Bullying - What is it?

[RNdynamic]

A lot of threads discuss whether or not bullying is rampant. I want to give some examples of behaviors and I am interested in people to tell me which one(s) consist of bullying, rude behavior, or social abuse.

(1) A nurse grabbing a sheet from her orientee's hands, stating in a raised voice that "its too sloppy, give it to me" so that she can fold it herself over a patient.

(2) A nurse not letting her orientee go to lunch or cover their orientee's lunch because the orientee had to catch up on documentation, even though the nurse had taken lunch herself.

(3) A nurse loudly commanding their orientee in the nurses station to finish their documentation before doing anything else because they don't want to get out late.

(4) A nurse asking another nurse "why did you needlestick yourself?" after an accidental needlestick that requires the nurse to go to occ health.

(5) A nurse asking another nurse during ICU handoff why they didn't obtain an order to replete their patients potassium of 3.8.

These are real life situations that I have experienced or observed. In my opinion, the majority of them demonstrate the height of rudeness. The last one demonstrates someone suggesting that a nurse didn't follow their patient's labs to replete their normal potassium level to one that was more normal.

[Esme12, ASN, BSN, RN]

The worst bullies I have encountered in several decades of work experience were executives just below the top of the pyramid. Those who delivered results and left behind a mound of broken spirits. Ever been in a lockdown meeting?

yes...that is when my eyes were opened about current administrations.

[motherof3sons]

I am very supportive to my oreintees. I don't refuse their lunch nor bathroom breaks.

I don't think your example are examples of bullying.

We will have to agree to disagree.

I agree with this and can't like it enough.

[rn.CB]

Only nursing sees food and elimination as something to deny oneself...or, in this case, deny to an orientee. Ridiculous. No one else, not even MDs, fail to eat for 12 hours.

Agree, denying a person meal or taking authority of this most primitive human function is documented somewhere in psychology literature. Come to think of it, I recall instances in my very early new grad days; a nurse makes a little antagonistic remark when I tried to run to the bathroom before doing some task. I ended up waiting on the bathroom.

This nurse was a bully by no means, but I am just now recalling the little control attempts with eating and elimination during preceptorship. Maybe on some deeper level, the denial of someones most instinctive human behaviors is a control mechanism...

Maybe its just us nurses that do this...however, taking on the job of deciding if and when someone can pee....just a tad beyond the preceptor's umbrella of authority...lol

[mama.RN]

Thought this might be helpful as it includes definitions of bullying and lateral violence and other troublesome behaviors: http://www.mc.vanderbilt.edu/root/pdfs/nursing/center_lateral_violence_and_bullying_position_statement_from_center_for_american_nurses.pdf

[Ruby Vee, BSN]

A nurse grabbing a sheet from her orientee so that she can fold it herself probably constitutes Type "A" behavior, not bullying.

A nurse insisting that the orientee catch up on documentation before going to lunch is probably a nurse who is trying to teach time management. Has time management been an issue with this orientee in the past? Have too-long breaks been an issue? There would need to be more context on this one before I could conclude that it's bullying, but as it stands, I'll say it is not.

A nurse loudly "commanding" their orientee to finish documentation before doing anything else because they don't want to get out late -- again, more context is needed. Many orientees seem to believe that anything said in a manner that they don't like is "bullying." Has the orientee had problems with timely documentation? Has the preceptor regularly had to stay over an hour late to help the orinetee finish documenting? Probably not bullying, but it makes me think there's some problem with the orientee's documentation.

A nurse asking another nurse why she got a needlestick is probably a nurse concerned about the other nurse. If it's a nurse asking an orientee, it's probably a nurse trying to elicit critical thinking on the part of an orientee. "Uh, I tried to stick a needle into a clave, which is a needleless system. That's how I got stuck. I won't do THAT again!"

About number 5, all I can say is "You've got to be kidding." How in the world is that bullying? It sounds to me like an attempt to elicit rationale. "Oh, you're right. I should have asked for that order" or "His creatnine is 3, so we're letting it ride" or "He just got dialyzed -- it will be 5 by morning." Just answer the question and stop worrying about being bullied.

Rude behavior is not bullying. But you throwing that last one in might indicate that you are a person who is looking for bullying everywhere . . . and it that case you're going to find it, whether it exists or not.

