Workplace Bullying for Nurses

[ericleeericlee]

Earlier, I was flipping through the May 2012 issue of The Walrus, and on one of its pages, there is a short item written by Victoria Beale, titled Ratched Effect: Nurses, the original mean girls. She writes:

Nurses are expected to show untold compassion toward patients and deference to doctors-which may mean their empathy is exhausted when they deal with fellow nurses. According to dozens of articles published in professional journals, nursing is prone to "lateral violence," or bullying within a group of roughly the same status. These studies contend that because the characteristics required of nurses, such as "warmth and sensitivity," are undervalued by those higher up in the medical hierarchy, nurses experience a lack of "autonomy and control" over their workplace. Some feel compelled to exert power aggressively over those equal to or just below them, such as novice or student nurses; in the United States, 60 percent of newly registered nurses leave their first positions within six months as a result of lateral violence (globally, it's one in three). Nurses refer to this phenomenon as "nurses eat their young," also the title of a 2005 study on the subject.

I am a recent entrant to a nursing program in Vancouver, B.C., and even though I have not worked in the healthcare sector, I can see the plausibility of Beale's observations, namely the exhaustibility of one's patience. I am, however, a little surprised by the researches that attribute nurse bullying to the perceived lesser ranking of nurses relative to other health professionals.

I would be very interested to hear from those who has witnessed or experienced this "lateral violence" in the Canadian healthcare sector. How was it dealt with, and are novice or student nurses the most common victims? Or has one noticed acts of aggression made toward foreign-trained, less-specialized (eg. LPN), visible minority, male, or older nurses? Or vice versa?

In three years time, I am expected to graduate from my nursing program as an Asian, male, registered nurse. I can't say at this point that I am worried at all about what has been stated in the article, nevertheless, I think this is a considerable issue given its commonness, and that one day it might happen to me or those around me, so I would like to have at least a little familiarity with current nurses' experiences.

[Daisy_08, BSN, RN]

I have a friend that loves the OR. She said because there is no drama. She comes in does her job and goes home. She does not take her work home with her. She very orderly, she like having her tools just so, like anticipating the docs needs.

And Fiona, she does do cataracts one day a week, loves it too.

Thats the thing about nursing, there is something for everyone.

I was one of those who wanted to work postpartum. I fell in love with end-of-life care. You never know where you might end up. Just keep an open mind to everything.

[ericleeericlee]

The B.C. student loan forgiveness program likewise only accounts for the provincial studnet loan, and not for the national student loan. Although by July 2012, the B.C. student loan will complete its integration with the national student loan. I don't know how that will affect the loan forgiveness program at this moment.

Since I have the option of relocating after graduation, I am not too concerned about employment availability as much as other graduates, but I have noticed that even for Northern Health (B.C.'s northern healthcare provider), currently at Prince George there are only few opening RN positions with 1.0 FTE, most remain casual or part-time.

I've had been reading elsewhere about nursing, on Reddit in particular, and like this example, what the posters wrote can get me really excited and motivated about the nursing career and OR specialty. I wouldn't think having an interest and setting a goal for any student would be disadvantageous to the student's study. Instead, they are catalysts for higher achievement and lessening academic pressure throughout the semesters, and during clinical rotations such students will be best able to assess and qualify any specialty options of choice. I agree that it is wholly valuable to have a realistic view of nursing and any future specialty option, but I don't think being provided a largely gloom and doom outlook is a true reflection of reality, and neither would it be helpful to students alike.

[loriangel14, RN]

Not doom and gloom Eric.It's called being realistic.That's a typical reaction from people who aren't nurses yet and don't like what they hear.

[Dela RN]

is there any thing positive that can be said about the OR specialty other than witnessing surgical procedures?

Although seeing surgical procedures is definitely one of the bonuses of the job there are other positives about working in the OR. Obviously some of these bonuses depend on the facility that you work at but most OR nurses I work with will generally say it gives you a great work/life balance and less shift work than floor nursing. This is obviously a generalization because there are exceptions but for the most part scheduled cases do occur through out the week during daytime hours.

Other things I like about the OR is the unique team environment. It's actually pretty cool when you think about how all the people in the room are completely dedicated to that one patient in the room. The anesthesiologist, surgeon, respiratory therapist, residents and nurses. As a floor nurse I found the interaction with doctors pretty limiting. They didn't seem to know me (except as the nurse) and they were always in and out. It seemed really segregated to me so it's pretty neat to have everyone in the OR be on the same team.

