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  1. Cliques and bullying are usually something that is generally reserved for the adolescent years. But unfortunately, you’ll find yourself dealing with cliques during Pre-reqs. I’ve dealt with them, from being bullied, childish rumors, and lies. As a prereq student, I never knew what meanness truly was until I stepped foot in my prerequisite science classes. As difficult of a time this was, it brought out character and wisdom that I’ll carry on throughout life. I’m not a self-help guru by any means, but I’ll give you the “types” of mean girls/guys I ran into, the experiences I’ve had with them, and tips that I’ve learned along the way. I felt urged to write this as a way of healing and a way of helping others. Know the “origins” of the clique A clique is usually made up of deeply insecure or bitter individuals. They typically band together to form what “seems” like a united front, but in reality, it’s not. The origins of a clique technically stem from loneliness or insecurity of some sort, and cliques pick on someone they deem to be weaker, but they are the weak ones. The clique consists of three subtypes: The Queen Bee, the lapdog, and the followers. Understanding Queen Bee, the lapdog, and the followers The alpha is usually on top of the game. She is typically smart and has many strong social ties, especially with the professors, but instead of being ‘humble,’ she’s the complete opposite. Most Queen Bees that I’ve run across are very skillful at having a Jekyll and Hyde persona and are extremely manipulative and jealous. Despite academic and social achievements, many Queen bees are usually trying to fill a void (explained to me by an older confidant). The lapdog is usually the Queen Bee’s best friend, and she usually does what the queen bee tells her to do; for example, if the queen bee wants to ruin someone, the lapdog will usually gather up a mob to make sure this is done, without leave a “trace” of evidence. Whom the lapdog socializes with strongly depends on the circle of the Queen Bee. Finally, the followers are either usually afraid of the wrath or want to be in the loop. Don’t give them a reaction From experience, if you usually give cliques a response, you go through the class or possibly the rest of your school experience with a target on your back. Yes, we are human and allowed to feel things, but when you deal with people with sinister motives, it’s best to remain stoic if possible. I will give you three experiences of mines. I had a study group (turned clique) to where they turned on me overnight. Back then, I had no idea what happened, just that before the lab in the hallway, I was treated horribly and began to cry, and then shortly after, the crap hit the fan, resulting in me having to drop and them spreading countless lies, it was basically mobbing. On my second try at anatomy, I had a girl I haven’t had a conversation with become hostile and somewhat competitive. She was attempting to humiliate me and bringing two other classmates (one who spread rumors and the other insulted me in passing) into the drama she was trying to create, unlike the first time I ignored her soon before COVID it diffused. Thirdly, during my Microbiology class, I had a girl that I hadn’t talked to try to start tensions, it started by her rolling her eyes, but I didn’t give her a reaction. Still, during one lab, she called me a ***, while inside I was fuming I didn’t react to it but did let my professor know about this, and she shared her wisdom, “ They look for reactions.” Me ignoring her attempts to get under my skin resulted in her not even wanting to look at me for the remainder of Microbiology. So despite the crappy experiences that I’ve been through, I try not to give in to the drama and stay as strong as possible, which is difficult at times. Know your worth and keep focused Know that you are in your prerequisites to build a future for yourself, not partake in drama! You are at the peak of your life and can do many incredible things! Also, keep your focus on whatever classes you may be taking, and do not get sidetracked! Value your mental health If you are going through a clique or bullying situation, know that you should not be going into class stressed or pondering whether you should stick around or not. It’s okay to take time to adjust yourself if needed. Talked to a trusted and professional counselor if your situation is too much to handle. Record incidents if possible This is so crucial if anything were to happen or decided to report. Reporting incidents (ex: names, descriptions, classroom room numbers, times and dates, and description of the events) will help the proper chain of commandment or the system you decide to report by identifying what’s going on. Alert teachers In the previous experiences, I had alerted teachers about these incidents. Two were very professional; one addressed the classroom, but both kept a watchful eye on the behavior, making things easier. Build a support system The support system can be friends, staff, teachers, or parents. When you are going through tough times, it’s very important not to keep things bottled up because this can backfire. Know that there are people out there who love you to pieces. Something that I want to say ... To the followers If you see someone getting bullied, report it instead of fueling the fire! There have been many times when someone spoke up and had a backbone that one person wouldn’t have to suffer over the wrath of a bully or a clique! To the bullies and followers with children Again, I write this because there have been several bullies and a follower who have had children. One of the worst ones was a male who had a daughter and an expecting parent. Before being nasty and following a crowd with negative motives, be an example of strength and positivity for your children! You wouldn’t like it if this was done to your children, and neither would they. One more step that I wanted to say that helped me is , don't force healing If it hurts it hurts , when you try to get over something super quickly that was traumatic I find that it just puts you back a bit while this happened 2/3 years ago I do still "ache" a bit from this but I am at a better place because I allowed myself go through the emotions I was feeling and then found later on down the road healthy outlets to deal with my bullying experience. I also wanted to thank allnurses too for helping me and giving me advice ❤️ References Academic Mobbing: Hidden Health Hazard at Workplace Mean girls in Pre-Req / Nursing School, how do you deal with them? How to Bypass Bullies and Get to Graduation
  2. amandaxyo

    New specialty bullying?

    Hi! I’m wondering if anyone has changed specialties and encountered passive aggressiveness / bullying from other nurses? I’ve been a medsurg/Tele nurse for 3 years. I also have some experience in outpatient same day procedures. I recently made the change to the ED. I have been encountering problems passive aggressiveness from some of the ED nurses. It’s unprovoked. They’ll make comments to me as they walk by or just flat out tell me they don’t know how I can work the floor without having critical care in my background. They act like an inpatient nurse, I never worked my butt off. I ignore it but it’s starting to irritate me. If you have experienced anything like this, how did you handle it?
  3. Nurse Beth

    Accused of Time Card Fraud

    Dear Beth, It’s me, ‘Sick to my Stomach’, I’m back looking for advice regarding the same manager who I felt was sabotaging me last year in February (I believe). I am now unemployed and I believe the manager played a part in my decision to resign. I’m also looking for advice on how or what I can do to help change the culture of bullying. I want to create a voice so loud that maybe somebody will listen, but I don’t know how. As you know, most of us are overwhelmed, overworked, morally distressed and are continuing to be where we are needed during this pandemic... except for in my case, until I was put in a position where I don’t trust the actions of the management team. I’ve been treated so poorly, I’ve talked to nurses who have been treated poorly and I feel like I need to do something to be the change in the culture of bullying and sabotage of nurses careers by fellow nurses. Colleagues confide in me, but only when I speak out about my own experiences. My most recent experience, the last straw that caused me to make the decision to resign, was just about two weeks ago when I arrived late to the Covid unit after working OT the night before. Regardless of working OT, late is late, and I am accountable for being late. I’m also accountable for making the decision to go straight to my assignments and not clock in. However, at the end of the shift we are also responsible to document our time of arrival in the missed punches book, a.k.a. the green book. As I entered the managers office and requested this green book I did so well announcing that I needed to do so because I was late and my manager proceeded to hand me the green book. As I’m writing my name I’m stating a loud that I’m not quite sure what time I got to work and then I was unsure exactly what to write and that I would be guessing. I get no response or direction from my manager so I say it again and this time her back is towards me, no response or guidance. At that point I’m tired I’m irritable I want to go home and I take accountability, this is my fault for being in this position at this time, however, in my opinion it’s obvious I’m requesting guidance. I then request that the time I swiped into the building be checked and used as my time of arrival because they do this anyway and have fired nurses for purposely falsifying their time entry. I am being open that I arrived late, open that I don’t know an exact time I arrived, requesting to be checked and corrected for discrepancies of the time I’m guessing and entering in the green book (we are required to correct entries the day of the missed punch) and use the badge swipe from the building as an accurate time of arrival. And still no participation from management for guidance. I close The green book and head home. The next afternoon I get a phone call from HR suspending me for time card fraud. I’m just beside myself that instead of calling me to come in and correct the time I knew I was writing as a guess, they called HR on me. I waited 24 hours after our meeting with my director and HR for them to call me with a decision of their findings and in that 24 hour time frame I decided even if they didn’t fire me I couldn’t work for them anymore because I don’t trust them now and I couldn’t give them a second opportunity to do something irreversible to my license. I sent my resignation letter and I’m just so overwhelmed with sadness because I honestly didn’t intend to commit fraud. I feel betrayed. I’ve never been accused of anything like this before and I don’t see how they feel I’m capable of doing this when I requested to be corrected. To be clear in the green book my entry stated 0707 but my building swipe into the hospital was 0709. Also to be clear 0707 is the cut off for rounding to the next pay bracket of 15 minutes so in their mind I was trying to steal 15 minutes of time from the company. What should I do if anything to create awareness if there’s even any awareness to be created from this experience. I just feel with everything I’ve gone through with the same manager, someone’s got to hear us who are targeted and address it Dear Tired, You are tired, you are irritable and you don't feel respected. This recent incident, as you say, broke the camel's back. You quit in a state of high emotion. Your estimation was off by only 2 minutes but represented 15 minutes of overtime to your employer and a reason/excuse for discipline, if they were looking for one. Perhaps it wasn't wise to choose 0707 as your clock-in time, knowing that it would be questioned and used against you. In any event, what is in our control, even in toxic workplaces, is to communicate assertively. Your manager ignored you when you tried to talk to her, which is unprofessional. You could be more direct "I need some help completing this, please. I'm not sure of the exact time. What is best to put as my arrival time?" Frustration at work comes from many reasons- not feeling valued, not being heard. Learning assertive communication is the best tool against frustration. The only thing we can change for sure is ourselves, and sometimes that means choosing a healthier workplace where you are appreciated. Best wishes, Nurse Beth
  4. CardiTeleRN

    BULLYING at work as Usual

    So long story short without giving too many specific details, I provided a doctor's excuse to cover a certain amount of days but was told by the nurse supervisor that doctor excuses are not acceptable to cover absences. Only COVID related illnesses and testing excuse absences - without a doctor's note. This is not written in the policy. Policy states documented/approved absences will be excused. I feel this is a clear cut case of intimidation. I could be wrong. I really try not to jump to conclusions but this feels like plain intimidating tactics. Thoughts??
  5. This is not an attention-seeking post, something I see a lot of people here accusing others of doing. I am not even asking for advice. Just venting. I am ganged up against, by a certain background of staff (certain native country) who make up the majority of my workplace. I know it doesn't make any sense, why am I still there. I am there because I love my residents, my company as a whole. I just wish there would be something they do about this bullying and retaliation (when they found out I c/o about it). The DON makes me feel like I am the problem, by ignoring even my written statement. She actually gets mad at if I ever say anything about it! I would get in detail, but I don't want even this innocent venting post to be used against me. The co-workers in question speak creole around me, in front of me, in front of patients. They act aggressively. I understand basic French and I more or less understand what they're saying. They ran so many nurses out of that place, I refuse to leave. Let them find a reason to fire me, they don't have one. 😞
  6. guest1156666

    ER nurse dealing with bullying...