[wooh, BSN, RN]

I think bullying has an element of cruelty to it. Not just mean. Not just rude. None of those would be "bullying" in my book.

In response to scotta, yes, nursing has a bunch of studies on bullying. Because nurses feel the need to study it. Airline pilots aren't looking for hot button topics to do research on. Surgeons research surgery, not getting along with their coworkers. It doesn't mean it doesn't exist in other fields. Just that in those fields people are worried about things other than getting along with their coworkers and aren't seeking to justify their desire to be victims.

[OCNRN63, RN]

​Bullying is whatever the nurse says it is, and occurs whenever she says it does.

[OCNRN63, RN]

I don't see doctors, pharmacists, teachers, and other professionals talking to one another in the manner I described above. But I see it in nursing. I also see it in min. wage places like Taco Bell and Burger King, or in hairdressing salons. The quotations I gave resemble how one might talk down to a misbehaving child, in my opinion. I wouldn't dream of grabbing stuff out of people's hands and saying "give me that." I actually see that as physical hostility. It's an invasion of space. Why in nursing do you find this behavior defensible? How come it doesn't pervade in other professions, or at least appear so? Is it because we (you) hold ourselves to a lower standard?

No one is defending it. We're just saying the examples you used don't rise to the level of bullying. I'd consider them things you'd hear a brusque, impatient person say.

[OCNRN63, RN]

In an era where nursing is supposed to be about evidence based practice I continue to be amazed by the people who ignore the evidence concerning bullying among nurses.

The data is clear and indisputable that bullying occurs at a higher rate within nursing than other professions. It is also shown that being bullied reduces productivity and increases job turnover. the job turnover creates a huge financial impact to facilities.

As far as the specific examples above I wasnt there so I don't know but if this is the same nurse interacting with the same person it would seem that this probably does rise to the level of bullying. Except for the second one which is most likely illegal as well as bullying.

What the profession of nursing allows due to its unwillingness to open their eyes and look at the data is an embarrassment.

I encourage everyone to look at the evidence before forming an opinion. Does bullying occur in other jobs? absolutely it does. Does nursing bully at a much higher rate than other professions? You better believe it. Does nursing pay a price in the loss of new nurses,drops in productivity and high turnover? The data is clear- absolutely.

Before you make a decision on this issue look at the data. (and I mean peer reviewed journals not a google search that provides no numbers and is based on anecdotal evidence at best and conjecture at its worse.

Just because someone disagrees with you doesn't mean s/he hasn't read the data. (And I mean peer reviewed journals, not a Google search.)

[Carrie RN]

I would say each is jerk behavior.

[OCNRN63, RN]

I don't think anyone wants the orientee to starve either. Nevertheless, if the orientee is hungry and there are no urgent matters that need to be taken care of, why shouldn't they eat? Documentation can wait. Additionally, why can't the preceptor who is doing little else but supervising watch for them? Coverage exists to maintain pts while people eat. There are days that I have gone to lunch even though some documentation needed to be finished. I did it when I got back. If I waited until I had nothing to do before going to lunch, I know that I might never be able to go.

You say they an orientee has to finish their tasks before they go to eat. What if they finish them, and new tasks arise -- new orders, a pt deteriorating. These things can't wait so they're stuck even longer. Then the cycle starts again. Documentation can wait. Everyone deserves to go to lunch, and eating is a need. You shouldn't have to get permission to do it any more than you should have to get permission to use the bathroom.

Who says the orientee will have time to do the documentation after lunch? Things could come up when she gets back from lunch that would further delay her getting the charting finished. The longer the documentation is delayed, the less likely it is to be accurate. Unless the orientee is a diabetic, it's highly unlikely that having a late lunch is going to cause a medical crisis. It may very well teach her to sharpen her time-mgmt skills. There's no reason to do so if she knows that someone will always take care of her problems for her. Mistakes are made when documentation is late/missing. The nurse covering her lunch would be out of the loop without that information.

[Emergent, RN]

I see a lot of threads here debating the subject of bullying.

I'm starting to think "bullying" is too loaded a term. What we really need to address is creating a positive culture that fosters clear communication, is supportive and healthy, which all evidence shows contributes to better pt outcomes.