Nurse Bullying

[amanda.sheerene]

Hey nursing family,

I am conducting a small study on how nurses and nursing students have experienced and dealt with nurse bullying. It's something I have unfortunately had to deal with in a clinical setting. I'd love to have a discussion about everyone else's experience.

I am also attaching a link to a survey about nurse bullying. I would appreciate it if you could fill it out.

https://docs.google.com/forms/d/e/1FAIpQLSdRWG9jOQlNQaUQyU18pGx09Hk0rAo1H-KRKt6707oOO4Wtqw/viewform?vc=0&c=0&w=1

[Ruby Vee, BSN]

On 1/24/2019 at 4:16 PM, amanda.sheerene said:

Hey nursing family,

I am conducting a small study on how nurses and nursing students have experienced and dealt with nurse bullying. It's something I have unfortunately had to deal with in a clinical setting. I'd love to have a discussion about everyone else's experience.

I am also attaching a link to a survey about nurse bullying. I would appreciate it if you could fill it out.

https://docs.google.com/forms/d/e/1FAIpQLSdRWG9jOQlNQaUQyU18pGx09Hk0rAo1H-KRKt6707oOO4Wtqw/viewform?vc=0&c=0&w=1

I think the focus on bullying in nursing is overdone and does us all a disservice. I won't say that bullying does not exist. I've been bullied. I've encountered two bullies in over forty years of nursing -- probably far fewer than I've encountered just living this long.

Many interactions which are reported as bullying -- especially in some of the more lively threads on this forum -- are nothing of the sort. The videos give a 1-1/2 minute snapshot of a day in the life of a new nurse. The first one may have been bullying -- if it was more than a one-time thing. The advice to report the incident and to document was probably good advice.

In the second video, a newer nurse asks for help starting an IV. That's all we know. We don't know if the other two nurses had already showed her how to start an IV five or six times since lunch, in which case their attitude was understandable. We don't know if the newer nurse consistently asks for help with tasks that she's been shown over and over and even been checked off as competent. We don't know if one of those nurses was a charge nurse who was talking to the other about transferring her patient out immediately so she could get a coding patient into that bed. We don't know if the incivility was due to the newer nurse sucking up everyone's time because she was unwilling or unable to complete any task independently. Or perhaps the more senior nurse was having a bad day because her mother has Alzheimer's, her father is dying, her teenaged son just wrecked both of the family cars and the dog has cancer. Perhaps that was a one off negative interaction due to everyone EXCEPT the newbie being slammed and having an incredibly bad day. We don't know anything except that small snapshot of the day. And don't get me wrong -- incivility is a bad thing and should never be acceptable. But it isn't exactly bullying, either.

Here on all nurses.com, we've seen newbies complaining that they're being bullied because someone failed to greet them in the hospital lobby. (And no, they didn't speak, either.) One nurse claimed she was bullied because everyone was jealous of her youth and beauty. Another claimed to have been bullied because her preceptor had lunch with an old friend and didn't invite her to join them. (This happened once, not every day.). One newbie claimed that the fact that the preceptor "tells all her problems to this other nurse, but never tells me her problems" was bullying. I personally observed a new nurse sighing about how much her arm hurt, and how she was tired because she'd spent all night in the ER with her sore arm. When the charge nurse asked, pretty sympathetically, I thought, what happened to her arm, the newbie exploded with vitriol, claiming "That's none of your business. You don't need to know anything about my private health matters. You are nothing but a big fat bully, and I am reporting you." And report, she did.

I think our time would be better spent focusing on how to promote positive workplace relationships, how to respond to negative feedback in a positive way, how to handle disagreements at work, or even how to deliver negative feedback in the most constructive way than all this time focusing on bullies, which I've found to be rather rare.

[JKL33]

Agree w/ Ruby's review of the second clip and subsequent comments.

The first clip was inappropriate in my opinion and was a *gross* mischaracterization of the complexities of workplace relationships.

If *any* nurse is too busy to take care of patients because they want to chat with their friend and leave early to get their nails done (or whatever the portrayal was), that is a management issue - one that hasn't been dealt with in a timely manner. The rest of us who are experienced professional nurses who care about both patients and newer nurses don't identify with that crap.