    Hi guys! So background... I have been nursing for almost 10 years but new to ER nursing. It was a big learning curve but I’ve felt like I’ve found my groove and everyone has been giving me great feedback (I had no concerns on how I was reforming). Well until now I guess.. OK so I just need to vent.. I saw my manager today to ask about vacation time and we were talking and she’s like ‘how are you doing, are you liking it here’ so I tell her for the most part yes, obviously there’s days that are harder than others. She then says ‘oh I’ve heard from some Charge nurses that you like to go in the separate break room to chart or look up your patients and they were worried’ so I explained I like to go there sometimes on my break only for the peace and quiet especially on some crazy days and she’s like oh OK yep that makes sense. So then I approached one of the charge nurses who I knew was the one who told my manager this and she was so rude to me. I was completely taken back from her cold response. I explained to her that I hope she wasn’t worried that I wasn’t staying on top of things and she goes ‘ ugh yes quite frankly I am concerned because you’re the only one who does it and I don’t think you’re charting in real time’ and scoffs and walks away. I literally felt like crying. Just needed to vent and shake it off. It completely killed my morale and I am so upset. To the point that I just want to look for another job. I am usually one to shake things off but this is killing my morale. Any advice or similar experiences??
  7. "Stigma, discrimination, or bullying may arise due to wearing or not wearing a cloth face covering," the CDC states. Since not all families may agree with mask policies, "schools should have a plan to address challenges that may arise and refer parents, caregivers, and guardians to CDC's guidance on cloth face coverings." CDC: Guidance for K-12 School Administrators on the Use of Cloth Face Coverings in Schools
  8. Nurse Beth

    Bullied in the NICU

    I'm a NICU nurse. I left a toxic workplace due to bullying 2 years ago and became a traveling nurse, but I'm getting tired of the constant travel and want to settle down in a more permanent position. There are only 2 hospitals with NICUs in my hometown. One doesn't have any openings and the other is the hospital I left. Their NICU is under a new manager but I'm not sure how many of the floor nurses are still there. Do I try to go back to that unit or do I need to look into changing specialties? Dear Wants to Settle Down, It should be easy enough to find out which nurses still work in your old NICU unit. Contact some of your previous colleagues. Before you decide to change specialties because of bullying, consider that you are a different person than you were 2 years ago. You have gained skills from working in different NICUs. You have are more well-rounded in your practice. It very well could be that you could now take on a bully much easier than you think. BulliesBullies make other people feel belittled, humiliated and oppressed. A nurse bully in a workplace unit is a bully who has established dominance over the group. Bullying behavior can be subtle, passive-aggressive and actually cunning, which makes it hard for poorly trained managers to address. Bullies often keep their behavior discreet. Workplace bullies often operate within rules and organizational polices. They can belittle with a raised eyebrow and a look of scorn. Often bullies are expert clinicians, high performers, and popular employees. They use expertise and popularity as weapons and as a smoke screen to deflect from their bullying behavior. The bully comes from a place of insecurity and has an insatiable need be in control. To gain power, they often ingratiate or manipulate a weak boss, which gives them referent power. A new nurse coming into the group will trigger the bully and will be a target. It's not a matter of if... it will happen. Be prepared. How to DealStepping back into a bullying situation can also be triggering for you. You will need to be strong from the beginning. Make sure you have support and even consider weekly therapy to talk it through. Here's some tips. Change Your PerspectiveChange your perspective. Instead of viewing the bully as a scary person, see her as the sad, small, injured, insecure person she probably is. This lowers your defense response and reduces your level of intimidation. Bullies come from a place of insecurity and need to be in control. A well-dressed doctor being a bully? Picture him as a little kid wearing his Dad's clothes, pants pooling on the floor. ConfrontYou must speak up, and it's very cathartic for you. Silence does not work to stop bullying. Not confronting a bully never works. Script your words ahead of time so you'll be prepared. "Please don't talk to me that way""I noticed you rolled your eyes when our charge nurse said I did a good job""You seemed annoyed when I asked you for help.""Please don't interrupt me when I'm talking".Stand UpBullies are weak people posing as strong people. When confronted with strength, they back down. They feed on weak people. It takes 2 to bully- the bully and the target. Don't be a target. Make eye contact with the bully. This puts you on a level playing field, peer-to-peer.Maintain assertive body posture. A lot of what takes place is non-verbal. Picture the posture you hold for parents- maybe leaning-in, concerned, professional. Now picture a victim stance- head down, hunched shoulders. Be assertive in your body language.Just say No. Bullies expect others to do what they say. When told "Jena, you'll bring napkins and plates to the potluck" you can say, smiling, "No, thanks, I'll bring a dessert and let you know later what it is".Appeal to ValuesIt can sometimes work to call them on the difference between their professed values and their behavior. "I know you really care about Quiet Hour for our babies, and when you talk loudly, it affects the team". I hope this has given you some tools for your toolbox. Best wishes in your decision, Nurse Beth Your Last Nursing Class-how to land your first nursing job...and your next!"
  9. The protracted tension a bully creates takes a physical toll. Adrenalin ramps up. Muscles tighten. The mind races long after the shift ends. The longer a targeted employee is exposed to abuse, the more likely they are to suffer at least one disorder from a laundry list of medical maladies--digestive tract ailments; sleep disturbances; neck, shoulder and back strains; cardiac complaints; memory problems; migraines. The illnesses are genuine, but the usual treatments may give only temporary or partial relief until the underlying work situation is remedied. Here's the real kicker--absences resulting from the bullying behavior now give the bully a visible and measurable excuse to discredit, demote or dispatch the victim entirely. The bully's primary goal is to undermine and deactivate someone they perceive as a credible threat. They employ tactics that are sneaky, manipulative, and deliberately frustrating. They may take credit for the target's ideas and efforts, pretend ignorance about agreements reached or promises made, berate the target publicly (or privately, without their knowledge until word gets back to them), and try to convince the victim that any problems are due to their own misunderstanding, misinterpretation or incompetence. Bully: "Sue, I called you in here to remind you about the big Shared Governance meeting next week and go over the list of things our unit wants addressed. Target: "But, you gave me next week as vacation time three months ago." Bully: Well, yes, but that was with the understanding that you'd be available if I needed you. You're one of my most valuable staff members, and I need you to go to this meeting. Just run in for the two hours and you can be on your way. No big deal." Target: It is a big deal. I never said I'd be "available" during my vacation week. I wouldn't have agreed to that. I'm going to be in Cancun on Tuesday. Can't one of the other committee leaders go?" Bully: "I suppose I'll have to get someone else. But I'll also have to factor this uncooperative behavior into your yearly eval next month." Or, Target:"Roberta, you talked at the unit meeting about your new project to get the families more involved in the diabetic patient's meal planning. That was my idea! I gave you six pages of information and resources and asked if you wanted to work with me on it. Remember?" Bully:"What I remember is that you gave me some vague notes that I could barely read. I had to spend hours and hours deciphering your scatter-brained proposal [untrue] and adapting it to our unit. I'm calling it my project because, after all of the time I spent working through that mess, it is my project." Target:"But what you presented today was almost word-for-word what was in my proposal. That proves there was nothing wrong with what I gave you. You can't just take my idea and say it's yours." Bully:"And you can't make accusations just because you didn't get all the attention you hoped for. Don't worry yourself about this anymore. I was going to suggest to Nancy that she make you head of the committee that would come up with some sample forms and scripting, but you don't have to worry about that now. In fact, you'd probably be better off just keeping your eyes on your regular work. I heard that Nancy's been getting complaints from your patients lately. " "Complaints? What kind of complaints?" "Nothing specific. Just that you don't act like you enjoy your job very much. And you seem preoccupied. Maybe you've been thinking too much about this plan of yours, trying to be a hero, when what you really need to do is focus more on your patients." Ouch! Contrary to popular opinion, although a target may be inexperienced or or in some other way vulnerable, many times it's the capable, confident person--someone who is highly skilled and well liked--who unintentionally fans the flames of insecurity and brings out the worst in a bully. These victims are shocked. Their evaluations have been consistently good. No patient or client has complained. They've even been precepting or mentoring new people Then--bang!--they're written up on flimsy charges (and informed they're now on thin ice). Every action they take is scrutinized for the smallest error. They feel like their own words are twisted against them. And the progression tracks swiftly downhill from there. What happened? Most likely, the target got too good for the bully's comfort. Continued in How to Spot a Workplace Bully, Part Three
  10. allnurses Admin Team

    Doctor Behaving Badly - What would you do?

