The Future Nurse Bully- Is it You?

[J.Adderton]

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

[SafetyNurse1968, BSN, MSN, PhD]

I enjoyed this article! My very first article on allnurses was about bullying:

it struck a chord with many folks. I have a short temper and have occasionally lashed out at folks without thinking. I hate that aspect of my personality and work on it all the time. I think there is a difference between being a "wild card" and being a bully for sure. Just the other day I had a student in fundamentals simulation come in without having watched the assigned videos. She had no idea what was going on and wanted me to lead her through bed making step by step. I was a bit short with her and suggested in a snarky tone "Perhaps you need to watch the videos several times." I immediately felt terrible and apologized to her at the end of class saying, "I'm so sorry I was rude to you, it's my job to teach you." She blinked a few times and said, "You didn't need to apologize!" But I firmly believe I did. It would have been better to take her aside and teach her about the importance of coming to class prepared than to model unprofessional behavior as a response to her mistake. Nursing is hard. Being a fully self-actualized human 100% of the time is challenging as well, at least for me.

Thanks again for a great article - I hope we keep talking about bullying and that the culture of nursing will eventually change.

[Persephone Paige, ADN]

I guess it's my age, or my life experience now after being a nurse for so long AND being in recovery, but holding in resentments is what can kill career, imho.

I've always been a very self-contained individual. I will ask for help at work when I need it, but only from the other self-contained, no nonsense nurses who mind their own business. Everything has a price, especially at work. I go with my gut vibe off the person before I even engage them in the most basic of conversation and ask myself if I'm willing to pay? No...? Then I pass on them.

Let me tell you exactly what happens when you address an issue immediately with a nurse bully: It addresses how you feel and relieves some of the resentments, which is awesome. Otherwise, nothing except it shocks the absolute *** outta the bully and backs them up. I don't know why this is, but some people have a need for dominance. Nursing isn't like a school yard where the bully is going to be waiting to black both your eyes at the swing set. They can't, they'll be fired. Even if violence was tolerated, which it isn't, I'd be willing to take one for the team to get rid of the ***.

I have learned to use past hurts to make myself stronger. There was a time when I was very timid, due to a dysfunctional upbringing. After suffering in silence, absorbing the insults, believing the insults, using a substance to dull the pain for years, being intervened on, getting healthier, going back to nursing knowing that I could never allow things to be they way they were before, if I hoped to survive and maintain my sobriety, I knew I was not the same nurse as before. Do I always do it perfectly when I decide to confront another nurse who is attempting to bully me? Nope... But, I don't curse and I don't have an emotional breakdown either.

I had it happen recently. I'd had a *** day: 6 patients, 2 (almost 3) discharges, 2 admissions, the usual care and 8 patients to chart on. I was exhausted by the end of my shift. My relief is a nurse who gets a pathological delight in coming early and researching everything about her patients. Then, while she's getting report she grills the off going nurse for this information which she already has. She's done this to me (and everyone else) on several occasions. That night, I was exhausted and in just the right mood to address it.

I can talk well, when I'm angry. And basically I just told her that I am me and she is she! I'm giving her the information that I required to operate safely on my shift. That's the information I'm responsible for, nothing else. I'm not responsible for what SHE needs to operate safely on her shift, she is. If she wants more information, go search for it on her own time. Otherwise, I'm fine with not having the answers to the questions she has. Turns out, she knew them and gave them to me outside the room. I said, "so you knew the information? What is this, a set up?!" Her eyes bulged! She called in sick the next night.

We teach people how to treat us.

[DallasRN]

Although this article is geared towards the nursing student or newer nurse, it is timely for me.

I'm an older nurse - in actual years AND in nursing years (1982 grad). For the past year or so, I've been trying to break into the home health field. My background was critical care and ER so this is new to me. An assessment is not. Frankly, I know I don't have the stamina for todays hospital environment so I'm happy to pass the torch. Part-time home health fits me perfectly. However, I've run into some of the nastiest, ugly, self-serving nurses than at any other time in my long career.

Not once have I even attempted to come across as a know-it-all. I don't know it all. This is a new arena for me. All I really know is how to assess. I'm having to learn wound care, the OASIS, communication notes in Kinnser, time management skills. So many things!! And sadly, many (not all) "seasoned" HH nurses have chosen to be negative and demeaning. Bullies. And most HH nurses are older. That makes it even sadder. We should have learned, by now, to nurture and support our peers. This type of behavior is a sad commentary on our profession - regardless of the specialty, the age of the nurse, the duration of his/her involvement in the profession.

[Thefourofus]

Bullying started in nursing school.

All the policies by Joint Commission and a varity of other organization including ANA are not going to solve anything. Incivility and Bullying are not nicessarily the same thing. We've got to stop being afraid to call something what it is. Deciding to call bullying incivility because it sounds nicer is part of the problem.