I still work on a med/surg floor and I found that some of the skills I have obtained from the OR are helpful on the floor. Besides the technical skills that you get a ton of experience in like IV starts, catheters, you also get a better understanding of how things work. Before the OR I always thought that a central line was the answer to all difficult IV starts and long term IV use but now I see that sometimes CVCs can be difficult to place and complications do occur.Basically they weren't as simple as I once thought. You get to use all sorts of drains, learn how to better position patients and actually get real hands on experience holding a bag valve mask that isn't in a code situation or isn't a mannequin in CPR class. It may seem easy but more than one anesthesiologist has said holding a bag-valve masks is a practiced skill. If you continue working goon the floor it's pretty neat to see patients on the floor pre-op, see them in surgery and then see them post op on the floor too!

There seem to be expert consensus that OR is one of the most boring and uninspiring fields in nursing, and that I am tempting career-happiness suicide by wanting to join the teams of OR after graduation. If true, I pity the hopefuls who are going into OR come this graduating year. Fortunately for me, I have this forum and the luxury of planning ahead.

Honestly the OR isn't for everyone just like how LTC isn't for everyone either. One of the posters here said it best when she said that, that's the great thing about nursing, there's many different places a nurse can go. I've had boring days in the OR... eye surgery isn't my favourite but that's why it's nice that I'm on OR nurses and not just an eye surgery nurse. I get to do ortho, general, urology, ENT, plastics, neuro, etc. I guess I can compare it to floor nursing when I get a patient assignment that is "boring" but at least you won't have that same pt assignment forever.

[Daisy_08, BSN, RN]

Doom and gloom? You asked a question and got an answer. Sorry that answer was not what you wanted. Not everyone likes (insert whatever area). I see students most disadvantaged when they set their eye on one area only. They miss out on so many opportunities for learning and end up being severely disappointed. " I should not have to do X because I'm only going to work with ........" ( my fav is I should not have to toilet/wash/wipe/shave because I'm going to be an RN and I'll have aides to do that. But that's off topic and not at all directed at you Eric) Nursing is great in many ways, not so great in many ways. But I don't think anyone said not to go into it, or gave a poor outlook?

[Mandalynne]

Geez... This is one ironic thread.

[joanna73, BSN, RN]

:(If you don't mind, I would like to hear corrections on what you think I said wrong again, so I don't further inflame this LPN vs RN flame war, or at least correct or defend my initial claim that LPNs are less-specialized than RNs.I simply think that LPNs and RNs received different basic training, with RNs having more indepth training in specific areas, hence the training-length and legal difference betwewen LPNs and RNs. Given that practical nurses now receive identical training to previous registered nurses in some provinces as you've said, and that recent registered nurse candidates are required to have a baccalaureate degree, I will assume the lengthened training time must indicate more is taught.Whereas if one completed advanced specialty training (as you wrote, usually after years of experience), I believe they are more knowledgeable in their specialized area than their peers who have not received additional training in the area. Which is why I gave the example that CRNAs (in the United States) would be more knowledgable in anesthesia than someone who graduated from medical school but has not yet taken any specialized medical residency program. Similarly, LPNs who have taken advanced specialty program will be more specialized in their specialist subject than RNs who have only received primary training (ie. general duty nurses).I do thank you for your advice and your real world observation. Personally, I intend to work in northern municipals and take advantage of the B.C. loan forgiveness program, as well as the increased employment opportunity in less urbanized and underserved parts of the province. After which I will hopefully be able to specialize in my preferred field.

While I will attest to the fact that I had more clinical hours in my BSN program than the LPN program (3.5 vs. 2 years of clinical), the "indepth" knowledge is more of a myth. Nursing leadership, politics, trends...3 courses I can think of off the top of my head that were a complete waste of time. Oh, and 3 years of nursing theory. I've worked alongside some intelligent BSN's and some who made you wonder. At the moment, you're making general claims and false assumptions. For one, an RN is only "specialized" after they have actively specialized in an area, not before.

[Ruby Vee, BSN]

Earlier, I was flipping through the May 2012 issue of The Walrus, and on one of its pages, there is a short item written by Victoria Beale, titled Ratched Effect: Nurses, the original mean girls. She writes:I am a recent entrant to a nursing program in Vancouver, B.C., and even though I have not worked in the healthcare sector, I can see the plausibility of Beale's observations, namely the exhaustibility of one's patience. I am, however, a little surprised by the researches that attribute nurse bullying to the perceived lesser ranking of nurses relative to other health professionals.