    This poster wished to remain anonymous to remove any chance of backlash. However, AN feels this is a story that many of us have experienced and it deserves to be told. Double checking the equipment we had laid out, I felt satisfied that anything the doctor asked for, we would have close at hand. Knowing that the patient had some kind of outlet obstruction or pyloric stricture, we are preparing to intubate to prevent aspiration. As I look at the patient's chart, and asked her a few questions, I couldn't help but notice her emaciated condition. Fragile, bony fingers gripped an emesis bag with the earnestness of someone clinging to life. Pale blue eyes followed my movements. Bending down, I looked her in the eyes and asked her what I could do for her. In this moment, we are her world. Her life is in our hands. Nothing else matters, except the next hour in this woman's life. Sometimes in our hustle, we forget how afraid the person in the bed is. As the doctor walks in, he tells us what he may need to do. We confirm that we are ready. Once we begin the EGD, we see several issues, among them an almost circumferential duodenal/pyloric ulcer. It is deep and ugly. "I want to balloon dilate her pylorus," the doctor says to me. My jaw dropped. I looked at my co-worker who appeared to be just as perplexed as me. I made no move to get the equipment, looking at the doctor I asked him if he was sure he wanted to dilate. The doctor mumbled something that I did not hear then the next thing I knew he pulled the scope out. Relieved, I called the end of procedure time and began cleaning up. The next thing I know, I hear the doctor right outside the door yelling. Looking up from the computer, I see him raising his hands and yelling. One of my co-workers came in with a clean gastroscope and began hooking it up. "What's going on?" I asked. Shrugging his shoulders, he said, 'I'm not sure". Soon after, the doctor comes in the procedure room and starts to rant about being the doctor and I as the nurse, am not allowed to question him. He looks me in the eye and states, "I am going to balloon dilate." My direct supervisor was not in the department at the time, so I wasn't sure how to proceed. I had voiced my concern. We did the procedure. As soon as he was finished, he continued to stomp his feet, raise his arms and yell at me about "questioning his judgement". "See," he said, " I didn't perforate." When I am in a situation such as this, I realize that saying anything is futile. So, I remained silent. My priority is the patient, the last thing I wanted was for her to hear an argument. He could be the lone ranter, but is was not over. This was not the first incident I was involved in with this particular doctor. There had been several other situations that had led me to question his skill level, decision making and safety concerning his patients. I had been witness to several of his temper tantrums that usually involved stomping of the feet, raising the hands, yelling, and irrational accusations. This latest situation was not just personal, it was professional. Usually it takes me a day to process, separate, and gather the thoughts in my head to figure out the best way to handle a situation. Of course there are usually many things that one can do in the moment, but often we forget and are so distracted that we don't act on some of the things we know can help us in these uncomfortable scenarios. In my current work place, my fellow workers are not used to confronting these doctors, and therefore the bad behavior has been allowed to manifest itself into a dangerous and unprofessional festering ball of bad that has to be halted. As soon as the patient was taken care of, I sat down at the computer and wrote an incident report. I felt like I was in a bad marriage, trapped with an abusive spouse. I could stand it no longer. I know my job, I know what is safe and not safe. I don't claim to know everything, but my long term experience allows me the luxury of having worked with many good doctors and seeing many different scenarios that are handled in many different ways. I am not used to working with inept doctors who are blind to themselves neither am I used to an atmosphere of apathy. Over the course of about a year and a half, I have written this doctor up for bad behavior, and dangerous actions. He has had fights with other doctors in the hallway, and in front of patients waiting to have a procedure, he has refused to abort the procedure on many occasions when food or liquid is present in the stomach, even with anesthesia asking several times. He has thrown the scope on the bed during a colonoscopy, taken his gown off all the while a snare is around a polyp and the obese patient teeters on breathing and not breathing. All because a nurse asked him to talk clearly so he could be understood. We know as nurses, that doctors are not good at regulating each other, and unless there is a paper trail, then our complaints are mute. I was not the only nurse to write this doctor up, but finally our voice was heard. He was brought up under peer review and the concerns were addressed to him by his peers. If anything else, there is a paper trail and the review on record in case future events happen. I will not be party to a doctor's inadequacy putting a patient at risk, we are by law to be the patient's advocate. This doctor has created with his bullying attitude and actions a place of uncomfortable violence. What are the laws about this? What can I do? This situation led me to investigate my facilities' policies as well as workplace laws regarding bullying. In the next article, I will address the latter
  11. Cindy was an older new grad. She went back to school after a long and successful career as a chemist, deciding that she wanted to be a nurse and explore other avenues of service for her “second half” of life. Capable and efficient in her first line of work, it was a shock to find herself as a novice where everything felt unfamiliar and where mastery was a ways off. Her first place of work was on a busy ortho floor. The second week at work, she called me crying. “Their expectations are so high. They keep threatening me.” I tried to listen without judging or offering advice, but something just seemed off. Every few days she texted or called and what she described didn’t seem like anything I had ever experienced as a nurse: where there should have been mentoring, there was censoring; where there should have been guidance, there was abandonment; where there should have been counseling, there was silence and isolation. The source of most of the problems was her preceptor, a young nurse, who my friend described and very physically attractive but unkind. As it turns out, she was a bully. Nursing is Not Immune to Bullying While we would hope that in such a caring profession, we would find a greater percentage of people with compassionate care agendas, sadly there are also a number of practitioners who exhibit the characteristics of a bully: they are critical, negative, they isolate their victims, avoid meeting with them, and generally make life miserable. According to a study by Etienne, “Bullying in the nursing workplace has been identified as a factor that affects patient outcomes and increases occupational stress and staff turnover.” (Exploring Workplace Bullying in Nursing) Signs of Bullying The trouble with bullying is that it is often subtle and therefore difficult to recognize as such. While the playground bully may be overt and even violent, the adult bully is usually disguised under heavy layers of professional accomplishment and years of experience with manipulating others. They come in all shapes and sizes, both men and women, old and young. The “mean girls/guys” from 7th grade grow up, don’t they? But sadly, they sometimes don’t leave behind their old ways of treating others, and they bring those tactics with them when they put on their scrubs and head to the nursing workplace. One of the primary manifestations of bullying is that the victim often feels that it is all his/her fault. After exposure to the bully’s tactics, they may even think to themselves, “If only I did this or that better, then they would not treat me this way.” The thought processes at the center of the bully/victim relationships can sometimes be lifted straight from our textbooks about abuse. Just as victims of domestic abuse many times blame themselves, nurses who are victims of bullying find themselves looking inward and wondering if there is something wrong with them. What are some of the classic signs of a bully boss or co-worker? 20 Subtle Signs of Bullying at Work More Subtle Signs Deceitful and manipulative- making promises but not keeping them or using promises to purposely disappoint. Shaming and blaming- bullies want the victim to blame themselves. Ignoring or undermining work- purposely “forgetting” to notify someone of meetings, belittling their work or accomplishments. Intimidating and criticizing- setting impossible standards and even threatening. Diversion and mood swings- bullies might avoid the victim so that the work issues cannot be resolved in a timely manner; and they are subject to widely varying moods (which boss/co-worker will be coming to work today? The sweet one or the nasty one?) Overt Bullying Aggression and intrusion- actual physical altercations with the bully entering your personal space. Belittling, embarrassing and offensive communication- using their position to cause you harm, either physical, psychological or professional. Coercion and threatening- pushing the victim to do things they don’t feel comfortable doing and using threats of termination or other punishment to get compliance with their demands. So, if you or someone you know is being bullied in the workplace, what can you do? Document- Keep a record of any threatening or inappropriate emails, texts or interactions. Should it become necessary to report the bad behavior, it will be important to have specific occurrences, words used, and frequency of episodes. Also, learn your workplace policies on bullying and what your recourses are. Detach- Try to look at the occurrences in light of how this person treats others. Have you been “picked out” for special scrutiny? Bullies are sometimes bullies across the board but at times they pick out a few victims, zero in on those and treat others as allies, making the other staff members into (sometimes) unwitting accomplices for their own bad behavior. Dare to Defy- Standing up to a bully is hard and practically can be impossible. Often, persistent bullying requires cutting our losses and moving on to another position. But adult and boss bullies—like those on the playground—can respond to pushback: maintaining eye contact, standing firm, ignoring or not acceding to their demands. This is harder to do than it sounds, because the victim of a bully at work frequently is not in a position to resist and finds themselves being jerked around by the perpetrator’s continually changing and escalating demands, whims and moods. Defend- Be on the lookout for bullying behavior around you and if you see something, say something. As for Cindy, in the end, she resigned after 3 months and went in search of another job—certainly not the route a new nurse wants to have on her resume—but a physical and psychological necessity given the bullying she experienced. After the rocky start, she went on to have an extremely successful career as a nurse and to find the profession a satisfying fit for her talents. Have you witnessed bullying in your workplace? How have you been a victim of bullying?
  12. VickyRN

