Why Bother Studying Workplace Bullying?

[Ruby Vee, BSN]

I have grown to hate the term "compassion". It seems that in current usage, it means no more than "I didn't get when I wanted when I wanted it, BOO-HOO! That nurse totally lacks compassion. Where is the compassion for MEE?" Or "I am the kindest, most compassionate nurse ever, no matter that I've flunked the NCLEX 7 times. The stupid test can't tell what a compassionate, wonderful nurse I am."

It seems that newer, especially younger nurses entering the field today have an idea of workplace relationships based on television sit-coms. Employees bond as "brothers and sisters" and spend not only their work hours together but their off-hours as well. Everyone likes everyone and no one ever has to work with someone whom they don't respect (or worse, doesn't respect them.) New staff who find less cordial workplace relationships then complain that their new colleagues are mean to them, don't like them, pick on them or lack compassion. They don't seem to realize that they must fit themselves into the workplace culture; it is not up to the workplace to change to accommodate their preferences. They don't seem to realize that work is work, and you are unlikely to meet your new best friend forever in the workplace. They don't seem to realize that giving them much-needed negative feedback and helping them to correct errors or weakness in their practice IS compassion. They don't seem to realize that the preceptor is under stress, too, just like they are and that compassion flows two ways. If you show a little compassion for that overworked preceptor who is taking you on with no warning and possibly against their will, they are more likely to show more compassion for YOU. It's NOT all about the new employee.

Starting out in the float pool must have been brutal, and I'm sure that your orientation period was less than stellar. Blaming your colleagues seems like misplaced blame, however. Your manager should have ensured that you were up to the task and understood what you were getting into -- and maybe should not have hired a new grad in the first place. My own first year on the job was harsh -- I was the first BSN hired in a hospital that usually hired their own diploma graduates. The diploma graduates who were familiar with my Medical/Tele floor chose not to work there, and I wasn't savvy enough to understand the implications. I didn't even have a preceptor until my second job; my mentors at my first job were the LPNs and nursing assistants who took pity on a clueless newbie and showed me how things were done.

I have said over and over that I know there are bullies in nursing. I've met two of them in forty years. Bullies aren't popping up everywhere (unless you count the new grads who are looking for them and seeking to "make them pay" for not giving them the kind of mentoring experience they expected and seem to believe they deserve.) The majority of claims of bullying we see here are nothing of the sort. Unless, of course, you believe that bullying consists of complaints such as: "My preceptor won't have lunch with me," "She won't discuss her marriage issues with me even though she does with her FRIENDS," or "she's picking on me just because I made a measly little mistake on that insulin dose. What's an extra zero, anyway?"

With all respect to your imminent PHD, I believe we do new nurses a disservice by continuing to discuss all those mean bullies out there who will pick on them and drive them out of a career. Instead, we should be discussing negative feedback. It's important because new people (and everyone, really) make mistakes and the stakes are too high in our profession to let them go. New people will make mistakes; we all understand that. What doesn't seem to be understood is that it's the job of the preceptor to correct those mistakes before they get to the patient. It is ideal to do so privately, but imperative to do so before a patient is harmed. Some mistakes will be corrected publicly, and they may be corrected in a tone or manner than the newbie feels is unjustly harsh. That isn't bullying. That's a preceptor who isn't good at giving negative feedback or a preceptor who is overly stressed and under-supported or a preceptor is fed up because you've made the same dangled mistake four times already today. We should be discussing how to receive negative feedback, how important is is to your career to incorporate changes into your practice, how vital it is to be perceived as someone who welcomes negative feedback and is open to making changes in practice. And yes, we should be learning to deliver negative feedback more effectively.

As far as finding bullies everywhere you look -- my own observation is that those who appear to be most worried about finding all those bullies everywhere seem to be the ones who are most likely to exhibit the behaviors commonly attributed to bullies.

