"I was working at a place not too long ago and it was a very old fashioned place. My background came into good standing because of 'yes ma'am, no ma'am, can I make you a cup of tea ma'am' as a part of the game, and if you could play that game you were left alone and I could manage it because I saw it as a game..."
Bullying comes in a lot of shapes and forms. It could be covert, amorphous, lateral, which is why it is probably one of the most pervasive forms of harassment in the workplace especially in healthcare settings.
I entered as a trainee nurse for a hospital in one of the supposed reputable hospitals in Northern part of the Philippines. I couldn't be more excited as I imagined myself being finally able to showcase what I got like a kid ready for her first day in school. During the orientation, the training manager emphasized that the institution is known to be a training hospital yet I guess one can never be too ready with what's in store once it actually starts.
My first day was greeted with smiles and a warm welcome. I always kept in mind that working as a nurse isn't supposed to be about fun and games. It is a place where life is at stake after all. So I guess a Halloween costume party wouldn't be a great idea.
On my third day, my shift mates and I all had to work overtime because someone, allegedly me, forgot to update the door tag of a patient in a 10-bed capacity room. I was in charge of the room and I was sure that I updated the door tags and true enough, I only saw eight after being accused of not removing the supposed door tags of patients that were already discharged from the ward. After finding out that I was right after all, I didn't even bother to tell her as the yelling continued dispersing all the other nurses like rats smoked out from a hole. I was already embarrassed in front of my colleagues and patients.
I already had this fear of being reprimanded or scolded by a superior as it reminds me of my mother when I was in primary school. I remember trying to always look busy though I know I never really accomplished anything at home. I guess with childhood experiences, some of us revert back to an older version of ourselves when faced with a person similar to our past despite gaining confidence and maturity from school, accomplishments, and peers. I read another article similar to this as a nurse narrated how she became an expert in violent behavior:
"I am the oldest child of a German mother and a Yugoslav father. I was born after the war so the Germans were not too popular anywhere particularly with the Yugoslavs. I was brought up in a community where the man was in charge and the woman was subservient. My mother was not really a subservient woman but she learned to be. I became aware of power, status, racial discrimination and all those unpleasant things very early and then I married a man who was into wife beating. So, my skill in reading body language was honed very tightly."
Not only does the above account illustrate how violence can be readily identified if one has previous experience of violent behavior but it also shows that being subservient makes a person's world less problematic.
Coming from another industry(service) where positive reinforcement, morale boosting, and motivation are the roles of our leaders to increase productivity, it really took time for me to adjust at a hospital setting. The call center industry, for example, regards their agents, as the jewels of the company since they are the front liners. Though it seems that they are at the bottom of the corporate hierarchy, much is invested in them not only to reach quotas but for retention as well. So I wonder why the dynamics are different in hospitals. Nurses are the front-liners. Why are nurses still treated like slaves through verbal attacks and brow beating by health care superiors and even administrators?
The article, "The Bullying Aspect of Workplace Violence In Nursing", discusses that nursing was founded in a patriarchal society and is still composed mostly of women. That the nursing profession was set up from the beginning to assume a subordinate role. Furthermore, it states that in order for this profession to be acceptable, and since women would be caring for men who were strangers, nursing was depicted as a "calling" or "God's work" and were viewed as angels of mercy and we all know that angels do not get mad. This would then entail that nurses should sacrifice, consistently care to the point of rejecting their own needs, never complain, and nurses are always subordinate and speak only when spoken to. The profession's history says it all. It started when the caring role were done by nuns during the Crimean war to care for wounded soldiers. The oldest sense of the word "nursing" in the English language is a woman employed to suckle and/or generally care for a younger child. The former being known as a wet nurse and the latter being known as a dry nurse. If we combine history and original meaning of the word, it would imply that nurses should be both like a mother and a nun.
If this is the case, then why should a female nurse supervisor, for example, maltreat the younger ones?
Is it because of the feeling that they already have reached a god-like status?
In my observation, there are different profiles of a nurse supervisor. There's the mother hen, the balanced leader who is strict with a caring personality, and the bully who appears strict but actually only has a petty, malicious urge to hurt or humiliate subordinates. These types do not necessarily correlate with tenure or years of experience. There's a nurse supervisor who already has 30 years of experience but still maintains her warmth and treats everyone with respect. Then there's that less than a decade supervisor who just blurts out whatever she feels without any consideration to the person or the situation/context involved. As mentioned, the act of bullying comes in different forms. She/he could be the person who ignores you as he/she flips through the chart as you speak, or reviews the assessment for a mundane insignificant detail that has no bearing on the patient's present condition. It could be their endless questions and complaints about what did or didn't get accomplished during your busy understaffed shift. This is an attempt at intimidation and in my opinion is detrimental to the new nurse's job satisfaction. Hope that managers realize that we are a team and it is a 24-hour job. As a neophyte, being new doesn't necessarily mean that rights can't be asserted and that I have to prove my worth before I get respect from anyone. Perhaps if our leaders show compassion and understanding towards us, then maybe we can emulate that towards our colleagues, new and old, and most especially towards our patients.
Some managers may think that they have become stronger because of their experiences of bullying in the past. It has become a rite of passage, a culture, and therefore, acceptable. I say that when you're on duty, the unnecessary verbal comments don't teach you to become a stronger nurse. It just teaches you to become desensitized with your supervisor and therefore block all future forms of communication even those that may be necessary for the neophyte/junior nurse to understand. The necessary reprimands lose their value and therefore become a missed opportunity for learning. Yes. Perhaps bullying indeed is part of the nursing or healthcare culture but so is corruption in the government. Developing something into a culture or part of it does not make it right. So is hazing, the culture of women being reduced as a housewife, the perspective that black is ugly and white is beautiful. All of these examples, bullying included, represent some type of oppression. The individual nurse then, as the article mentions, is coerced to reject its own values and ideas to maintain those of the dominant group/person. In other words, nothing is gained from bullying. The job is stressful enough even without this going on. Supervisors, managers, and seniors should be mentors and be tools of instruction, not destruction.
Perhaps the best testament to the belief that bullying is unnecessary for learning is from a head nurse who had this to say:
"I am an older nurse (30 years) and have many friends who are also older nurses by definition of experience. I don't test and question new grads that I've been precepting. I try to take their hand and guide them, impart to them some of the wisdom I've learned in the past 30 years to help make their way a little easier. It is true that bullying is all about intimidating. However, they come in all shapes, sizes, genders, ages and years of (in)experience. I speak from the experience of having been a supervisor and nurse manager who saw this kind of behavior and also experienced it over the years. A secretary can be a bully just as well as an RN. Bullies can ignore you, ask endless intimidating questions and complain about your performance, but these are only outward manifestations of the true heart of this beast that really has an ulterior motive of seeing herself or himself as being better than everybody else. Bullies are inherently mean, negative people who want to have power over everyone else and will not stop at using these kinds of nasty little behaviors to accomplish this."