A question for career changers.

[dudette10]

Do you feel that the interpersonal behavior in the healthcare environment is different from the interpersonal behavior in other professional settings?

If so, what is different, and why do you think it's that way?

I have my own opinion which is probably transparent in this question, but I would like to think about others' opinions.

[WyndDrivenRain, BSN, RN]

I don't know. My Husband works in higher education on the Dean/Director level. There is so much backstabbing and trying to get people fired (so people can get their "friends" in to those jobs). I think what he goes through is just as bad as some of the stuff I saw as a floor nurse. I do have to say I worked for several years at a detox where none of that childish crap was tolerated and everyone worked as a team. The whole culture was so positive. I'm just shocked at the lack of professional respect in general these days.

Sue

[Bill E. Rubin]

Yes, the business world has many of the same problems you see in nursing. The difference to me is that in the business world people actually suffer consequences for many behaviors that are widely accepted norms in nursing. Therin lies the problem. Instead of taking a stand and demanding action be taken when these behaviors occur, nurses run to internet forums and write a long, emotionally charged post about it.

I still maintain what I said. I have worked in the corporate world for over 20 years in all levels of hierarchy from entry level to senior management, in eight different jobs in seven different companies, not including the consulting gigs and family businesses. I've seen even worse backstabbing in the corporate world. And often the backstabber suffers no consequences while the victim of the backstabbing might lose his/her job, because peoples' jobs are cut at the drop of a hat in the corporate world.

One other thing that's different. Once, when I was working in my large Boston hospital, there was an announcement made that due to budgetary problems some 200 jobs were being eliminated. Given the size of the hospital, this number was quite small, yet in the email making the announcement, it was stated that most of the jobs would be eliminated through attrition, meaning people who left their jobs simply wouldn't be replaced. Others would be transferred to existing job openings. The end result was that twenty people would be let go from the hospital which represents a fraction of a percent of the workforce.

In the corporate world, if the company is publicly traded, it was commonplace for a company who was actually profitable to lay off say 10% of its work force just to raise the stock price (it still baffles me that laying people off raises the price of stock, but many times it does, if spun correctly). Allso, this is rarely announced to employees, but is just dropped on them, usually on a Friday, with no notice, and employees are escorted by security out the door once they are told they have been laid off.

I'm not naive enough to believe that my hospital is a charity and that the bottom line is not important, but the fact is that it is a much more humanely run institution and that people never lose their jobs just for the helluvit to make some extremely rich people even richer. But it is run with some modicum of conscience and that the people that work for the institution are at least given some thought as human beings when making sweeping decisions some of the time, whereas in the corporate world, most of the time, no thought is given at all to the negative impact on peoples' lives. None whatever.

Anyway, this cold cruel reality of the corporate world permeates the culture and makes people cold and cruel to each other when times are tough. Dysfunctional workplaces whether they be a dysfunctional nursing unit or corporation are terrible places to work. The type of dysfunction in nursing units tends to be more of the passive aggressive thing that is more the female style, and the type in the corporate world tends to be more the smile in your face and stab you in the back style. Men as well as women in the corporate world can be gossip-mongers. I have been the target in one job of some unfounded gossip that really negatively affected my standing in my position and made me paranoid that I was going to lose my job in a recession when many people were being laid off (thankfully I did not lose my job, but it made my life miserable until I found a new job).