Additionally, constant complaining about less well-defined treatment in the workplace (don't like the way someone looked at me, didn't like her tone - even if it was simply harried and not 'mean', etc., etc) is becoming an issue that is every bit as manipulative and problematic as the classic examples of bullying.

I think these projects do a major disservice to all nurses. They've been done thousands of times now, anyway. Time to stick a fork in it.

I suggest a project that encourages professional behavior by novice and experienced nurses, and managers and leaders all the way to the top. The best way to discourage poor behaviors is to treat people well yourself (regardless of position) and see where that takes you.

[amanda.sheerene]

Thank you so much for your feedback Ruby! There is so much to unpack in your response. Your last point on focusing on positive workplace relationships and how to respond to negative feedback is actually a major focus of the literature I read.

Various research articles focused on how providing nursing students on educational modules on the issue and how to professionally respond better prepares nurses for dealing with nurse bullying in the workplace.

I agreed with so much of what you said, but I do disagree with you on one thing. I do think too many things can be mistaken as nurse bullying I do not think the issue has been exhausted. I do think the conversations have been misguided. This brings me back to your point of learning how to address it.

Reporting the incidents/lashing out/quitting often come as a result of the "victim" not addressing the issue directly and having so much pent up resentment and anxiety.

I chose this research subject because as I am going through school and working in the emergency department I have such a love and respect for the profession that it frustrates me that some of the nurses I work with don't respect themselves or their peers enough to be more professional in how they deal with issues.

Something we did touch on in lecture is that nursing is actually a young profession (compared to medicine) and I hope it continues to move forward where nurses expect more from themselves, the profession, and the institutions they work. And your last suggestion is the starting point for that.

Again thank you for your awesome feedback!!!

[amanda.sheerene]

25 minutes ago, JKL33 said:

I suggest a project that encourages professional behavior by novice and experienced nurses, and managers and leaders all the way to the top. The best way to discourage poor behaviors is to treat people well yourself (regardless of position) and see where that takes you.

That is actually the focus of my research study. So much of the research I find stresses the importance of teaching nursing students self-efficacy, professionalism, and how to appropriately respond to nurse bullying. The studies I modeled my survey on were about the effect of educational modules and if they work. As I discussed with my clinical instructor those short videos aren't long enough to change anyone's behavior (victim or perpetrator), but I am also gathering data on how nurses and nursing students may perceive bullying differently.

All in all, I am really excited by both yours and Ruby's responses!! You both make excellent points. I am glad the literature supports both of your wisdom I hope you were able to complete the survey, but if not I really appreciated you taking the time to respond to me.

[JKL33]

15 minutes ago, amanda.sheerene said:

I chose this research subject because as I am going through school and working in the emergency department I have such a love and respect for the profession that it frustrates me that some of the nurses I work with don't respect themselves or their peers enough to be more professional in how they deal with issues.

Fair enough. ?

I would like to make a request, though - for educational purposes.

Take a bird's-eye view of what you are seeing, if possible. Take a step back. Aside from people who are outliers (just generally rude and inappropriate) I think you will see that the majority of the less-than-perfect interpersonal interactions can be an effect of chronic stress.

I don't know about your ED, but in mine there is a massive emphasis right now on how fast we can do things (known as "throughput" or how fast the patient goes from check-in to discharge). All of the time it takes nurses to perform tasks can be tracked on the EMR dashboard in real time. Speed is an over-arching theme, even when it is at the expense of patient care. Things like this cause major stress, and in my humble opinion are infinitely more concerning than whether my coworker speaks with a perfectly tempered voice or is "supportive" when I need something (which she likely doesn't have time to help with). KWIM?

I realize my first reply was a little....straightforward (aka harsh) and that is because I believe we have way bigger fish to fry than constantly critiquing each other.

?

[JKL33]

I appreciate the way you have received the feedback. Truly.

Please consider my comments nothing more than food for thought.

[amanda.sheerene]

3 minutes ago, JKL33 said:

Fair enough. ?

I would like to make a request, though - for educational purposes.

Take a bird's-eye view of what you are seeing, if possible. Take a step back. Aside from people who are outliers (just generally rude and inappropriate) I think you will see that the majority of the less-than-perfect interpersonal interactions can be an effect of chronic stress.