    How to Handle Student Incivility

    It's a sad and indisputable fact that our society is becoming increasingly rude and narcissistic. The emphasis now is on an individual's "rights," but not taking personal responsibility or accepting the consequences for one's actions and decisions. (Witness the sad behavior of some elected officials.) The vast majority of nursing students are professional, earnest, ethical, and carefully follow the policies of the nursing program. That said, there is a tiny minority of students whose behavior can be quite distressful for educators. Examples of incivility can be Making threats (whether explicit or implied) Bullying Rudeness and disrespect (e.g., use of cell phones and texting in class) Sense of entitlement (e.g., demanding the instructor to do this or that) This is by no means an inclusive list. What are some practical strategies for educators to employ when confronted by these sorts of behaviors? First and foremost, KNOW your learning institution's and nursing program's policies for student and faculty behavior (e.g., student handbook). Enforce the policies by clearly and explicitly stating in your syllabus what student behaviors are expected and what behaviors will not be tolerated, along with the consequences. Be consistent, professional, and impartial. Don't fall into the trap of reacting emotionally but take the time to carefully and thoughtfully respond. Address the behavior immediately. Sometimes it's easier just to ignore unprofessional behavior, but be advised that such behavior rarely gets better on its own. In fact, the entire learning environment can rapidly disintegrate if the incivility is not dealt with. Document, document, document. Know and follow your chain of command. Since your syllabus is your learning contract between you and the learners, it is important to proactively address these types of situations. Examples of clauses from my class syllabi at two different colleges Students should be familiar with and follow the class etiquette rules. Students are expected to remain alert and respectfully attentive in class. Respect the faculty lecturer, other students, and the learning environment. No whispering or texting during lecture. No talking when someone else is speaking - one speaker at a time. Disruptive students may be asked to leave. Please turn all cell phones and beepers off prior to entering the classroom. Texting is expressly forbidden in class. Students found texting in class will be asked to leave. Personal laptops must be used to take notes during lectures. No surfing the Internet during class. Make sure that your use of laptop computers is strictly restricted to matters being discussed in class. While using your computers, take measures to avoid distraction for your fellow students. For example, turn off the sound. Make sure that cell phones are turned off when the class begins. A failure to do so may result in a grade of zero in class participation. Common courtesy is defined in the statements that follow: All cell phones or beepers must be turned off during class. Arrive on time, and stay for the entire class period. In this course, we begin with the assumption that the opinions, positions and perspectives of others are worthy of respect. At the same time, we will challenge one another to support and defend our viewpoints with clear and logical arguments. In all events, we treat persons with dignity and respect, even if we personally reject their views. If you need to leave the room at any time for toilet breaks, please close the door quietly after you. What have been your experiences with students displaying incivil or disruptive behavior? What has worked for you in dealing with these unpleasant situations? Students, we also welcome your perspectives. Thank you in advance.
  13. RegisteredNuisance

    Nursing Hostility and Other Nonsense

    In my short career as a nurse I've seen some terrible behavior among nurses, and I'd like to share my take on things. I've only been a year for two years, and working as a nurse for 13 but in that short amount of time, I've seen an astounding amount of hostility between my coworkers and directed at me in the two facilities I worked at. It made me sad, it burned me out and it made me feel like I was working in a mine field. As a fellow nurse, I respect you. We ALL had to work our tails off to get through the hell that was nursing school, study feverishly for the NCLEX exams, then scramble desperately for a job - hopefully in our chosen specialty or facility - after graduation. We have ALL earned our licenses and are all worthy of respect. As a fellow human, I respect you. We all have feelings, different psychological and familial backgrounds and different emotional and interpersonal needs. We all share the same basic few reactions to negative situations. We all liked feeling liked, respected and valued by those around us. In the face of conflict, it's easier to turn your back on someone, come up with reasons why you don't like them and find reasons justifying your ill treatment of them. It's easy to cling on to that anger. For some of us (myself included), that anger mobilizes us and is how we're most used to expressing ourselves. It's hard to resolve conflict in a mature, diplomatic fashion. But it's worth it. Our interactions with other people are more meaningful if we can move past anger, communicate our feelings without hurling insults and get back to working together. So the night nurse gave you a poor report which you took the fall for later that day. She was probably tired from a long night and the missed information slipped her mind. One should always give the most complete report possible, but mistakes happen. Forgive her and make the best of it. So the day nurse left you with meds to finish and missed orders in the chart. She probably had a hectic day with never-ending distractions and demands made of her. FORGIVE her and make the best of it. So your coworker spoke to you sharply when you asked her a question. She was probably in the middle of thinking about something and you inadvertently interrupted that thought. FORGIVE HER and move on. Sensing a pattern here? We get so wrapped up in little issues and small infractions with our coworkers that it completely clouds our ability to look at the bigger picture: your coworkers are your team members and you owe it to them to be respectful. You owe it to yourself to have them at your back when you need them. So the next time another nurse is giving you the stink eye or says something rude or snaps at you... Forgive her, and try to resolve the issue after tempers have cooled. We owe it each other to respect each other. Nursing is hard enough.
  14. plasmic

    Bullying in the workplace

    "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."