[SummerGarden, BSN, MSN, RN]

i agree with the others that say that the business world is political and has problems too. however, unless your company is going-under, you will not hear the garbage or have to tolerate the junior high school mentality/politics of floor nursing (when i say floor nursing i mean nursing that deals with direct patient care even in specialty settings). this is why i plan to move into management as soon as i can ...

similar to another poster, i have no problem with upper management. i also have no problems talking to doctors with "god-like" mentalities. in fact, until now, i learned most of my nursing from doctors because within my past work environments my co-workers were gossips, backstabbers, eat-their-young-types, and mean-girls so they did not attempt to teach me anything!!!

in general floor nursing is pure childishness. for example, i know of nurses that were very good, but were fired because he/she was just not liked. period! i do not know of upper management people who get fired for that reason without being compensated like royalty so that he/she can move onto something more lucrative then before. also, having additional education is not a threat to anyone. in fact, it is an expectation!!! playing the game on the management level is not complicated for mature adults!

within a production environment of a business world, success is all about numbers! it is not necessary in most cases in the business world to throw your peer under the bus. the politics in the business world is to make more money than your peers and to get along with your manger to show him/her that you make more money than your peers. in other words, numbers talk and emotions walk!

yes, there are environments where business people will be cut-throat to make his/her numbers better than yours.... however, you can always see this coming if you have a little common sense. the kind of backstabbing that occurs in business is different than nursing because numbers do not lie. therefore, the nature of a business environment is nothing like nursing on the floor. i have never ever heard garbage talked about me within ear-shot prior to becoming a nurse. yes, i suspected gossip was said about me in the business world, but i never heard who was saying it or what was said. i have also not had people try to prove a point about me as a co-worker by withholding valuable information or services that would jeopardize my client (patient in the case of nursing) as one poster pointed out. i have had this happen to me several times as a new grad nurse in an attempt by some of my former co-workers to see me fired. it did not work however, because i learned quickly not to rely on certain people for information or help to their dismay.

in addition, as someone else pointed out, i too never had a meeting to talk about feelings and emotions with a middle manager!!! give me a break! numbers spoke for me and so meetings were pure business. i cannot wait to go back to that again, but this time as a nurse, of course!

[Bill E. Rubin]

Most of the companies I worked for are still in business and have not "gone under." Laying large numbers of employees was just a part of doing business, and people who got laid off usually were due to not being liked by the right people in management rather than by any "numbers" you talk about. Unless you work in sales, numbers are often abstract in terms of productivity.

Some of you have clearly worked in some dysfunctional nursing units, but childish/high-school-like behavior is not limited to nursing units. I have experienced it firsthand.

As to my nursing unit, I have experienced some cattiness and my share of marginalization due to my gender and the age I started nursing, but by and large, it's a functional, reasonable group of people whom I mostly enjoy working with.

I have worked in great teams in the corporate world as well, though ihave seen childish, vindictive behavior just to take people down, either for professional gain, or to be more "in" with the "in" crowd.

Dysfumnction, pettiness and childishness are not limited to nurses.

[whodatnurse]

Prior to becoming a nurse, I worked in corporate america for 14 years.

And some days, I MISS it. Never had I've experienced so much unprofessional behavior in corporate america as I have in nursing. I will tell you, if some of the behaviors that I've seen in nursing were done in a corporate setting, NOBODY would have a job!

I am used to being direct, up front, and to the point, along with being cordial. That's professionalism to me. I am used to dealing with conflict behind closed doors and directly with the person I have an issue with. I am NOT used to all this passive aggressive behavior I see in nursing.

And another thing, you were EXPECTED to behave in a professional manner, or you had a meeting with management to discuss your options of employement. I've never had to meet with a manager to discuss "feelings and emotions".

There is a problem when we are having meetings on "hortizontal violence" and when "gossip" is the norm.

I second everything you said.

When I worked in the corporate world you communicated honestly and directly, and IN THE MOMENT. So if people were annoyed or irritated about whatever, that got communicated (in a respectful manner), and then, it was OVER. What I've seen in nursing is that folks complain about their co-workers behind their backs, turning molehills into mountains in the process, to the point that the smallest matter that could have been addressed with a 2 minute conversation with the person, is turned into a ridiculously overinflated 'issue'.

