have enough energy for teaching in addition to keeping her patients safe. So sorry -- meet your new orientee, Edgar. The nurse who just came back to work after a six month medical leave . . . your orientee is Eileen, but she's in class today so we'll have you working with Susie's orientee because Susie called in sick. We've tried not to give Lucinda an orientee because she's a lousy preceptor and her practice is somewhat questionable, but Gilbert needs a guest preceptor today and Edgar needs a guest preceptor tomorrow and Agatha will need a guest preceptor on the weekend, so that's your next four shifts. We've been promising Bertha that she'll have a break from precepting due to her anxiety issues, but we have nursing students on the unit today, and Bertha will have to take one. Or two.

And this could be the start of a thread about why you shouldn't expect that your preceptor is a good teacher and eager to teach YOU at this time.

[Ruby Vee, BSN]

Ruas61 said:

These types of posts would be better listed as 'commentary pieces'.

This should have been just a thread, not an article. I think the new owners have gone overboard on the "articles".

[SmilingBluEyes]

I think for such articles to be valuable, we need to remember what " bullying" really is. It's not when the older nurse does not say "hi" in the parking garage. There was a case written about here on allnurses, where the older nurse did not have her contacts in, did not see the newer nurse in the parking garage, and failed to greet her---- and was accused of being "mean". The older nurse who does not tell her whole personal life story to the brand-new nurse on the unit, but is commiserating with the one with whom she has worked side-by-side for 10 years, that is not bullying. The nurse who harshly yells "STOP", preventing another from giving a deadly dose of insulin (yea that nurse was me), to a patient, again, is not a bully. The nurse who finds another in the break room, playing Candy Crush and tells her to get up and help her wipe a butt on a large patient, and is asked "why-- that is what aides are for" and is promptly and roundly criticized and corrected, is NOT being bullied!'

I could go on and on, but you get the point, OP.

Yes, in each of these cases, those nurses were indeed, accused of being bullies. I am, myself, rather tired of hearing NETY and bullying being misused. Because bullying does indeed, occur in nursing and other places and it takes away from the truly horrible experiences of those relatively few, I might add, who suffer. And buzzwords cheapen and do nothing to help those who are harmed by maltreatment. So, I would appreciate a bit more thought and introspection before such articles are written, and perhaps, a bit more research and caution used, before we tag people as "Mr Bully". Because truly, for those suffering bullying, it cheapens and insults their situations.

[DTWriter]

In terms of nursing - No, I have not precepted yet (unless taking care of nursing students once in a while counts - I kid, I kid). But, I get a sense that it is a very stressful role as it is now (i.e. having your normal duties on top of being responsible for the orientee's, not to mention dealing with an unappreciative orientee and life stressors).

That is why I am suggesting that it should be its own separate role, like the nurse educator.

The "nurse preceptor" role could go to someone that has experience on a particular unit and is looking for extra pay, and I mean real extra pay (i.e. not the $1 extra/hour for precepting). It could be like travel nursing - a temporary position.

Yes, there are new policies and procedures to be learned but that is where the nurse educator could step in and assist as needed.

Maybe the preceptors could be trained in the policy and procedures for a couple a weeks prior to the orientees' arrival?

With experienced nurses out there looking for extra money, I think some would be opened to precepting once in a while (and take the load off the regular staff nurses), if the price is right.

[MrChicagoRN, RN]

From the original "article:"

Nurses are divided in two groups. The first is tough skin, and strong willed. The second is sweet, angelical, compassionate and don't have a mean bone in their body. When group number one gets frustrated they take their grievances to the young and docile. Please don't do it Mr. bully. Have some guts and face your boss and his rules, the ones you really have a problem with....

...Well actually there is: and that is to relief the pressure on the least dangerous and inconsequential outlet – the young and vulnerable ones. The perplexed and scared nurslings are the recipient of a lot of pent-up anger. But why older nurses engage in this predatory and coward behavior?

...The alternative to bullying is to preserve and protect the young: because teaching the young the right ways is the only viable way to change nursing culture. It changes things because the young always will change the world. But instead we teach them the culture of bullying. We create perfect students in the art of bullying others. Nothing changes.

So, Mr. Bully next time you decide to torture the young, think of why you went into nursing back in the day. Bullying the young will only perpetuate the culture of abusiveness you were ounce, and continues to be a victim of."So, all nurses fall into only 2 groups; the oppressed and the oppressors? Nothing in between, no diversity of personality or thought? Wow, when I took Population Health, imagine the response I'd have from instructor and peers if I had simplified any ethnic, national, or racial category as being divided into only 2 groups.

This old vs young business is patently absurd.

"Mr Bully" indicates the author evidently that the 10% or so of nurses, who are in the minority, are the ones doing the bullying. How about Mr or Ms. Bully of any age?

After about 35 years in nursing, I still have never "decided to torture" any peers or direct reports. This Opinion piece is not only sexist and ageist, but presents opinions as facts, and are not substantiated in any way. Should we stop bullying? Of course, but that should be in all aspects of RL or virtual life.

A very disappointing piece.

[SmilingBluEyes]

Precepting new nurses is anything but easy. The small change made for taking on such a huge commitment is hardly worth it. Why do I do it? Because believe it or not, I love teaching and mentoring new people. I have had a couple of nurses over a few years whom I have regretted even working with who are out there, that I worry one day will harm someone, whom I voiced my concerns over. I can only do so much.

I mentor the young. I currently mentor those who are in nursing school; I work with several who are taking pre-requisite coursework in anticipation of entering nursing school one day. I encourage them every step of the way. Why? They are our future. But don't bite the hand that feeds you. That's all I would ask. There are some amazing people out there who are young nurses/future nurses and I have great hope and aspirations for our future.

But I have been fortunate enough to be able to take a break from precepting new nurses. I just had enough. I needed a break. I agree that new nurses deserve good preceptorships as much as preceptors deserve a break!

[allnurses Admin Team]

Horseshoe said:

I totally agree. Newspapers call them "editorials." There is nothing clinical or research-oriented about this "article." It's not vetted in any way, contains no verifiable facts, and was not properly edited. I'm not saying it has no value as a post or thread, but calling posts like this a "featured article," which will end up all over the internet, incorrectly representing to the public the kinds of "articles" generated by nursing professionals, baffles and disturbs me. I don't understand how questioning that is wrong.

Maybe the concern some of us have voiced about the recent slew of questionable "articles" is best addressed in a separate thread so as not to come off as a personal attack towards the OP. Would this be allowed?

It would be best to take this discussion of articles to another thread in the site feedback forum so as not to highjack this thread. We are interested in your input, but this is not the appropriate place as it appears that all of you are attacking the OP.