I don't know about your ED, but in mine there is a massive emphasis right now on how fast we can do things (known as "throughput" or how fast the patient goes from check-in to discharge). All of the time it takes nurses to perform tasks can be tracked on the EMR dashboard in real time. Speed is an over-arching theme, even when it is at the expense of patient care. Things like this cause major stress, and in my humble opinion are infinitely more concerning than whether my coworker speaks with a perfectly tempered voice or is "supportive" when I need something (which she likely doesn't have time to help with). KWIM?

I realize my first reply was a little....straightforward (aka harsh) and that is because I believe we have way bigger fish to fry than constantly critiquing each other.

?

I completely saw where you were coming from not to worry. I absolutely agree that nurse bullying is a drop in the bucket in terms of what is happening in healthcare. The ER I work is exactly like what you described. The focus on faster turn over times is actually why I regretfully won't be starting there after graduation. After six years I see a shift from timely, but patient-centered care to "how many patients can we process through the department".

I chose nurse bullying as my capstone topic because as the stress increased in the department, so did the amount of disrespect and unprofessional practices. Again not from everyone, but certain nurses would give their least favorite nurses the heavier load, block off rooms in a section close to the desk so they can watch the tv (while loading up everyone else), or put patients that are too critical for fast track in that section because that nurse won't complain. It affects their ability to provide safe care which is the heart of what I am concerned about.

When I look at a lot of the issues I see in nursing, I see a stressed out nurse on one end and a nurse who can't/won't advocate for herself on the other. My capstone tries to shed light on the need for nurses to be more confident in their role. It's interesting because some of the nurses I work with who spoke to me about my project said "things will never change" while you two have both said the exact opposite and gave the how.

Anyway, I'm overly excited. But I am passionate about the potential future of nursing. ?

[Orca, ADN, ASN, RN]

Disrespect and unprofessional practices are not bullying. Bullying is a threat of physical harm and/or actual physical intimidation. Too many people throw around the word "bullying" to describe anything that a coworker or boss does that they don't like, without having any idea what the word really means. In 25 years of nursing I have never witnessed a single instance of bullying. On the other hand, I have seen quite a few instances of disrespect, and a several instances of unprofessional practices.

[guest1048932]

I'm a new nurse (almost 2 years in the field). I have yet to personally experience bullying in the professional setting. I had a nursing prof though who bullied me mercilessly through nursing school. I nearly left nursing school because of her. Any time it was purely her word against mine, I mysteriously failed assessments, despite being a very competent student. She called me arrogant, standoffish, and a know it all in front of the class. Another time, she recommended I leave nursing. She said worse, and I left her class in tears once.

I think the problem is that some people mistake constructive criticism for bullying. When actual bullying happens, we don't even register it. Sure, my coworkers and I have said things that hurt, but we have never bullied each other. Sometimes the truth hurts.

[amanda.sheerene]

On 2/3/2019 at 6:48 AM, JollyBug92 said:

I'm a new nurse (almost 2 years in the field). I have yet to personally experience bullying in the professional setting. I had a nursing prof though who bullied me mercilessly through nursing school. I nearly left nursing school because of her. Any time it was purely her word against mine, I mysteriously failed assessments, despite being a very competent student. She called me arrogant, standoffish, and a know it all in front of the class. Another time, she recommended I leave nursing. She said worse, and I left her class in tears once.

I think the problem is that some people mistake constructive criticism for bullying. When actual bullying happens, we don't even register it. Sure, my coworkers and I have said things that hurt, but we have never bullied each other. Sometimes the truth hurts.

Interesting, I rarely hear about it happening anymore in the school setting. Glad your work experience has been positive. Thank you for sharing!

[Orca, ADN, ASN, RN]

On ‎2‎/‎3‎/‎2019 at 3:48 AM, JollyBug92 said:

I think the problem is that some people mistake constructive criticism for bullying. When actual bullying happens, we don't even register it. Sure, my coworkers and I have said things that hurt, but we have never bullied each other. Sometimes the truth hurts.

Even if the criticism isn't constructive, it isn't bullying. Bullying involves threats.