    Break the Silence: Report Bullying

    The importance and impact of bullying in the workplace are significant to nursing in many ways. Bullying threatens the very foundation, of not just nurses, but its business ethics, structure, and productivity. Nursing is a sensitive structure that demands teamwork, dedication, and drive. The rise of bullying threatens to create barriers in nursing that will result in a negative way. This impact bullying has on nurses impedes their ability to function professionally by interfering with teamwork, morale, and personal health. Prevention is the only way to stop or eliminate bullying. An anti-bullying program must become an integral part of nursing training by deeply embedding the need to identify and prevent this destructive action in the workplace. A nurse takes the oath to do no harm to others. Nurses dedicate their hearts and minds to practice faithfully in their profession. The qualities a nurse must possess are to be compassionate, sympathetic, and empathetic towards others. These qualities are especially important for nurse managers so they can guide and mentor nurses along with their career path. A nurse manager who lacks these qualities and does not support their nurses creates problems in their working environment. An unspoken problem is nurse manager bullying. The nursing issue is that nurse manager bullying can cause intimidation and psychological harassment amongst their employees. This harassment can cause the employee to have devastating psychological, physical, emotional, and social outcomes. It is time in the nursing profession to break the silence that nurse managers who bully nurses create an unhealthy work environment that can result in health problems or cause nurses to resign. Post Traumatic Stress Disorder (PTSD) and suicide do occur in staff who are bullied by their co-workers and/or nurse managers. It is time to be proactive as nurses and identify bullying behaviors and report them immediately. Look at your co-workers who are being treated poorly reach out your hand and guide them to get counseling so they can heal from this. Here are some basic suggestions on what to do if bullying occurs in the Workplace: Send the employee who is being bullied to Employee Health to talk with an appointed staff member who can guide them in where to get counseling. Remove the employee immediately from the toxic environment and place them in a better working environment so no form of retaliation can occur. Employee Health should report bullying to the Bullying Task Force. The Bullying Task Force is composed of a Peer Counsel Committee who will review each case. This Peer Counsel Committee is important because it does not consist of management who possibly would not be as objective as a peer. Implement a Bullying Support Group. This is important in the recovery of staff who are bullied. The Bullying Support Group will utilize a twelve step program much like Alcoholic Anonymous. Have employees fill out a survey online that can be filled out anonymously and sent directly to the Associate Directors office. Have Human Resources track all staff who leave a position and have them fill out a bullying survey online. Exit interviews should be conducted on all employees leaving their jobs. This interview should be kept confidential so it does not interfere with or impact new job opportunities. Surveys should be done that ensure confidentiality in the data collected. In order to collect honest and accurate data, it is extremely important to provide confidentiality. Surveys that ask identifiable data such as age, work level, and sex are often a deterrent for employees to complete the survey honestly. A person's identity can easily be assessed by this information. All of the data collected can be utilized to help strengthen the laws, guidelines, and policies to provide a safe working environment and to stop bullying Educating hospital staff on the importance of looking for suicide and PTSD symptoms is extremely important. Nurse managers need to be educated that treating their employees in a caring way will help to retain them. They will realize happy employees are more productive and tend to stay in their jobs. Cruelty will cause the human spirit to fail. Nurse managers that bully allow the human spirit to fail in the employees they bully. The human spirit is affected by the consequences of bullying which are physical and psychological changes in the person that is bullied. Jean Watson's Human Caring Theory should be taught to all employees to restore caring in the health care system so bullying behavior can be stopped. Educating and providing resources to new employee nurses on bullying, the Whistle Blowers Act, and sexual harassment should be incorporated into new employee orientation. All staff would also benefit from a yearly review on these topics. Hopefully, this will keep nurses aware of proper workplace behavior and we can retain nurses. There are programs available for this problem, but many nurses are not aware this issue exists nor how to identify bullying. There are several others that provide information on books, education, and counseling available for anyone who is bullied. There are no governmental laws that prohibit workplace bullying. Governmental laws addressing workplace bullying should be in place. There needs to be a law acknowledging that bullying exists. Once legislation is established then health care organizations will have zero tolerance in allowing this behavior. Strong institutional policies need to be in place in every healthcare organization to prevent bullying in the workplace. Report Bullying; Break the Silence; Save Your Co-Workers Life Sarah Yuengling RN MSN
  16. Dealing with a bully is a challenge for members of both sexes, but women are especially bad at it. In an article in the New York Times, Mickey Meece says male bullies outnumber females sixty percent to forty percent. But when it comes to their victims the bullying womenm "prefer their own kind, choosing other women as targets more than seventy percent of the time." The reasons for this are both logistical (women have more female co-workers and subordinates) and gender-related (women tend to be easier victims--they are often less skilled at identifying an attack, less confrontational overall, more likely to doubt themselves, and more willing to compromise in the name of reaching a resolution). Women want to reach out to other people, be team players, and find connection. Such approaches can work wonders in disputes with reasonable bosses and co-workers, but they're blood in the water to a bully. If women have a tough time coming to grips with workplace bullying, they have an even tougher time getting others to take the issue seriously. Normal people (especially other women) don't want to acknowledge that this kind of twisted behavior actually exists. It's easier (and less unsettling) to pin the problems on personality differences or blame the target for having a problem with authority (even if that's never been an issue before). Those who don't understand what they're really looking at might recommend meeting with the offending supervisor or coworker one-on-one to clear the air or encourage the complainer to simply rise above the whole thing and be the bigger person. When a bully is involved, such assessments are inaccurate, and the advice is unwise, ineffective and possibly even dangerous. We wouldn't make these same suggestions to victims of domestic violence, would we? Being targeted by a bully who is friendly with management is similar to the situation of a woman being battered by a police officer husband. When she's had enough and she finally calls 911, how quick do you think her husband's brother officers will be to see her side of the equation? Then there is the other end of the stick--management that fears the bully as much as the target does. Whether it's anxiety over the bully turning her sights on them personally or worries about being able to build a case for the bully's termination or even just the trepidation of finding a suitable replacement, supervisors may know the score but chose the path of least resistance by relocating the target to a different shift, department or facility. In a worst case scenario, the target is fired, leaving the bbullying boss or co-worker to operate with impunity. Can you say, "Punishing the victim."? No one is indispensable, but generally, the higher up the food chain the bully is and the greater their participation in committees and other activities, the safer they are to continue practicing their violence. That's what workplace bullying is, after all--a form of psychological violence that leaves its target stunned and wounded. And just like a skillful physical assailant, a bully often knows how to land blows that don't readily show, especially if those who might be able to stop it don't know what to look for. Part of the difficulty with making a bullying complaint stick is that the pieces of the puzzle seem innocuous or even petty when looked at individually. HR Person It's only when the fragments are assembled into a whole that the real picture emerges. HR Person Target Another hurdle in being believed is that a frequently-used assessment tool for the existence and severity of bullying is the damage it does to its victims. Observers don't see the bow or the arrows, and they certainly don't see the archer for the bully he or she has become. The only evidence that shows are the holes in the target. What this amounts to is that the victim has to try to prove her case by displaying her wounds. HR Person Target It isn't right. Workplace bullying is a pattern of crazy-making behaviors and threats designed to undermine a co-worker's or a subordinate's professional and/or personal life to such an extent that their confidence, their sense of safety, and their health are compromised. It has nothing to do with problem-solving, conflict-resolution, or appropriate workplace discipline and everything to do with a toxic person attacking others to protect herself at their expense. Resources Workplace Bullying Institute The Silent Epidemic: Workplace Bullying New Laws Target Workplace Bullying kickbully.com Why Do Women Bully Women in the Workplace? They're Easier Targets. Backlash: Women Bullying Women at Work Women Bullies Often Target Other Women
  17. When it comes to my career as a nurse I consider myself lucky. I did not consider myself lucky in the beginning of my career. But hindsight is a beautiful thing, if self-reflection has taught me anything. I am not one of those nurses who loved their bachelors' program and reflect fondly on memories of clinicals, lectures, and professor reviews. Most of these events were traumatizing and left me in tears. My first experience with "nurses eating their young" began in nursing school. I should have counted how many professors told me I would make a terrible nurse. (It is a pleasure to work with my patients today, and the cognisant ones all are very appreciative of our 12 hours together.) The summer before my senior year in nursing school, I was accepted into a nursing residency program. It was one of the best decisions I made in nursing school. I learned more working with my preceptor in this program than I did in all my clinicals combined. I had the best preceptor; we are friends to this day. She did not talk behind anyone's back, she was constructive, she gave me praise, and she let me form my own opinions about nursing and the workplace. She was everything my nursing professors lacked. She was such a positive influence on my experience with nursing; I choose to work in her unit upon graduation. She was my preceptor while I oriented to my new role as an RN. Upon the end of my orientation she went on maternity leave with a pending promotion to return as our assistant nurse manager. The veil was lifted from my eyes in her absence. My sign on bonus/contract was for two years in this specific unit-no transferring to another unit. These two years did not pass quickly. I experienced more "nurses eating their young," generation differences among co-workers, poor scheduling, day and night shifts in the same pay period. I ended up going to a gastroenterologist for stress induced health issues, and seeing a therapist regularly. My friends called less because I only complained about work; my boyfriend developed a "no work talk ever" policy. My negativity seemed to spread through all parts of my life. One pay period after my two-year contract ended I began in an ICU at a magnet hospital. The things that people complain about in this new setting pale in comparison to my first job. I am actually enjoying being a nurse for the first time in my career. I am no longer thinking I chose the wrong profession. I am considering going to graduate school in nursing. There are many stories of nurses eating their young. But I have read few articles that address solutions to this problem. AACN has the "Bold Voices" commitment, which states the importance of identifying problems and creating change to make the work environment positive. I signed this statement for my new job. The culture in this ICU is phenomenal compared to my first job. It is our responsibility to treat our colleagues equally and respectfully. We cannot decrease the shortage if we cannot keep our new nurses in the field. We must consider the trickle down effect.
  18. I believe nurses are very special individuals. Think about it. They are professionals who take care of others in their dire moments. They patiently heal the putrid wounds of some; calm the fear and hopelessness of others; tolerate ingratitude and hostility daily; endure day after day of toiling around the sick and dying. Is only natural you'll find compassionate and warm hearted beings among nurses. I have been in other professions and the contrast is clear to me. But because nursing is a tough job; some of us develop a thick skin. In a way, is a protection mechanism some develop to survive - you either get tough or you die. Although there is nothing wrong with being tough, some nurses can become quite aggressive and hostile to other nurses. We all have met them at some point, I surely did. But even being aggressive and assertive, nurses cannot match the aggressiveness of some bosses. Oh yes, let's talk about them bosses. But bosses are people too. Yes, there are reasons why nurse bosses are sometimes so bossy. But bosses also have their though fights to fight. They too must develop an even tougher skin to survive the trials and tribulations of health care. Sometimes bosses are just nurses who left the floor because they simply couldn't take it anymore. Then to find even more stress in management. Nurses are usually between a rock and a hard place. They have lots of responsibility, but lack the power to make decisions on their own. Doctors have much more say so in regards to their professional lay out. They call the shots, they can fire patients and are respected by most. Nurses on the other hand need to make decisions but always filtered by a set of rules created by others. Nurses must endure whatever BS is thrown at them. If you have an abusive patient, all you can do is to write a note and hope for the best. Most nurses can't simply fire a patient or they'll get fired. Nurses run the show but are told how things should run. Often by someone who is deciding for them from an office chair; people who never worked on a floor or have not worked in years and can't remember anything. So, nurses are in a pressure cooker situation. Pressure from all sides and not an outlet in sight. Well actually there is: and that is to relief the pressure on the least dangerous and inconsequential outlet - the young and vulnerable ones. The perplexed and scared nurslings are the recipient of a lot of pent-up anger. But why older nurses engage in this predatory and coward behavior? It must be their inability to change the system and claim their power. Their extreme frustration lead them to eat their young. The ones they should be nourishing, protecting and grooming to take nursing to the next level just got eaten for lunch. Just like scared animals - they step on their own eggs. This is unfortunate. If young nurses were well groomed and nurtured they would be the ones able to take nursing to the next level. Instead nurses create a culture of perpetuating the errors inflicted in them by transferring it to the young. Protecting the young Again, if you want to bully someone bully the oppressor and not the oppressed. Bully your problems and not the people who are here to learn. The bully energy is good energy but wasted and pointed in the wrong direction. The alternative to bullying is to preserve and protect the young: because teaching the young the right ways is the only viable way to change nursing culture. It changes things because the young always will change the world. But instead we teach them the culture of bullying. We create perfect students in the art of bullying others. Nothing changes. So, Mr. Bully next time you decide to torture the young, think of why you went into nursing back in the day. Bullying the young will only perpetuate the culture of abusiveness you were ounce, and continues to be a victim of.
  19. Dear readers, I'm a new grad, and have been working as a new nurse for early 5 months. I've heard a lot regarding "nurses eat their young" before I stepped a foot into this profession, however, I didn't quite comprehend the significant meaning behind it until I have personally experienced it at my work place. She's one of my preceptors when I initially started working there. As a new grad, I anticipated a lot of support, a hand of guidance, and patience, however, after a period of time spending with her, sadly to say, she had successfully made my life miserable, and made me feel extremely unwelcome. At a point I even contemplated whether this is what nursing is about. I lost my eager passion for nursing. Initially, I would greet her with a hi and bye whenever I see, and her reaction to my greetings were very indifferent and sometimes she would just look at me and turned away. Ultimately, It made me feel very embarrassed in front of everyone, several times, I thought to myself, why am I so persistent with her? why am I so desperate to get her approval? Why am I let her put me down again, and again? For what? So yesterday was the climax of this bullying business, or perhaps, put an end to my misery. First, I walked in on her gossiping about me with another co-worker in the nursing station. At that moment, I just looked at them both in disbelief. Secondly, what really ignited my untold emotions was with a patient's IV antibiotic. Another co-worker, let's name her B, whom I gave report to, also a close friend to hers, and her (A) were discussing that she discovered that there's very fluid backed up, about 5ml, in a 3g Unasyn bottle which was attached to the 100ml 0.9% sodium Chloride. Be mindful, I gave all my reports already, had to stay to hang another bag because another co-worker © was complaining that I should have done that during my shift, of course, I willingly agreed to change the IV bag. It was close to 8am in the morning, I was preparing to head back to the locker room, when I heard my name, I looked up it was nurse A calling for me to go to nurse B. They knew exactly what to do with the bag, but had me call the Pharmacy and bring it down to the Pharmacy department to have them show me how. On my way down, I was so upset, tears were inevitably rolling down my cheeks. My nursing educator saw me. She told me that she heard a calling from God and saw me standing in a corner crying. I thank God that she saw me. After hearing what had happened, she furiously took me upstairs and called in each person for confrontation. My manager was there at the time of event. My former preceptor, nurse A, admitted that she was closed off to me, and it all started when she first precepted and perceived my attitude and action as not receptive to her teachings. I stood there shaking my head while listening to her complains. So my manager inquired when all of this was going on, how come as a senior nurse, especially a preceptor, she didn't express it to her when they had meetings together. In addition, she fabricated more lies about me not giving her full reports in the morning. I voiced myself and said it loud and clear in front of everyone that every time we sat down to give her reports, she's either not listening attentively and in the middle of giving reports, she would turn away to start conversing with another nurse, or snatching reports from my hand and telling me she knows the patient and need no more reports from me. I've been thinking a lot. I don't know if I can still work on that unit anymore. I don't know if I should transfer to another unit, or apply to another hospital. I know distinctively that these nasty people are everywhere, but especially, since the confrontation and mediation took place, I'm not anticipating my work life to be any more easier or comfortable on that unit. Words will spread like feathers throughout the whole unit. I don't know how people will view me after this incident. Perhaps, using higher authority to report the "bullies"? I feel lonelier than ever. It makes me dread going to work everyday. Please help! Sincerely, Your desperate fellow nurse
  20. Xtina, BSN, RN

    Attention nurse bullies... and victims!!

