As a student nurse you spend nearly the entire time in school telling yourself to make it through this last hurdle, dig deep and delve down because once you graduate the pain lessens. You fumble through the most stressful two years of your life between feeling like a walking idiot, to feeling like you can take on the world and solve the world's largest medical mysteries. The last semester comes and you pat yourself on the back for making it to the end. You tell yourself that the next year will be hard with dealing with learning the skill sets of a nurse, understanding time management, and learning prioritization. What you don't understand at that time, is that one of the hardest contentions you will have to deal with is an unspoken problem in the world's most ethical profession; nurse to nurse bullying.
No one wants to admit it is happening on their unit, no one wants to admit it is happening to them, and no one wants to admit there is not really an answer to this problem, that makes it solvable. Even as an author that wants to buck against the system and yell NO I will DEFEND these nurses!†I don't. Even when it is happening to me. Why? I am scared of rocking the boat, most of the behavior is actually encouraged by the leadership of my unit, and they believe it gives new nurses thicker skinâ€. How do I know they feel this way? They told me so.
When I have tried to speak up before I was told, don't take it personal, have thicker skin, and that my nurse preceptor just says it like it is. I like to think of myself as a pretty tough person. I usually do have pretty thick skin, yet as a new nurse it does make me doubt myself very deeply. What, you may be asking as a reader, am I defining nurse to nurse bullying as? The easy answer is belittling, and talking badly about the new nurse with other nurses. However, I do understand examples are needed to get a true understanding.
A little background: I was told prior to be assigned this preceptor that she is tough, cuts it straight but will also be able to build me into a great nurse. She was all those things and a lot more. She would disappear many times leaving me on my own to figure many things out. If I was ever brave enough to ask something I got eye rolls and a put-out answer (yet one of the most repeatable pieces of advice a new nurse gets is to ask questions and not to be afraid to ask for help!), if I needed her to help me with procedures this is where she would get outright mean! An important aspect to remember throughout this is that she had NO patients or 1-2 MAX just so she could help train me. I am not a complainer, I am an older student so I have world experience behind me as well. I am not meek usually and for the most part I have a mouth that I will certainly use to advocate for my patient but here I was not the one that was trained but instead the one being trained.
Example 1: A patient needed an NG tube. This patient had been eating and drinking all day. The doctor had just changed the patient's status to NPO about an hour earlier. The patient was having an NG tube done to see if the edema the patient was experiencing was due to air, or something else. I was very excited to get another check off done and was up to 4 patients on my med-surg floor. I grabbed all my supplies (I had previously notified her of the procedure, got heaving breathing over my ASCOM and told FINE be right thereâ€) and put them outside the room. Went back to find her and get my glass of water with a straw for the insertion. Here I did stop and tell myself the patient is NPO…but he just went NPO, has other fluids already in the stomach, and insertion without drinking the water could lead to the tube inserting into the lungs therefore it is wiser to use a bit of water. While I was filling up the cup with water here came the preceptor. Instantly she launched into me about why I was getting water. When I tried to explain the only thing I was able to get out was how else am I going to insert the tube†and suddenly I was being berated in the middle of the hallway. Dry swallow had to have been repeated 6-10 times, I kept trying to explain my thought process but was talked over (almost to a yell) and spoken down to. I felt like an idiot and like I had nearly killed my patient or something. I proceeded to mess up the entire day and go home bawling. It is important to note that I did speak up for myself here, I did at one point say that's enough! Be nice! Be nice!†but it never phased her or make her stop.
Example two: I admit I am not the best IV starter. I am not the worst but not the best either. I refuse to stick a patient however blindly. If I am going to stick them then I will either feel a vein or see one (DO NO HARM!). Why in the world would I state this, since it seems like common sense? Because it is important to this example. My patient had previously told me that the IV s/he had was placed by the rapid nurse due to how hard a stick s/he is. When that one lone IV was infiltrated I tried to find a vein. I couldn't even find one on the hand!! At this point I am up to 5 patients and have been on the unit about a 1 ½ months. I am still in training but nearing the end. I cringe as I pick up my ASCOM to notify my preceptor I need help. I know what is coming. I get told I better figure it out and hung up on when I try to ask for help to start the IV. I try really hard not to cry in front of my patient, and be a wuss. So I start at the wrist and work my way up to the armpit with no luck. I had tried before but I knew if I didn't at least try to stick one time I would hear about it. I didn't try though, my patient's comfort and safety came before my own feelings of not wanting to be belittled and yelled at. So I picked up that dreaded ASCOM again and this time I said if you can find a vein I'll be happy to stick it but I can't find even ONE!†This time my preceptor came after I got a fineâ€. When she couldn't find one either and tried over 6 times before saying the patient either needed a PICC or the rapid nurse, it was very hard for me to not look at her with a smug expression. Very hard!
In the middle of this awful experience I did ask my fellow trainees how they were doing. Their preceptors actually went with them to do everything (even med passes). They never were afraid to ask questions or for help and several times they had heard the way my preceptor talked to me and informed me they would be curled into a ball crying. They complimented my strength and claimed I looked so confident and independent on the floor. That was total fake it tell you make it†at work. When I tried to talk with my management they encouraged my preceptors behavior and then the very week that I decide ok it's time to speak up, they put those same trainees with her to toughen them upâ€. I am not joking, those exact words were used. My preceptor was being encouraged to toughen us upâ€. Other trainees have overheard the preceptors throughout the training process talk about us from how slow we are, to how stupid we are.
I have no recourse I can take. There is no avenue I can go to and report without making matters worse. I cannot quit because I am in a town that is monopolized by a very large hospital, and as a new graduate my options are so limited. I cannot go to my upper management for the same reason I cannot go to my immediate supervisor. The bullying or toughening as they call it, has been encouraged and this will only make it worse. So the only thing left to do is to vent, grind down and make the best of it but also make sure to NEVER be that nurse. To point out when I can safely do so what is going on, and when I finally get to claim to be a seasoned nurse or preceptor, make sure I intercede on that new graduates behalf. I can post my story on the internet so that new graduates read it and know they are not alone if this is happening to them. I can point it out to hopefully shame the preceptors that are doing this, even if it is privately. They became a nurse for a reason and hopefully that ability to care for their fellow human beings will reach out to their fellow nurses as well.
My advice from a new graduate to an old battle ax nurse. Remember that we too have a story, that you once were a new graduate and that tough love†really isn't the only way to get your point across. By no means does this imply that new graduates should be coddled or handled with kid gloves. No they should just be treated and spoken to in the same manner you would want to be spoken to and treated as. Most of all remember battle axes one day you may wake up with that nurse you treated like crap standing above you. Pray that she does not hold a grudge!