Bullying is ugly; it destroys people's careers and lives and makes a mockery of the profession.

[rhellner57]

First, you probably do not want me to get on my soap box about this issue. I personally feel that most of us have felt bullied as new graduates and nursing students but it may have been the way that the comment was made. Now, I realize that their is bullying in the workplace and that each of us is responsible to STOP it. Often, it is done in a way that most really do not know how to confront it without jeopardy to us. To stop it means to speak up and do not join in the malacious verbage or action. I am an older nurse and have probably made someone feel insecure just by doing what I do best- take care of my patients. I appreciate teaching new nurses but I do not appreciate that they feel the book is God and that they do not have to learn from an "old nurse". When I was doing my BSN degree ( graduated 2016 after many years of experience and diploma nursing program 1978 grad) The question arose, "how the old nurse eats her young" needless to say, I gave the responder that described the old nurse as insecure in new technology and evidence based practice as a reason. 1000 words later, he knew exactly where I stood on the issue after giving a thorough history lesson, My experiences as a travel nurse over past 7-8 yrs (at that time). Computers too many to mention that I have had to learn and different settings throughout the years where you adjust to staff, physicians and administrations. When you SBAR report to a doctor or staff nurse as in report, this leaves little for bullying to occur and a smile and thank you go a long ways. Enough said but I am moving on soon to a permanent position ( been traveling 11.5 yrs) and yes I will probably feel a bit inadequate and may

deal with some attitudes that will cause me to feel bullied but as a traveler, I have put on the armor that God gave me and let a lot of situations roll off my back.

[scubareed]

Whether or not someone becomes a bully from attending nursing school is dependent upon how they handle nursing school and if they are a bully before they enter nursing school. When I went to school for my BSN the faculty ate us for lunch and enjoyed every second of it. They were dishonest, unkind, and showed favoritism. It was the most unhealthy, unsafe learning environment I’ve ever been in. The class Vice President was the very definition of the term bully and when I went to the Dean about this individual’s behavior (as well as the faculty’s) she couldn’t have cared less and spoke about how important it was to raise the percentage of our school’s NCLEX passing rates. Even though I’m not normally someone who will stand by and watch people be bullied, in this case I put my head down, studied hard graduated, passed the NCLEX, and got a job at a nearby hospital. Patients themselves can be bullies, cruel, and sometimes violent. I’ve been both physically and verbally abused in the 2 years since graduation. It’s not an easy job and it’s not always fun.

There are some nurses I work with whom I don’t particularly care for, but they aren’t bullies. We all have vastly different perspectives and personalities but we keep things professional. It’s been disheartening to see how management handles situations when patients are violent - they don’t care much about anything other than turning a profit and trying to maintain unsafe nurse to patient ratios.

You have to watch out for yourself, remember that people will treat you how you allow them to treat you, and find joy and kindness where you can. I treat people the way I want to be treated, enjoy learning new things, and building positive relationships with patients. When students come in and I precept them, I treat them how I wanted to be treated when I was in school. Just because this profession can be difficult and sometimes cruel doesn’t mean I have to be. It’s a choice I make every shift I work.

[J.Adderton, BSN, MSN]

On ‎2‎/‎23‎/‎2019 at 12:57 PM, rhellner57 said:

First, you probably do not want me to get on my soap box about this issue. I personally feel that most of us have felt bullied as new graduates and nursing students but it may have been the way that the comment was made. Now, I realize that their is bullying in the workplace and that each of us is responsible to STOP it. Often, it is done in a way that most really do not know how to confront it without jeopardy to us. To stop it means to speak up and do not join in the malacious verbage or action. I am an older nurse and have probably made someone feel insecure just by doing what I do best- take care of my patients. I appreciate teaching new nurses but I do not appreciate that they feel the book is God and that they do not have to learn from an "old nurse". When I was doing my BSN degree ( graduated 2016 after many years of experience and diploma nursing program 1978 grad) The question arose, "how the old nurse eats her young" needless to say, I gave the responder that described the old nurse as insecure in new technology and evidence based practice as a reason. 1000 words later, he knew exactly where I stood on the issue after giving a thorough history lesson, My experiences as a travel nurse over past 7-8 yrs (at that time). Computers too many to mention that I have had to learn and different settings throughout the years where you adjust to staff, physicians and administrations. When you SBAR report to a doctor or staff nurse as in report, this leaves little for bullying to occur and a smile and thank you go a long ways. Enough said but I am moving on soon to a permanent position ( been traveling 11.5 yrs) and yes I will probably feel a bit inadequate and may

deal with some attitudes that will cause me to feel bullied but as a traveler, I have put on the armor that God gave me and let a lot of situations roll off my back.

Thanks for sharing a different perspective.