    Hello fellow nurses! One of my last projects for my RN-BSN program will be on lateral violence in nursing. I have a few questions for those who have been involved in bullying just so I can gain perspective. Questions for the bullies (you know who you are and only the brave will answer...ha!): What sets bullies off? Are you just angry people in general which carries over to your treatment of others? Do you realize it affects patient care? Tell me what drives you nuts at work. What is the most effective way someone has responded to you to get you to back off? Questions for the victims: Have you ever left a job because of bullying? How do you respond to bullying... ignore/confront? Does your facility have a way they deal with bullies? Have you noticed it directly affects the way you provide care for your patients? NO JUDGEMENT HERE! Please be honest with your responses and maybe we can get a healthy dialogue going. Thanks in advance!
  21. J.Adderton

    The Future Nurse Bully- Is it You?

    Bullying and nursing have a long and well documented history. The American Nurses Association defines nurse bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient”. "I easily recall my first nursing job and my assigned preceptor. During the first week, my preceptor instructed me to call the on-call cardiologist to report a patient’s conversion to atrial fibrillation. However, she provided no guidance on the assessment data (including vital sign trends, labs and medications) I needed to have ready for the notoriously thorough and rude physician. I remember hanging up the phone- red faced and teary eyed- as my preceptor stated “congratulations on your first initiation”. My experience is not unique. Research has shown 85% of all nurses have been bullied at some point in their career. In addition, 60% of new nurses leave their first nursing job due to some form of harsh treatment from other nurses. When I taught my first nursing course and clinical, I quickly identified potential future nurse bullies. The humiliation and distressed inflicted by these students caused the same level of damage and distress as in other nurse settings. I also discovered some faculty failed to model desired civil behaviors. Instead, faculty modeled bullying behavior through rigidity, being over critical and treating students unfairly. Do you remember hearing these words in nursing orientation, “look to your left then right and understand most at least 1 of you will not be here at the end of the semester”? As if nursing school wasn’t competitive enough, faculty introduce the fear of failure into an already stressful environment. And so it begins. If you are a current nursing student this article provides you an opportunity to reflect and evaluate if you have behaviors that could lead to future bullying. You may also identify bullying at the hands of a classmate. Let’s look at common characteristics of bullying and relate to the experience of nursing school. Have you ever tried to control or dominate other nursing students? Examples of this bullying behavior: Interrupting another student in class, lab or clinical. Encouraging another student to break rules or act in an unprofessional manner. Asking another student to not tell or report behavior such as cheating, clinical errors or other rule infractions. Providing unsolicited criticism of another student’s performance. Have you ever verbally intimidated another student? Examples of this bullying behavior: Assigning an unfavorable or offensive nickname to another student (often timid or weak) or simply engaging in name calling Making insults under the guise of a “joke” Telling ethnic jokes or using slurs Gossiping about other students or sharing information told in confidence Making outward signs of frustration with another student such as inappropriate sighing or laughing Speaking in a loud or aggressive manner Have you ever blamed another student for your poor performance? Examples of this bullying behavior: “Thanks for asking so many ridiculous questions in class. I failed the test because you were so distracting.” “I studied with you and look what happened!” Have you ever found fault, sabotaged or withheld important information from another classmate? Examples include: “John thinks we have an hour for lunch instead of 30 minutes- let’s not tell him. Jokes on him!” “Why are you always nervous before clinical? No one else is acting like you.” Making unfair assignments in group projects or clinicals Withholding information that would be helpful/beneficial to another student. Have you ever intentionally or unintentionally demonstrate behaviors of cyberbullying? Examples include: Confronting another student on public online social media Singling out another student by excluding on message boards, chats and class-related media Using social media to gossip or talk negatively about another student? Other covert forms of bullying: Eye Rolling or other gestures for the purpose of intimidation, embarrassment or threat Excluding a student from a group (i.e. cliques) Using profanity Being confrontational There are overt bullying characteristics that lack subtlety and are easier to recognize and often occurs in front of other people. Threatening is a direct form of bullying and is intended to scare or coerce an individual into certain actions. Coerced actions may be engaging in verbal and physical altercations, withdrawal or avoidance of people and places. Note: This article focused on subtle bullying behaviors that are sometimes difficult to recognize. Physical violence is a clear and dangerous form of bullying. It is also less common because the consequences are higher- being expelled, arrested or other legal issues. Did you experience bullying behaviors in nursing school or are you experiencing as a student now? Share your experience. Reference: Violence, Incivility and Bullying
  22. Jkaiservi

