Disappointed in nursing

RedInScrubs, ASN, RN · Jun 6, 2015

Change of scenery and being in a supportive environment changes a LOT with job satisfaction. If nurses feel supported where they work, they don't backstab as much.

nekozuki, LPN · Jun 7, 2015

I've been a med/surg nurse for three years and I can't believe how caddy and back stabbing nursing can be. I know all about nurses eating their young but this is about mentoring and support then back stabbing. Makes me want to use my degree to do something else:(.

You have two choices:

1. Quit and try to find a less toxic work environment

2. Take a step back, re-evaluate yourself, and figure out how you can develop and improve your interpersonal relationship skills to function in a work environment that sometimes seems hostile.

While option one might seem like an easy fix, your outcome is dependent upon others (and you may never find a place that is friendly). The second option gives you the control, as well as the opportunity to grow as both a colleague and a person. Even if you ultimately decide the leave your job anyhow, these skills have universal applicability.

You worked so hard to get through nursing school and to where you are today. Don't sell yourself short. You can adapt and survive in a fast-paced, high-stress industry if you develop the assertiveness, confidence, conflict resolution*.

*Unless you feel like your license is genuinely being threatened. In that case, get the hell out of there!

technofreak · Jun 7, 2015

Got any citations?

Too many to list. Simply Google "lateral violence nursing," and you will have the answer that you seek.

Dogen · Jun 7, 2015

As with any "research study" you have to look at the assumptions and definitions to determine the validity of the conclusions. Based on anecdotal evidence presented here on AN, bullying is an overused / misused term that says as much about the ill-prepared new grad as burnt-out overworked and abused practicing nurses.

It's possible that bullying (lateral aggression) is a problem and the term is overused. So, the overuse of the term itself doesn't necessarily mean there isn't a problem. Also, adult bullies are different from childhood bullies. No one gets beat up by the monkey bars anymore. Adult bullies act in private, or within a culture that supports them, that enables them to hide and/or deny any complaints made against them.

Also, I'm not sure basing anything on a sample drawn from a subset of users on AN is the best way to rebuff research, especially when recent threads suggest there's a sizable group of users who believe there is a problem.

So, let's talk research, which is my favorite thing in the world to talk about. Seriously, you can ask me for citations for anything. The benefits of academic affiliation: it's all at my fingertips.

Hader (2008) sent a survey to 1,377 healthcare workers (not just nurses) about workplace violence. Workplace violence was defined: "Repeated, health-harming mistreatment of one or more persons by one or more perpetrators that take one or more of the following forms: verbal abuse; offensive conduct/behaviors (including nonverbal) which are threatening, humiliating or intimidating; and work interference - sabotage - which prevents work from getting done." 73% of those 1,377 people reported that workplace violence happened occasionally, and 19% said it happened frequently. Patients were the number one perpetrator, and nurses were the number two.

Farrell (1999) surveyed 270 nurses at a public university (RNs seeking higher education) and those working at a large hospital and found that while physician-to-nurse was the most commonly reported, nurse-to-nurse was the most distressing and had the biggest affect on work. Their sample had a mean years of practice of 15, with an SD of 8, meaning 68% of respondents had between 7 and 23 years of experience. Only 7% of respondents reported experiencing no aggression at work.

An AACN study published in 2006 found that 88% of 4,000 respondents reported experiencing verbal abuse, gossiping maliciously, or self-promotion at the expense of others. Disrespect was identified as one of seven behaviors linked to avoidable errors in healthcare. A follow-up study in 2011 narrowed it down to the most dangerous three behaviors: shortcuts, incompetence, and (wait for it) disrespect. 20% of the 6,500 respondents in that survey said disrespect in the workplace was making them consider leaving the profession.

A 2010 systematic review (level 1 data, for those who appreciate a good evidence pyramid) by Vessey, Demarco, and Difazio found that the collected data so far suggests lateral aggression is widespread, that it's often ingrained in the culture and viewed as a "normal part of the job." They found that incidence has increased alongside patient acuity and what they call attempts to "right-size" the nursing workforce (read: being short staffed). They also cite multiple studies showing that when the culture protects the bullies rather than the victims, and when individuals fail to speak up when they observe lateral aggression, that those individuals begin to create excuses for behavior they previously identified as problematic.

An interesting thing to me is how people who denounce the idea that lateral aggression is a problem sometimes counter that nurses are expected to be warm and fuzzy or nurturing. I'm not sure how widespread that particular stereotype is, but I never encountered it personally until I started talking about lateral aggression. I cut my teeth in healthcare working telemetry on an ICU. The nurses there weren't warm and fuzzy. They were tightrope walking, dark-humored badasses... and they were utterly supportive of one another. Not being an abusive jerk is not the same as being a surrogate mother.

References

American Association of Critical-care Nurses (2006). Silence kills. The seven crucial conversations forhealthcare. Retrieved June 7, 2015, from http://www.aacn.org/wd/practice/docs/publicpolicy/silencekillsexecsum.pdf

American Association of Critical-care Nurses (2011). The silent treatment: How silence still kills. Retrieved June 7, 2015 from Silent Treatment: How Silence Still Kills

Farrell, G. A. (1999). Aggression in clinical settings: Nurses' views -- a follow-up study. Journal of Advanced Nursing, 29(3), 532-541.

Hader, R. (2008). Workplace violence survey 2008: Unsettling findings: Employees safety isn't the norm in our healthcare settings. Nursing Management, 39(7), 13-19.

Vessey, J. A., Demarco, R., & Difazio, R. (2010). Bullying, harassment, and horizontal violence in the nursing workforce: The state of the science. Annual Review of Nursing Research, 28(1), 133-157.