[belgarion]

Before I did my 20+ years in the corporate culture I spent 11 years on the production floor. My first 12 years in management I was a "project engineer" which was a fancy way of saying it was my job to get the the multi-million dollar equipment we sold to a construction project installed and running. I ended up as a corporate "hit man" where I finally made enough enemies to where I was exiled to a division that was being shut down. The reason for this background is to show that I have seen both sides of the coin.

Yes, all the behavior that has been described here permeates the corporate world. It is NOT, however, the norm on the production floor or the construction site.

Chronic whiners and criers and complainers are not tolerated well by other workers who are doing the same job and facing the same issues. Nobody wants to hear the bs because it's the same bs they are living.

Backstabbing happens but for the most part the workers won't tolerate it because a backstabber can't be trusted. You never know when you will be the next victim.

Conflicts that disrupt the department are handled quickly and sometimes decisively. No supervisor or manager wants a squabble to come to the attention of upper management or even worse, HR. When it leaves the department it make the supervisor or manager appear weak.

Care to guess what would happen to a supervisor who allowed a problem that impacted on the departmen's effiiciency continue in the hope it would just go away?

My point is that as floor nurses WE are the production workers or the plumbers or electricians or the peson behind the counter. But nurses tend to engage in behavior at a level that is normally seen in management and above. While the worker bees in a factory, on a construction site, etc. may not always get along but they tend to have a "we are all in this together" or "it's us against them" mentality and do quite a bit of self-policing of problems. If you don't believe this watch a few episodes of Deadliest Catch.

The business world (notice I didn't use the "c" word) is far from perfect. Yes there are always cliques. Yes, there are the bullies. Yes there is lateral violence. Yes there is gossip. But not to the extent I have seen since entering nursing or that I have read about in AN. And what does occur in the outside world is very often dealt with very quickly. As I said earlier, nobody, workers or supervisors wants higher ups involved. Nurses on the other hand seem to absolutely relish running to the unit manager, the DON, the CEO, their congressman, senator, and the President because so and so talked mean to them or susie-q left a syringe wrapper on the counter in the med room.

Maybe the reason is that nursing is an estrogen powered profession. Personally I think it has more to do with the fact that healthcare in general and nursing in particular were somewhat insulated from the real business world for a long time. Now the insulation has been striped away and nursing is having to grow up.

I know in my earlier posts I did not do a good job of getting this point across and for that I apologize. But in the business world, the behavior of the workers on the floor, in the field, or behind the cash register bears very little resemblence to what goes on in the upper floors of the headquarters of MegaCorp Ltd.

[JSlovex2]

Only in nursing is it normal and routine to see employees ***** at each other just to do it without caring that the patient is within earshot, or wait, do it standing over the patient in bed and not be fired. Only in nursing can you keep your job if you do not hop out of your chair and help another employee whose patient is crashing. Only in nursing can you run to a manager to complain about some personal issue you have with another employee again, and again and expect to not be fired for being immature. Only in nursing can you withhold critical life jeopardizing information from another employee and not be fired. Only in nursing is having a good or great professional relationship with all other levels (all MDs) something that you may or may never be allowed to obtain (this is still odd to me as I am used to working side by side with the top folks - which is effortless for me. I don't get rebuffed much by MDs, but i do get odd puzzled looks like, "That one is smart. I think it wants to interact with me on an intellectual level or maybe just wants to know how my day is going" Then what follows is guarded attempts at friendly communications like I'm some patient or something -- until I roll my eyes...)

i agree with this. the environment, gossip, and complaining is much like the environment of my HS job in fast food which is scary. there is complaining about what one shift should've or could've done and didn't do. there are people taking breaks when others are drowning (and it's always the same people). everything is always "someone else's job." the doctor blames the nurse, the nurse blames the CNA, the CNA blames clerical, clerical blames phlebotomy, etc, etc. there is just a huge lack of respect and accountability that i've never seen in other professional settings.