[compassionresearcher]

Thank you for your post. You're right compassion can be watered down and overused in mainstream vernacular. The way I'm using it in my paper has a clear definition of what it means in the context of the study. I am not calling feedback on unsafe practice or telling someone a hard to hear truth about their performance, bullying or incivility. In fact that is why the JC stopped using the term disruptive behavior, because sometimes to prevent a catastrophe you have to talk loud and or fast. In the middle of a code you can't say pretty please hand me the epi.

I'm referring to gossiping, making unbalanced assignments, intimidation etc. Nurses being afraid to call a physician at 3 a.m. because they don't want to get yelled at. Some people are okay with confrontation and can stand up to that, but many are not. If you haven't seen it a lot, consider yourself lucky. As I've said before this topic is discussed in countries all over the world and in professions outside of nursing it is not exclusive to a few "whiners." My purpose in focusing on nurses is that they are taking care of patients and their abilities may be compromised from a hostile work environment, so now there are two victims, the nurse and her patient. Whereas in industries where a mistake isn't life-threatening it may be less of a big deal. Although there is still the burden on the healthcare system and loss of productivity.

[Daisy4RN]

Thank-you for doing this study and Congratulations on the PHD. I believe that there are some new nurses who do not understand and/or like the fact that the preceptor is there to correct them. I also believe that bullying is alive and well within the nursing profession. I have had my own experiences on both ends. I had a nurse who just didn't like me and let me know every chance she got, this was not a one time deal, it went on for years (even in hind-site I still believe this). I have also been accused of being "mean" to a new nurse while attempting to correct errors she made. She had enough respect to tell me this directly and we were able to work it out with no further problems between us. I have seen other nurses who (truly) bully not only new nurses but others as well. I don't understand this and like you wish nurses could have that camaraderie that other professions have. I believe that the work environment and public opinion also affect this. Nurses are under attack the minute they walk on the hospital floor, this causes much stress which of course affects behaviors. Also, nurses are not generally supported by Managers, so even if a nurse attempts to get assistance, it usually doesn't help the situation, and can in fact make it worse. I hope that your study will shed some light on this important topic because all those involved (nurses and patients) deserve a workplace that supports wellbeing, and at the very least does not make the level of stress increase. Kudos to you, hope the study helps, good luck!!

[compassionresearcher]

Thanks Daisy! I agree with you on so many levels. The stories people are sharing with me are not these "help I'm being corrected for my errors" they are true incivility. People may agree or not about the topic, all I ask is that they share the link so that nurses who do find it meaningful can be heard.

[JadedCPN, BSN, RN]

I'm referring to gossiping, making unbalanced assignments, intimidation etc. Nurses being afraid to call a physician at 3 a.m. because they don't want to get yelled at. Some people are okay with confrontation and can stand up to that, but many are not.

Even with that being said, I don't believe those instances necessarily count as bullying when you compare it to other non-nursing examples of bullying in the world that has lead to extremes such as suicide.

According to Mirriam-Webster, bully is defined as "to frighten, hurt, or threaten (a smaller or weaker person) : to act like a bully toward (someone) : to cause (someone) to do something by making threats or insults or by using force." Is gossiping and making unbalanced assignments right? Absolutely not, but that doesn't mean that it is bullying.

In regards to nurses being afraid to call a doctor at 3am because they aren't okay with confrontation - that issue is on the nurse that they can't handle that confrontation when they may need it for their job.

Finally, as Ruby Vee has mentioned, I agree that people who look for bullies are going to find them where they don't necessarily exist. I'm not disagreeing that there aren't true bullies who happen to be in the nursing field, I am just saying based on my experience, interactions, and readings on AN I don't believe it is as prevalent as people make it seem. Furthermore I truly believe that only certain people can be "bullied," you can guarantee that if I encountered someone who truly was a bully that they wouldn't be bullying me because my personality just doesn't allow for that.

[compassionresearcher]

According to Mirriam-Webster, bully is defined as "to frighten, hurt, or threaten (a smaller or weaker person) : to act like a bully toward (someone) : to cause (someone) to do something by making threats or insults or by using force." Is gossiping and making unbalanced assignments right? Absolutely not, but that doesn't mean that it is bullying.