    Incivility: Beyond the Nurse

    Nursing Incivility and Leadership: A Missing Link? The American Nurses Association Code of Ethics implores nurses to maintain caring and professional relationships with colleagues as well as with patients and their families. Provision 1.5 of this code specifically states that the nurse must "create a culture of civility and kindness, treating colleagues, coworkers, employees, students, and others with dignity and respect" (American Nurses Association, 2015, p. 4). The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is the primary authority in healthcare regulation. The Joint Commission has issued a mandate for institutions to address uncivil behaviors in healthcare as they create a threat to patient safety. Despite these directives, nurse-to-nurse hostility is a known problem according to the past 25 years of professional literature (Embree & White, 2010). Inter-collegial hostility, or incivility, is particularly prevalent in the nursing profession versus non-nursing vocations. This is an enigma, as the nursing profession is based upon interpersonal relationships and the care of others. Civility is defined as the display of polite and courteous acts and expressions that show regard for others (Clark & Carnosso, 2008). Clark & Carnosso, in a concept analysis of civility, find that civil behavior includes tolerance, listening, accepting other viewpoints without negativity, respecting differences, treating one another with dignity and honor, and engaging in social discourse (2008). Civility not only denotes particular behaviors but also describes an attitude of respect for other persons. The word civility has Latin roots in the word 'civilitas' meaning community or city. Civility is more than just polite behavior; it is a prerequisite for humans to live together and function as a community. Thus, civility has been described as active engagement in creating and participating in a group or community (Clark & Carnosso, 2008). Conversely, incivility can then be understood to delineate impolite, discourteous, rude conduct that shows a disregard or disrespect for others. Common forms of incivility in nursing are non-verbal innuendos, verbal affronts, condescending language, impatience, reluctance or refusal to answer questions, disrespect, and undermining (Embree & White, 2010; Weinand, 2011). Unlike civility, uncivil behavior purposely keeps others out of the in-group, e.g. the community. Nursing has been considered the primary occupation at risk for horizontal violence and workplace bullying. Studies estimate that approximately 85 percent of nurses are victims of incivility and up to 93 percent of nurses' report witnessing incivility in the workplace (Christie & Jones, 2014; Lachman, 2014). Studies comparing nursing versus non-nursing work environments find a rate of incivility at 85 percent in nursing work environments, compared to 75 percent in non-nursing occupations (Hunt & Marini, 2012). Additionally, non-nursing occupations generally report managers as the perpetrators of bullying in a top-down relationship of power (Hoel et al., 2010). Unique to nursing is the prevalence of incivility between workers with equivocal levels of power. Patient care environments may be particularly susceptible to incivility due to high-emotions, stressful conditions, challenging and difficult work, and diverse roles and interactions. Nonetheless, nurses as a distinct sector of the healthcare team have a particular propensity toward uncivil treatment of each other. Causes of Incivility in Nursing A perceived power imbalance is most often a requisite to bullying. Bullying appears to be particularly prevalent in institutions where hierarchy and power imbalances are strongly emphasized (Salin, 2003). Nursing was founded as a predominantly female profession in a patriarchal society with a cultural standard of gender oppression (Bartholomew, 2006). Additionally, in Western healthcare, nursing is practiced in a medically-dominant environment, where work structures are traditionally hierarchal in nature. Patients are admitted under the treating physician's name and nameless nurses will execute physician's orders. Furthermore, the organizational model of nursing is derived from historical roots in the military. This hierarchal system is thought to place nurses in a position of inferiority of rank and subordination. Literature supports the subordinate role of nurses, finding that nurses lack autonomy, control, and self-esteem (Freshwater, 2000). As a result, nursing has been described as a culture characterized by obedience, servitude, dedication, and adherence to hierarchy (Hutchinson, Vickers, Jackson, and Wilkes, 2010). Uncivil behavior among nurses is posited to result from this culture of oppression and subordination. Horizontal violence and incivility was originally described as an internal manifestation of conflict that resulted from oppression of one group by a more powerful entity (Freire, 2000). An oppressed group is one in which members lack power or control except within the group itself (Peters, in press). Internalized beliefs about their own inferiority prevents the oppressed group from controlling their own destiny, maintaining the status quo and allowing power structures to remain unchallenged. Frustration with these feelings results in aggression toward colleagues within the oppressed group (Hutchinson, Vickers, Jackson, & Wilkes, 2005). Members of the oppressed group direct their frustrations toward each other as they cannot act out directly to those who create the oppression (Freshwater, 2000). From this perspective, incivility in nursing is the reaction to the oppression and subordination experienced by nurses as a collective profession. Besides a culture of oppression, the socialization of nurses into the profession is said to propagate a culture of incivility. Foundational paramilitary influences are said to have fostered a culture in which insult, humiliation, and hazing are considered part of the on-the-job training (Hutchinson et al., 2005). In fact, the metaphors frequently used in nursing orientation include "earning one's stripes" and "boot camp". A common narrative is to intentionally subject a novice nurse to the same experience seasoned nurses had when they entered practice, with the mentality of "if I had to do it, (s)he can too" (Bartholomew, 2006). Compounding the problem is that most females have been socialized not to react to conflict, to avoid it, and to keep the peace. Nurses too have been socialized not to assert themselves individually or collectively. The result is that nurses often are silent as either targets or witnesses of incivility (Croft & Cash, 2012). Students and new graduates are particularly at risk to be targets of incivility. In Freire's theory of oppression, any member introduced into a powerless group is at high risk for horizontal violence (Freire, 2000). Additionally, Kanter's Structural Theory of Empowerment finds that when subordinates try to assert their power and authority, only to have it blocked, they usually will seek power over those whom they can dominate. Usually that power is directed downward in the hierarchy (Twale & De Luca, 2008). Incivility is used to acculturate new members into the oppressed group; it is how the unspoken rules are taught (Bartholomew, 2006). Targets of incivility are usually individuals who are different or threaten the status quo (Salin, 2003; Twale & De Luca, 2008). If the status quo is disrupted, fear escalates within the group and is expressed as hostility. Until the newcomer is acculturated as a subordinate group member he or she is considered a threat and treated as such (Bartholomew, 2006). Victims often have done something unknowingly to disrupt the status quo that results in hostility. These acts may range from simply being hired to questioning a philosophy or process of a seasoned organizational member. If someone is introduced to the culture who does not adhere to the group expectations, or worse, challenges the dominant members or cultural norms, they are eliminated, treated uncivilly, bullied, taken advantage of, or marginalized (Twale & De Luca, 2008). As is often heard, the notion of "nurses eating their young" continues to prevail in contemporary nursing. More recent literature has considered contextual factors such as job conditions, levels of empowerment and the presence of in-groups as explanations for incivility. While some organizational factors have been explored, no studies in any setting involving nurses are found that explore the relationship of the leadership style of a nurse leader with perceived levels of incivility. It is well established that leaders have a profound impact on the culture and interpersonal relationships of a group. A potential explanation for uncivil behaviors that has been little explored is the impact of leadership style on nurse-to-nurse incivility. Organizational Culture In the nursing literature, incivility has been predominantly understood as the reactions of an individual agent within a subordinate group exhibiting oppressed group behavior. Oppressed group explanation of incivility provides one consideration, but is not the only factor that impacts incivility in nursing (Hutchinson et al., 2005). Organizational issues contribute to an environment in which incivility is normalized and acceptable. The assumption that incivility is simply a result of the unique socialization of nurses as a subordinate group fails to consider the organizational contexts in which nurses work, as well as the organizational factors that impact incivility (Hutchinson et al., 2005). "Organizations and management structures have been able to remain immune from any further consideration as to their role in perpetuating bullying" (Hutchinson et al., 2005, p. 120). Organizational culture influences how members perceive their interpersonal interactions and how they manage and respond to such interactions (Keashly & Neuman, 2010). An organization that encourages genuine friendships will have a more positive atmosphere. An organization that promotes boundaries and professional distance may have respectful interactions, but may fall more easily into incivility in times of stress or conflict. Lateral violence has been described as an emotion-based response triggered by factors such as rapid change, pressures for increased productivity, and chaotic work environments (Hutchinson et al., 2010). Workplace demands are thought to create pressures and opportunity for incivility. Hutchinson et al. notes that contemporary "healthcare organizations are now characterized as transactional climates, strongly focused on productivity and its reward" (2010, p. 27). The central pressure within healthcare organizations is cost containment, with organizational goals described in terms of efficiency and quality. Nurses are under constant surveillance and are challenged daily with providing care in a corporate context (Hutchinson et al., 2005). This added pressure and scrutiny compounds the already complex environments in which nurses work, including a frantic pace, high-stake decisions, and heavy workloads. This type of environment induces frustration and high emotions (Croft & Cash, 2012). The effects of stress contribute to the use of incivility as a reaction to the environment. In some organizations, incivility is more or less permitted as the way things are done. There exist organizations in which bullying is actually considered acceptable and creates advantages to the perpetrators (Salin, 2003). Furthermore, it is suggested that uncivil behavior amongst nurses is 'accepted' within the profession as part of the metanarrative (Hutchinson et al., 2005), i.e. "nurses eat their young." Often in nursing units, cliques with nursing management and select staff are formed, and this group dictates the norms of the unit. Self-assured of their position in the alliance, these nurses act to enforce the 'rules of work' (Hutchinson et al., 2010). It has been found that bullies within the nursing workforce in particular are often protected by those in power (Croft & Cash, 2012). The Corollary Role of Leadership The leader of an organization has a powerful influence on organizational culture. The important role of leadership and organizational structures in influencing a positive workplace is well-documented. In a workplace with a strong sense of team membership and community, incivility is much less likely (Clark & Springer, 2010; Weaver Moore et al., 2013). Leaders are powerful role models, and their actions communicate messages as to what is considered acceptable behavior (Clark, Olender, Kenski, & Cardoni, 2013). Leaders play a key role in establishing the climate and culture of the organization. Ultimately, people are more likely to follow the performance cues of those with social power or social status within an organization (Twale & De Luca, 2008). Organizational culture includes the norms, values, and rituals that characterize an organization, and "serves as a social control mechanism that sets expectations about appropriate attitudes and behaviors of group members, thus guiding and constraining their behaviors" (Bally, 2007, p. 144.). It is vital to identify the effect of leadership and organizational culture on uncivil behaviors among nurse coworkers. Summary Incivility in the workplace has far-reaching, damaging effects to both the individual and the organization. Incivility is a particular problem in the nursing profession, which, paradoxically, is founded on caring. Leaders can play a key role in attenuating or contributing to levels of incivility. Hence, it is important to first understand what particular leadership styles or behaviors are more or less associated with worker incivility. From this information, actions by the leader to prevent workplace hostility can be better implemented. References American Nurses Association (2015). Code of Ethics for Nurses with Interpretive Statements. Nursebooks.org publishing program of the American Nurses Association: Silver Springs, MD. Bartholomew, K. (2006). Ending nurse-to-nurse hostility: Why nurses eat their young and each other. Marblehead, MA: HCPro, Inc. Clark, C. M. & Carnosso, J. (2008). Civility: a concept analysis. The Journal of Theory Construction & Testing, 12 (1), pp. 11-15. Croft, R. K. & Cash, P. A. (2012). Deconstructing contributing factors to bullying and lateral violence in nursing using a postcolonial feminist lens. Contemporary Nurse, 42 (2), pp. 226. Retrieved from Contemporary Nurse - Contemporary Nurse: Healthcare Across the Lifespan. Embree, J. L. & White, A. H. (2010). Concept analysis: nurse-to-nurse lateral violence. Nursing Forum, 45 (3), pp. 166-173. Freire, P. (2000). Pedagogy of the oppressed (30th anniversary ed.). New York: Continuum publishers. Freshwater, D. (2000). Crosscurrents: against cultural narration in nursing. Journal of Advanced Nursing, 32 (2), 481-484. Hutchinson, M., Vickers, M., Jackson, D., & Wilkes, L. (2005). Workplace bullying in nursing: Towards a more critical organizational perspective. Nursing Inquiry, 13 (2), 118-126.
  23. Ruby Vee

    How To Tell If You're A Bully

    Are you a bully? I'm getting fed up with some of the threads on allnurses.com. there's a 2000+ post thread on "do nurses eat their young?" And, the majority of the posters seem to claim that they know it for a fact that nurses eat their young because they've been "eaten." Usually they go on to describe one incident with one nurse which they're using to characterize an entire profession and sometimes the whole gender. Sometimes the story smells of bullying, but often not. Yet no one admits to being a bully. There are multiple threads about how awful it is to work in a predominately female profession because women are all sly, manipulative, gossipy or backstabbers. or all of the above. "And, I can say that because I'm a woman myself!", the post will proclaim. "But I'm not that way." Clearly, some of us are liars! There cannot be that many bullies in nursing without there being some on allnurses.com. And how is it that "all women are catty, manipulative backstabbers -- except me, of course"? There's a thread going around right now -- there have been many of them lately, but this particular one irritated me today -- about rushing to "report" a preceptor because the student in question didn't agree with his practice. A whole lot of people jumped on the "let's lynch him!" bandwagon and someone went on to say she had no empathy for the guy whatsoever. I agree that the practice discussed is egregious -- but no one suggested that perhaps the student involved ought to just have an honest discussion with the preceptor before going off to report him. If you were the one who had developed a habit someone else found disgusting, wouldn't you want them to discuss it with you and give you the opportunity to make changes before they "stabbed me in the back by going to the manager"? And by the way, has anyone ever heard of "mobbing"? If you are rushing off to "report" someone and haven't taken the time or summoned the courage to discuss the situation with them or haven't tried to resolve it without involving management, you're probably a bully. If you and your friends think Gertrude is a horrible nurse because she always washes her hands with soap rather than using Purell or brings her own lotion to work or has artificial nails or doesn't like white people, do you talk to Gertrude about it? And think about what she has to say? Or do you and your friends get together in the break room and titter about "Gertrude's going to be really upset because every one of her patients today is white" or back and forth on Facebook about Gertrude's nasty smelling lotion? congratulations, ladies -- you've just identified yourselves as bullies. If Elmer snaps at you when he's stressed or cusses you out because you made a big mistake or "made you feel bad" because you didn't learn a skill fast enough, that's bullying, right? But if you snap at Yorhonda because she's asked a "really dumb" question for the tenth time this morning and can't she see how busy you are or how hard you're trying -- that's justified, isn't it? You're just giving her what she deserves for being so clueless. and if you cuss Elmer out because he snapped at you and he has it coming, that's fair isn't it? After all, he snapped at you first and you're just giving him back what he dished out. In fact, nobody gets away with treating you badly because you'll give it to them back, worse than they gave you! you're just standing up for yourself, after all. Hate to tell you this, but it's you who is the bully. You get along great with all of the guys at work, and you much prefer working to guys to working with your own gender. Dick and Willy roll on the floor laughing when you do your imitation of Cassandra who you know never comes to work for any reason except to try to "catch a doctor." Cassandra actually thinks you like her, and she often comes to you with questions. After answering her questions, with or without a condescending manner, you go back to your friends and ridicule the woman. All those women you work with who are nasty, gossipy, catty backstabbers? You're one of them. Reading between the lines on post after post, it seems that many of the folks who are complaining the loudest about bullies or about catty, backstabbing women are guilty of the same behaviors that they claim to deplore. But it's different when they do it, isn't it? after all, they're not the bully. Or, are they? I'm going to don my flame retardant suit here and go out on a limb by saying that if you're not treating others with decency, honor and respect, you might be a bully. Now, about those young you've been eating . . . .
  24. kitcatt24