I would be very interested to hear from those who has witnessed or experienced this "lateral violence" in the Canadian healthcare sector. How was it dealt with, and are novice or student nurses the most common victims? Or has one noticed acts of aggression made toward foreign-trained, less-specialized (eg. LPN), visible minority, male, or older nurses? Or vice versa?

In three years time, I am expected to graduate from my nursing program as an Asian, male, registered nurse. I can't say at this point that I am worried at all about what has been stated in the article, nevertheless, I think this is a considerable issue given its commonness, and that one day it might happen to me or those around me, so I would like to have at least a little familiarity with current nurses' experiences.

I followed your link, and was more interested in "The Bully Pulpit" article by Rachel Giese in which she asks if the anti-bullying hysteria is harming our kids. Anti-bullying hysteria is an extremely accurate way to describe what I've seen going on in these boards for the past several years. There is so much hysteria about the POSSIBILITY of experiencing bullying, that young people are posting to say they're afraid to become nurses because they MIGHT be bullied. Yet "bullying" is not a new phenomenon. It happened when I went to school, when my parents went to school and when my grandparents went to school. It's receiving more attention now, and I suspect that because of that, we're looking for it, we're seeing bullying where it doesn't really exist.

New nurses are writing to AN to complain that they know their preceptor hates them because she doesn't smile at them when they come in to work in the morning, or because she had a "scornful" expression on her face when they did thus and such. Other posters are quick to jump on the thread and accuse the preceptor of lateral violence or of being a bully, and still others urge the OP to "report the bully" and "see that she loses her job" because "bullying should not be tolerated. Yet some of these "antibullying posts" are bullying in and of themselves.

And then there are the posts that suggest "reporting" preceptors for such offenses as neglecting to wear gloves when touching a patient, flushing a dialysis catheter "incorrectly" (meaning, I'm afraid "not as my nursing instructor said to") or "not being supportive enough." It seems that these very same posters who are most vociferous against bullying are themselves the perpetrators of it.

Giese writes: "

It's easy to recall with outrage the times we were teased or our son was called names, but tougher to admit the moments when we acted like thugs or our daughter behaved like a mean girl. The reality is that every kid can be awful and nasty and insensitive at times. The World Health Organization and the Canadian Council on Learning report that more than 25 percent of boys and 18 percent of girls in grades six through ten admitted to bullying others. Children must be taught to be kind and unselfish, just as they need to be instructed in reading and long division."

Bullying, it seems, is something that is done to you. When you turn around and do it to someone else, you describe it as "giving as good as I got" or "getting my own in" or "they got what they deserved."

[COLOR=#333333]Bullying will go away when we all stop doing it. We must learn to identify REAL bullying and distinguish it from interactions we don't like. Meanwhile, maybe we should all stop LOOKING for bullying, because when we look for it we'll find it -- even if it isn't really there. When we cavalierly indentify any behavior we don't like or that makes us uncomfortable as "bullying", we devalue REAL bullying.

[protoxeno]

eric,

every work field has bullying, what do you think the terms "paying your dues" comes from? don't be persuaded by these old time hardcore nurses who don't believe you should do it for the money. your other option besides nursing is simply much worse because there will be bullying and you will be paid $12 bucks an hour selling something. So go into nursing man.

[Ruby Vee, BSN]

eric,

every work field has bullying, what do you think the terms "paying your dues" comes from? don't be persuaded by these old time hardcore nurses who don't believe you should do it for the money. your other option besides nursing is simply much worse because there will be bullying and you will be paid $12 bucks an hour selling something. So go into nursing man.

Those "old time hard core nurses" are not the ones who are blathering on about "the calling" and how you shouldn't do it for the money. That would be those young, soft, good-looking nurses who all have so much more compassion than us old biters.

[joanna73, BSN, RN]

eric, every work field has bullying, what do you think the terms "paying your dues" comes from? don't be persuaded by these old time hardcore nurses who don't believe you should do it for the money. your other option besides nursing is simply much worse because there will be bullying and you will be paid $12 bucks an hour selling something. So go into nursing man.

Based on your comment, "old time hardcore nurses", you've stereotyped an entire group of people. I find this ironic, since this thread is discussing workplace bullying. You are absolutely correct, bullying exists everywhere.

[pinkfish333]

Im in Toronto Canada. Lateral violence is huge, Ive witnessed it in every job and student placement I have been at. I recently quit my dream job because I didnt want to put up with such a negative toxic unsupportive environment. The bullying I have seen is towards, all nurses, new and old, students, managers, allied staff.. everyone. Its awful. Good luck.