In regards to nurses being afraid to call a doctor at 3am because they aren't okay with confrontation - that issue is on the nurse that they can't handle that confrontation when they may need it for their job.

There different definitions of bullying in the literature as to what constitutes it. I'm actually looking at the continuum of mistreatment from incivility to bullying. I use the term here because it is recognizable by more people than workplace mistreatment.

I disagree with you about the comment on the nurse uncomfortable with confrontation. I think the job is stressful enough without dealing with inappropriate behavior, it's about maintaining a healthy work environment. You may be right that certain people are easier to bully, I don't see how that makes it okay.

[JadedCPN, BSN, RN]

There different definitions of bullying in the literature as to what constitutes it. I'm actually looking at the continuum of mistreatment from incivility to bullying. I use the term here because it is recognizable by more people than workplace mistreatment.

I disagree with you about the comment on the nurse uncomfortable with confrontation. I think the job is stressful enough without dealing with inappropriate behavior, it's about maintaining a healthy work environment. You may be right that certain people are easier to bully, I don't see how that makes it okay.

In regards to people not being comfortable with confrontation - in my opinion, that is part of the job because ultimately you are the patient's advocate. I'm not saying it is okay for the doctor to act like a complete jerk, or that it can't be slightly intimidating to make those phone calls. I'm just saying I have not and will never let a doctor (or another staff member) intimidate me so much that I wouldn't call to report what I felt was important and relevant information necessary for the patient's care. I don't care how grumpy they are at 3am or how high up the chain of command they are at 3am, if that is what my patient needs then that is what I have to do and if other nurses can't do that because they "don't like confrontation" then they are doing their patients an injustice.

My point in regards to certain people being easy to bully also isn't that it makes it okay, but rather perhaps some of the accountability has to be placed on both parties in those scenarios. Also to consider that perception plays a large part in many cases - just because someone says they are being bullied does not automatically mean they are being bullied.

[TriciaJ, RN]

I keep saying that negative workplace behaviours are almost always the function of poor management. Hospitals and nursing homes have become brutal places to work. When people are overloaded for too long, sparks start flying. That's just how it is.

I've worked for systems and managers that love to pit people against one another. The people who herd us to anti-bullying workshops are the same ones who encourage petty tattling, throw their staff under the bus at the slightest provocation and continually push the staffing envelope. Then when a coworker is less than cordial someone cries bully and complains about "lateral violence". That's because it's safer than trying to hold management's feet to the fire.

People get unfair assignments because nothing a charge nurse can do will make it be fair if the total workload is unreasonable. When you don't get to take many breaks, and especially not together, it's hard to form any type of relationship with your coworkers. Then it's too easy to misinterpret something said under stress.

I don't think any research about "bullying" is valid without a thorough study of workplace culture and dynamics. I think a lot of this so-called research is missing the boat.

[Wuzzie]

There different definitions of bullying in the literature as to what constitutes it. I'm actually looking at the continuum of mistreatment from incivility to bullying. I use the term here because it is recognizable by more people than workplace mistreatment.

And that's the problem then. By doing that you are lumping everything under the "bully" category when, in fact, by your own admission it isn't all bullying. This dilutes the meaning of the term "bullying" and minimizes what people who have actually been bullied go through. Not only that but by your mischaracterization of bullying behavior you allow people to redefine it into whatever makes them feel uncomfortable/sad/hurt/angry when in reality it doesn't even come close to their actually being bullied. Trust me, those of us who have experienced bullying in the true sense of the word don't appreciate it being watered down to include such things as not being greeted in the hallway (which was a behavior dramatically presented as evidence right here on all nurses and when we disagreed WE were accused of being bullies).

[Horseshoe, BSN, RN]

There different definitions of bullying in the literature as to what constitutes it. I'm actually looking at the continuum of mistreatment from incivility to bullying. I use the term here because it is recognizable by more people than workplace mistreatment.