    Nurses that eat their young

    I will have a side of humility with that... My career beginning... The phrase "nurses eat their young" is often said. I learned it quite early in my career. I was perplexed on why an older, wiser nurse would not want to show me the ropes, why they would they not want to guide me and mold me to their perfect mini me. Most of the time nurses did not want to be bothered with training others, they did not have time or they just plain did not care. Many times I was just left to fend for myself wondering if I was going to make a major error or worse actually kill somebody because nobody wanted to take the time to speak to me or give me eye contact. I promised early in my career I was never going to be to like that. I would always make that nurse feel welcomed and comfortable in coming to me for advice or questions. Feeling unwanted was such a horrible feeling. I came through with all my promises year after year through many different types of jobs. I have always had the mentality that I treated people just how I wanted to be treated. It worked just find most of my life until 2013. As the years move on... I came across a person that I had never encountered before in my life. I met Shelly in June she was bubbly, fresh, not the sharpest tool in the shed but was so sweet. I invested quite a bit of time working with her, building her self-esteem up. Explaining reports and charts. The jobs we had at that time had a lot to do with marketing so we spent hours doing role playing on marketing scenarios. I taught her how to analyze reports, and compare it to our competitors. I was so proud of her on how well she caught on. Well, there is also another saying "Fool me once shame on you, Fool me twice shame on me". Shelly was playing me! She was collecting data the entire time in order to further here career, to take a jump forward. Shelly then moved forward in the company received an award with the information I gave her and claimed it as her own. Shelly got a pay raise and I stayed at the same rate. Shelly also moved up in positions and I stayed in the same position. I was so angry and upset. The thoughts that went through my head first, besides running her pretty blonde head over with my car was, This is why us older, wiser nurses eat our young. Yes I did run in the mirror and double checked. I have become that older nurse overnight. I am now protective of my knowledge. I felt worse now than when I was that young kid nurse who barely knew anything. I felt like I was tricked, I felt old, out played and too slow. This was never going to happen to me again, I told myself. I was never a ladder climber...but I certainly was not going to sit here and hold the dame thing while others climbed it! Common ground... So where is the common ground? Where you do stand where you not have to eat your younger coworkers for breakfast, lunch or dinner, and you do not completely give them all of your trade secrets? Why this phrase is only said in the nursing field? Are we to be exempt from this type of behavior because our job is for caring for others? Do we have some sort of godly quality that makes us magical or something? My promise... I can promise to be kind to others, be caring and I can reflect on that one act to not be true to every young nurse out there, and not every older nurse eats their young. We all have knowledge to share and the only way this knowledge is going to be passed on is to share it and we will have to take that leap of faith as we do everyday as we care for or patients to empowers those who will be there when we can no longer go on.
  25. It's 3 p.m. The witching hour for any operating room. As our medical director makes rounds, he tallies up how many late rooms are running, and compares that to how many surgical and anesthesia staff we have available to run the late rooms. If the numbers don't add up, then cases are put on hold. While our director speaks frankly and with tact to the surgeons whose cases are being held, it never fails that the surgeons immediately call me and try to barter, beg and plead. End run at its finest. I am the charge nurse for a busy OR. My job is to facilitate case movement, troubleshoot delayed cases, help staff to overcome challenges, tend to red traumas, make staff assignments, and put out fires. Many, many fires. I am busy assigning relief staff, and delegating duties to nurses and scrub techs that I have not assigned as relief. A new anesthesiologist takes over the anesthesia charge duties, and he has lots of questions. I answer them as best as I can while being constantly interrupted. Our medical director is waving his hands at me, trying to get my attention through the crowd of staff. Shouldering through the crowd, he approaches my desk. "Canes, we have too many late rooms. I've moved Dr. Y to OR 5 so he can get started with his last case. He told me it was a doozy and may need cell saver. I also held Dr. R and Dr. L. I told them that their cases will start when some of these rooms come down." "Canes, line one!" my unit secretary shouts over the group of OR and anesthesia staff gathered near the charge desk. For some, the day has come to an end. They are sharing stories, venting, and socializing. I can hardly hear my secretary as a loud burst of laughter rises from the group. I pick up the phone and cradle it between my ear and shoulder while writing out the answers to the anesthesiologist's questions and nodding to the medical director. "This is Canes," I answer. The laughter and rising voices of the group near the desk makes it difficult to hear. "I'm the fellow for Dr. K, and I just want to know why you chose to move another case into our room," the fellow demands in a clipped tone. "We have an add on case, you know," she continued. I didn't catch her name. I began to explain my decision. "Block times are by service, not by attending. Your colleague, Dr. Y is behind in his schedule. Our Medical Director, Dr. D decided--" "There is an empty OR. We are ready, our patient is ready, and I don't understand why you made this decision," the fellow said. Her tone was singsong-that of an adult explaining something to a child. "If you would let me explain--" "This is totally nuts. I mean, here we are-all of us are ready to go, and you put another case in OUR room?!? It makes no sense at all!" she exclaims. I take a deep breath and start over. "Scheduled cases should always be done before add on cases. Dr. Y ran into some problems in his first case, which delayed the rest of his cases. His following case is a very difficult one. We made the decision to get him started in the empty OR so that our staff could have everything in place, anesthesia staff could place lines, and the room would be set up and ready to go when he comes out of the case he is working on," I said. "But that is OUR OR!" the fellow shouts. "I understand your frustration, which is why I asked you to let me explain. You are reading a paragraph, while I am reading the entire chapter. Of course the paragraph won't make sense unless you read the chapter," I explain calmly. A vascular resident rushes up to the desk, posting sheet in hand. Breathlessly, she said, "Canes, this is an emergency fasciotomy. We need to go back within the next 20 minutes." I tell the fellow that I would like to discuss block time rules with her later in the day, but I was needed for an emergency case that was just posted. Surprisingly, she continues to rant about how irrational it is to put her colleague's case in HER room, and how unfair it is to punish HER just because her colleague is lagging behind. I am half-listening. All of the phone lines ring at once. "Canes, there's a code in OR 9!" my secretary shouts. I put the fellow on hold while I deploy necessary staff to attend the code. I pick up the phone again and apologize for the interruption. "OR block times aren't based on the SURGEON, they are based on the SERVICE," I repeat for the third time. "I would be glad to discuss this with you some other time, but I have two emergencies that I must attend to now," I said. "So you mean you don't have the time to explain why we can't follow ourselves in an empty OR? the fellow asks, her voice taking on a saucy tone. "Correct. I don't have the time right now. An emergency case has been posted and another patient is coding. I need to coordinate many things right now," I said. I feel my anxiety level increase. I need to get off the phone and help my staff with these emergencies. "You don't seem to have a grasp on continuity of care, do you?" the fellow asks sarcastically. "I guess the saying is true: management doesn't understand how to take care of patients," she spat. I refuse to take the bait and engage in verbal warfare. I replied, "I will not tolerate being insulted. If you continue to be disrespectful, I will end this conversation. As I said before--" For the third time, she interrupted me. She spoke directly into the phone while talking to her attending, "Dr. S., I'm sorry, but I can't give you an answer as to why we can't follow ourselves in an empty OR, despite the fact that our patient is ready and we are ready. I am just as frustrated as you are....I agree...it seems like the charge nurse doesn't have a clue what's going on...I know...she must have no sense of logic." CLICK. I hung up on her. This might seem like a very unprofessional thing to do, and it is. However, the fellow not only disregarded my rationale and explanation, but also personally insulted me. She didn't take me up on my offer to explain block times, but continued to speak to me in a condescending tone. The most troubling factor with the above scenario is that she did not acknowledge that there were two ongoing emergencies. This is classic bullying behavior, and we as nurses have every right to refuse to be bullied. Recently, I lectured new OR residents on bullying in the workplace. While researching this topic, the message really struck home was that it didn't matter WHO was bullying WHOM, or what kind of alphabet soup followed their name. Nobody deserves to be spoken to in a disrespectful manner. According to the ANA, a whopping 48% of nurses reported experiences involving strong verbal abuse (ANA, 2001). The impact of workplace bullying is often insipidus. Like a cancer, it grows slowly, silently, and has devastating effects. Low staff morale, increased absenteeism, attrition of staff and the deterioration of quality patient care are some of the results of bullying (Hughes 2008). To combat bullying, you must adopt a "zero tolerance" mindset. No one, no matter who they are or what their relationship is to you, has the right to be disrespectful to you. Helpful Guidelines As soon as you recognize bullying behavior, speak up and set boundaries. Point out that you are willing to listen to the content of the discussion, but you will not tolerate disrespectful behavior. Do not reduce yourself to engaging in a verbal tete-a-tete. Speak calmly and resist the urge to raise your voice; it will only escalate the situation. Clearly state the consequences of continued verbal abuse. Make eye contact and speak with confidence, not with anger. Follow through on your stated consequences. Privately seek out the advice of nurses whom you respect and admire about your experience. Avoid "bashing" behavior, and don't tell everyone within earshot about the exchange. Keep a journal and write down what you felt during the experience. Don't include names, but write what your initial reaction was, and how you felt you handled yourself. Did you lash out? Did you freeze up? Did you speak calmly? As you gain more experience, you can look back on how much you have grown by reading your old passages. Keeping a journal is also very cathartic. Nursing is a tough profession, no doubt. We are constantly on the move, we multi-task while triaging priorities, and we are constantly troubleshooting. It's no wonder that at the end of the day, we are both mentally and physically exhausted. When we are faced with bullying behavior, tension and negativity can become distracting elements in our daily lives. By setting boundaries and adhering to stated consequences, we have the power to diminish bullying behavior. References American Nurses Association. (2001). Health and Safety Survey. Hughes, N. (2009). Bullies in healthcare beware. American Nurse Today, 3(6), 35.