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This is a discussion on How to promote tolerance and support teamwork, in Nurse Colleague / Patient Relations, part of General Nursing ... There are numerous posts here about bullying and lateral violence. There is no denying the...by Teacher Sue Sep 5, '12There are numerous posts here about bullying and lateral violence. There is no denying the existence of this behavior, and anyone can be a target. Early in my career, I was a target more than once, and I am ashamed to admit that I was also a perpetrator. For some reason one of the influential nurses on my first unit took a liking to me, and I became one of her followers. I was so afraid of becoming one of her victims that I tried to become just like her. I thought I was protecting myself, but in reality I was just being mean. When I stopped blindly following her lead, she did target me for a while, but then moved on to easier prey. Anyone at any age or level of experience can be bullied.
Six years ago, I was asked to take over the management of my current unit. Turnover was extremely high, and staff morale was lowest in the hospital. There were two "Queen Bees" who ran roughshod over other staff, and made things miserable for everyone. It took three years to change the culture on this unit from hostile and unwelcoming to friendly and supportive. More than once I thought of giving up and returning to my old unit. It took a lot of hard work and committment from my director and from the staff who wanted to see things get better. Now I love the staff here, and would never consider returning to my old floor. Maintaining this culture is important to me and to the staff.
There is of course still conflict on our unit, but it is handled in a positive manner. I believe that one of the most effective ways to control this behavior is to refuse to hire bullies. It is not always easy to determine during an interview if someone has this type of personality, but attitude often shows. I observe how a candidate interacts with all staff, and ask questions about their relationships with coworkers. You would be amazed at what some people admit to in an interview.
Our unit also has a code of conduct that was written by our practice council, based on the Commitment to my Coworkers pledge. Everyone on the floor signs this and they understand what the behavioral expectations are. The fact that staff developed this document makes it more effective.
When there is conflict between individuals on the unit, my expectation is that the involved parties do their best to work it out. I do not get involved right away. This allows the person who feels bullied to become stronger by facing the issue, and sends a message to the perpetrator that her behavior will not be tolerated. I will coach people on how to approach a coworker, and help tham to decide what to say, but I expect it to be handled peer to peer. This seems to be an effective means for our staff to handle conflict.
If the situation does not improve, I will then schedule a facilitated conversation with both parties. This is not to place blame, but to help both parties try to come to a resolution. By observing the interactions, I can usually determine if there truly is bullying going on, or if there are communication problems. And I have run into the occassion when someone has difficulty dealing with criticism, even when it's constructive, and feels bullied, even if this is not the other person's intent. A facilitated conversation will bring this to light as well.
If there truly is bullying going on, and these steps have not corrected the problem, then I begin the disciplinary process. I have only had to do this once in the last three years, and that person left the unit, knowing that she would be terminated if she did not change her behaviors.
So this is a little about how we try to address lateral violence on our unit. I do think the manager sets the tone for the unit, however. A manager needs to know her staff, and be willing to work on maintaining this kind of environment.
Bullying can cause a great deal of pain. I can almost hear the pain expressed in some of the posts I have been reading here recently. I do have one last bit of advice for those who have been the targets of bullies. I know you have been through a painful experience, but please try to move past it. Do whatever you need to do. See a counselor, talk with a friend, pray, or whatever else you need to do to let go of the pain. If you do not, that pain can turn into bitterness. Not only will that bitterness show when you are interviewing for your next job, if it is allowed to grow, it might just turn you onto the same kind of person who perpetrates thiis behavior.
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- Sep 5, '12 by brandy1017Are the two troublemakers still there? What became of them and how did you get them to stop the bullying behavior?
- Sep 5, '12 by AICU RNWe had a conversation about this the other day at work. One of the nurses I personally look up to reccomended When Nurses Hurt Nurses: Overcoming the Cycle of Nurse Bullying by Cheryl Dellasega, PhD, RN, CRNP. It's supposed to be helpful when dealing with "Queen Bees." I can't wait to read it.
- Sep 5, '12 by Wise Woman RNYou sound like a truly awesome manager... *sigh.*
- Sep 5, '12 by hey_suzI dream of a workplace such as you describe- teamwork, supportive manager. I know a CNS who was instrumental in a turnaround of a unit similar to what you accomplished, so I know it does exist.
- Sep 5, '12 by Teacher SueNo, they have both gone to other hospitals. They both tried to transfer to other units within our hospital, but their reputations were well known and no other manager would have them. I started out by changing scheduling guidelines. The previous manager gave them whatever they wanted, because she rationalized that they would just trade shifts with others to get what they wanted anyway. I scheduled them a fair number of off shifts, and set the expectation that all trades had to go through me. They did try to pressure others into trading shifts, but I would not approve the trades. I also started making out assignments myself, rather than have the charge nurses do it. They would try to change their assignments when they came in, but I would not allow this either. The practice on the unit had been to rotate charge among all of the staff. I picked two promising staff members and made them permanent charge so that these two were not in charge any longer. And I gave the charge nurses authority to help with performance evaluations. Queen Bee number one was chair of the unit practice council, and I relieved her of that duty. And I just started making them accountable for their behaviors. They were very angry with me at first, and would tag team me with complaints. One would be in my office with an issue about the way I was handling things, then the next day the other would be there complaining about the same thing. Their previous performance evaluations had been stellar, I think because the previous manager was intimidated by them. When they got "unacceptable" on their evaluations, they were livid. And I did place both of them into corrective action for their behaviors. Throughout the process I had extensive support from my director and the CNO. A big part of the issue was that the previous manager had left this situation continue for several years. She was a good person, but I think she was bullied as well. She did tell me that these two were the main reason she decided to leave her position. They both hung on for about a year and a half, then left. I truly hope that they did not continue acting this way in their new positions.
Quote from brandy1017Are the two troublemakers still there? What became of them and how did you get them to stop the bullying behavior?
- Sep 6, '12 by struggling rnim am really a struggling rn as i m a victim of severe bullying right now. I wanted to leave this job but i cant, due to my visa which is given by the employer.......God alone can save me..
- Sep 6, '12 by CrunchRNSounds like every unit could use someone like you. Maybe your words of advice will inspire others and give them ground work to implement this in their units.
- Sep 6, '12 by itsmejuliYou're awesome Sue, wish you could take over the unit I left a few months ago.
I left a job I really liked because I was just bullied, I was subject to mob behavior. The manager knew what was going on, so did HR and the union. The only answer I got was that "they're working on it and it will take time".
- Sep 6, '12 by nola1202ditto. I thought I'dfound the perfect job, now I find out someone has lied about me to management and mangement believes them. I'm stuck with a "performance improvement plan" and having to go through more "orientation" so I can learn to be more supportive of my co-workers. I feel so bitter. I've been a nurse for over 24 years. I'm good at what I do. I am supportive of my co-workers. ARRRGH!
I know, I know, tell it to the hand cuz the face don't give a da@$!
I'm so angry and hurt and betrayed, it's all I can do to keep showing up till I can find another job. I just can't deal with being treated like yesterday's garbage.