And that's the problem then. By doing that you are lumping everything under the "bully" category when, in fact, by your own admission it isn't all bullying. This dilutes the meaning of the term "bullying" and minimizes what people who have actually been bullied go through. Not only that but by your mischaracterization of bullying behavior you allow people to redefine it into whatever makes them feel uncomfortable/sad/hurt/angry when in reality it doesn't even come close to their actually being bullied. Trust me, those of us who have experienced bullying in the true sense of the word don't appreciate it being watered down to include such things as not being greeted in the hallway (which was a behavior dramatically presented as evidence right here on all nurses and when we disagreed WE were accused of being bullies).

I agree. When practically anything is called bullying, it begins to mean absolutely nothing. In order to be bullying, it needs to be ongoing, there should be a power differential between the parties, and there must exist a deliberate agenda to do actual harm. So many of the examples of bullying related on AN fall laughably short. Basically, anything you say or do that I don't like is bullying. No wonder when actual bullying occurs, true remedy rarely occurs. "Incivility" rarely rises to the level of bullying. Micro aggressions are not bullying. Refusing to accept a nursing student because one is already supervising a senior nursing student in her last semester is not bullying.

The bullying label has really gotten out of control. In some cases, I think it has everything to do with the current trend towards refusing to admit mistakes and lack of personal accountability. If I'm being "bullied," then I have no incentive to examine my practice or behavior and feel the pain that introspection can bring. The problem is that what you don't acknowledge cannot be improved upon.

There have been some heartbreaking stories of true bullying that nurses here have experienced. Unfortunately, these incidents get lost amongst all of the other rubbish that is labeled as bullying.

[Ruby Vee, BSN]

According to Mirriam-Webster, bully is defined as "to frighten, hurt, or threaten (a smaller or weaker person) : to act like a bully toward (someone) : to cause (someone) to do something by making threats or insults or by using force." Is gossiping and making unbalanced assignments right? Absolutely not, but that doesn't mean that it is bullying.

In regards to nurses being afraid to call a doctor at 3am because they aren't okay with confrontation - that issue is on the nurse that they can't handle that confrontation when they may need it for their job.

There different definitions of bullying in the literature as to what constitutes it. I'm actually looking at the continuum of mistreatment from incivility to bullying. I use the term here because it is recognizable by more people than workplace mistreatment.

I disagree with you about the comment on the nurse uncomfortable with confrontation. I think the job is stressful enough without dealing with inappropriate behavior, it's about maintaining a healthy work environment. You may be right that certain people are easier to bully, I don't see how that makes it okay.

Someone is making an awful lot of money blogging about, speaking about and writing all those journal articles about "bullying". They're making so much money and creating so much talk that they're creating bullying out of situations that really don't constitute bullying. "Incivility" is just rudeness. There are rude people everywhere, and while I don't condone rudeness nor do I enjoy being the recipient of rudeness, it is not bullying. Someone who is too afraid of confrontation to call a physician at 3am isn't advocating for their patient appropriately and they need to learn to step up and do so. We cannot control what the physician does (yelling or not yelling) but we can damned well control what WE do.

Making unbalanced assignments -- some days there is just no way to balance them. Maybe Nancy Sue always gets more patients because Patsy Ray gets the sicker ones. Perhaps PoorJoyce gets the more stable patients because she can't handle the sicker ones, even after two years in the ICU. Unless we hear both sides of the story, we don't know that the assignment is truly unfair. As far as gossiping -- that's human nature, and I don't think it's necessarily bad. It's the social grease that helps build a team. There's good gossip -- "Patsy Sue makes the best meatballs you've ever tasted -- I hope she brings her meatballs to the potluck" -- and bad gossip ("Mellie Ann's husband just got arrested for soliciting a prostitute"). There's true gossip ("John's applying for the job in Case Management") and untrue gossip ("John only got the job in Case Management because he's sleeping with the DON"). I'll agree that nasty, untrue gossip is bad but I truly don't see the harm in gossiping about meatballs and whether or not Patsy Sue will share the recipe or about who applied for the job in Case Management.

Again, I think those who scream loudest about bullies and "workplace mistreatment' are those who are most likely to engage in the behaviors commonly attributed to bullies.