[JSlovex2]

As I said earlier, nobody, workers or supervisors wants higher ups involved. Nurses on the other hand seem to absolutely relish running to the unit manager, the DON, the CEO, their congressman, senator, and the President because so and so talked mean to them or susie-q left a syringe wrapper on the counter in the med room.

this is exactly right. in other settings, "problems" between co-workers are usually dealt with without higher-ups getting involved or even being made aware. i've never used the word "snitch" so much in my life as i have since working in a hospital. i saw a young, new nurse leave medication (ready to administer) sitting in an unlocked cabinet that anyone could've walked by and gotten ahold of. i know because i opened the cabinet and there it was. i simply told her, "i wouldn't do that if i were you," but then i got a lecture by my supervisor for making a "negative comment" that upset a co-worker. of course, the co-worker never spoke to me about it - just went straight and reported it. i'd never want to see someone get in trouble or even fired, but that doesn't seem to be the case with a lot of people - it's like a mission in life to see how many people's license they can get pulled or how many people they can get fired. it's very odd.

[dudette10, MSN, RN]

Thank you for all your responses. Every one of them gave me food for thought, which was the reason I posted the OP in the first place.

I began thinking about my family members who work the public, e.g. teachers, policemen, other nurses, etc., and a lot of what I see in nursing also happens in those professions. It may be the nature of the work. When you are exposed to situations that you can barely fathom (dysfunctional family dynamics, lifestyle choices that are completely irrational and cause self-harm, etc.), it affects you.

I do know that I was insulated from the end consumer during my corporate career, which, ironically, was part of the reason I chose nursing as a 2nd career. From the responses here (again, thank you), it is also apparent that each corporate culture is different, just as there are differences from one nursing unit to another.

[NamasteNurse, BSN, RN]

YES VERY DIFFERENT! I am 53 was 51 when I graduated nursing school. I was a teacher before and also lots of experience in the business and not-for-profit sector. Nursing is

1. Way more serious

2. Much more competitive

3. Nurses want to be right all the time

4. Way more nasty gossip.

5. Less help from co-workers

6. Way more "me-me-me" it's shocking.

Maybe it's just where I work...but that's how I see it

Sadly...

[hiddencatRN, BSN, RN]

I think it all depends on where you work. I used to work in commercial real estate, and my boss would frequently ask me if callers interested in certain properties "sounded black." He made fun of gay people, people with accents, etc. But he made the company a ton of money, so rose to the executive level there. How exactly is that being held accountable?

[nursel56]

I was a career changer that came back to nursing so I will offer my .0002 :) I think nursing does foster immature behavior. It is certainly true that not all environments are that way as anurseatlast pointed out. I would add to that if you are lucky enough to work somewhere with a management structure that sets high standards nursing can be "the best of times". You can only know what the rewards are of contributing to the lives of other people (ie the idealistic view of why one chooses this field in the first place) unless you've lived it, and my own feeling is that very few other jobs give you that feeling when things are working in a synergistic fashion.

Why this job is "the worst of times"? (lateral violence, horizontal bullying, etc) is still a conundrum. I've tried to figure out why nurses undermine each other so much and all I can come up with is that it's related to two forces that are deeply ingrained in most people. The first would be the urge to compete, the second would be what are the intangible rewards for a job well done, or how do we know when the job is well done?

Despite what many people believe here, you need to have above average intelligence to be a nurse, yet there are no sales figures, profit charts numbers of widgets produced at x amount of cost, or in most cases is there an easily discernible next rung up the ladder. So how do we affirm to ourselves the feeling of "I succeeded"? It might be when a little old lady squeezes your hand and says "thank you, dear" but not everyone is hardwired to translate that to job satisfaction in general.

If there is a success, it is a shared success. It seems to me that the idea of shared success requires quite a bit more maturity than the natural urge to stand out from the crowd does. and results in the type of dysfunctional behavior - a subconscious attempt to affirm to ourselves that not only are we good, that we are "best". The culture of nursing is highly resistant to the "look what I did" impulse, nevertheless it is below the surface, in some people more than others.