Red Kryptonite · Jun 7, 2015

Dogen, I appreciate the term "lateral aggression" so much. I have argued against the terminology "lateral violence" for interactions that are verbal only, and gotten my posts deleted and warnings from moderators for my trouble. One can certainly be aggressive with words, but it's a ridiculous misuse of the English language to call purely verbal interactions "violence."

Dogen · Jun 7, 2015

Yeah, the field seems to have not settled on a term. You see "lateral aggression" and "lateral violence," but one of the most-cited articles (Longo & Sherman, 2007) is entitled "Leveling horizontal violence." Part of it goes to the characterization that language can be violent. For instance, it's not uncommon to include verbal abuse among domestic violence behaviors. Of course, you'd hope that wasn't the type of behavior anyone would display at work, but I can't exclude the possibility. I personally prefer lateral aggression because I think it's inclusive of less obvious behavior that can make a workplace feel less safe.

Psychology refers to this as "relational aggression," and has studied it extensively in teen girls (where generally speaking boys tend to act out physically and girls relationally). So, the phenomenon isn't new (of course), it's the focus on it being so widespread in nursing that's novel, which has only happened in the last 20 years.

kalycat, BSN, RN · Jun 7, 2015

I cut my teeth in healthcare working telemetry on an ICU. The nurses there weren't warm and fuzzy. They were tightrope walking, dark-humored badasses... and they were utterly supportive of one another. Not being an abusive jerk is not the same as being a surrogate mother.

Just stopping by to say....love this!!!

And thanks for the excellent information. :)

WinterLilac · Jun 8, 2015

I can understand where you are coming from and I agree with some other posters - perhaps find a different nursing niche.

When I was training, my 65 year old mother was also training to be an EN (LPN) as well but she was in another class. The students in my class were all supportive and kind however in my mums class, she was treated atrociously by 3 other students (2 teenagers and a 30 year old) who would laugh at her, whisper in class, scoff at her questions and confront her in the passage way. I often found myself at my mum's house in the evening reassuring her and once, the bullies even had the audacity to bully her IN FRONT OF ME. I hit the roof and made a formal complaint to the lecturers. Nothing was done. However, my mum pushed through, finished her studies and has now a fantastic and rewarding career in community nursing. Her manager and colleagues are super supportive and almost like a family. The moral of this story is to allow your experiences to remind you of how NOT to treat people. Hang in there and you'll find a team to work with who will help you love being a nurse!

BonnieSc · Jun 8, 2015

Agreeing with others who say to find a new job. I liked my first job but thought hospitals were gossipy and nurses were catty. My next job was on a similar floor in a different hospital/community and wow, what a difference! The nurses weren't warm and fuzzy and didn't have as many bridal showers but they were friendly, open, competent, team players... In other words, the problem wasn't hospitals or nurses, it was THAT hospital and THOSE nurses.

ixchel · Jun 8, 2015

I will now sit back to be flamed.

Whether I agreed or not with your post, it was so well written and clearly reasoned until this last part. Do you feel if someone in general disagrees with your thought process, you are getting flamed? I don't get it, and it makes me hesitant to even want to respond to the rest of your post because I'm afraid you'll feel I'm flaming you, as opposed to simply wanting to discuss your post further.

I have not witnessed a single act of bulling at my facility. There are some people I like less than others because they aren't as friendly, but there has been no bullying. The only workplace bullying I've been witness to was in property management. I've held positions are three different communities. The first, I was the lowest on the totem pole - just a body to keep a seat warm, basically. The person above me tried to blackmail me, but I sang like a canary and she was canned. She did a terrible job of trying to get her stuff together to pull it off. The person who replaced her let the property fall apart quite rapidly. Turns out she was embezzling, but anyway, she needed a person to toss under a bus, so she picked me.

The second property, one of the maintenance guys was one of the most deviant, evil people I've ever worked with. He tried his hardest to set a coworker up. The evil guy wanted the nice guy's job (supervisor), basically. I was management, so it was my ear he wanted to bend. The stuff he said about the nice guy was horrific. Thankfully it wasn't way too long before I figured out the truth, but nice guy had already quit. Evil guy left not too long after we figured him out. Last I heard, he moved to South America. I hope so, for North America's sake. lol

I didn't work the third place long enough to find out if there was bullying there. There WAS more embezzlement, though.

Anyway, if we were going purely anecdotal, I'd say nursing has no bullying (more honesty, though). Property management is filled with bullies and thieves.

ixchel · Jun 8, 2015

OP, I know you did not use the word 'bully', and I feel quite appreciative of that.

Before this thread goes much further, and since the word 'bully' did come up on page one, let's be clear on what bullying truly is. This article is a great start on that topic - Bully/Jerk -- It's Not the SameÃ‚Â |Ã‚Â Claire Wapole

Essentially, we really need to stop using that word for smaller, less significant actions.

jojo489 · Jun 8, 2015

I wouldn't say I've been bullied, not near it, but I have worked with straight up malicious people who have tried to set me up for all sorts of nonsense.

I have also worked in a place where I was treated like a five year old constantly with repetitive reminders of what should be done (which was getting done on each of my shifts, we just had one of those people the shift after me that claims everyone is soaking wet and tasks weren't completed-and because that one is the pet, i got flicked on the nose)

I have worked in the most stressful and the most laid back places. Let me tell you, the more time people have on their hands, the more the nonsense happens. Always trying to make themselves look better and smarter at the detriment to someone equally competent, evil rumors and gossip, and pointing the finger. But the most stressful places, I have found, is where the most supportive staff are with the greatest amount of teamwork. More work, less jabbering.

But I also think it depends greatly on the place. There will always be "those places" with "those nurses" but another unit or location could be completely different.