Workplace Bullying for Nurses

World Canada

Published

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

Nurses are expected to show untold compassion toward patients and deference to doctors-which may mean their empathy is exhausted when they deal with fellow nurses. According to dozens of articles published in professional journals, nursing is prone to "lateral violence," or bullying within a group of roughly the same status. These studies contend that because the characteristics required of nurses, such as "warmth and sensitivity," are undervalued by those higher up in the medical hierarchy, nurses experience a lack of "autonomy and control" over their workplace. Some feel compelled to exert power aggressively over those equal to or just below them, such as novice or student nurses; in the United States, 60 percent of newly registered nurses leave their first positions within six months as a result of lateral violence (globally, it's one in three). Nurses refer to this phenomenon as "nurses eat their young," also the title of a 2005 study on the subject.
I am a recent entrant to a nursing program in Vancouver, B.C., and even though I have not worked in the healthcare sector, I can see the plausibility of Beale's observations, namely the exhaustibility of one's patience. I am, however, a little surprised by the researches that attribute nurse bullying to the perceived lesser ranking of nurses relative to other health professionals.

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

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

Yes, I work with bullies. Their union knows, my union knows, HR knows but nothing is done. I put it down to they have miserable lives outside the workplace and take it out on their co-workers. Add in an ineffective unit manager and you have a goatflurck of ginorousness.

As a first year student, I am astounded that you think LPNs are "less specialized". This could be seen as bullying by some. I work with LPNs who are extremely specialized. Breast Feeding education at educator level, OR specialists, Dialysis nurses. These LPNs have advanced skills that the "average" floor RN doesn't possess.

Any nurse can be a victim. New transfer onto a unit and the old girls don't like the look of you? Watch your back.

In all, I'd say male nurses have a far easier go of it. The old girls either leave them alone completely or launch an all out hate war against them. Every time I've seen them try that tactic, it's been shot down pretty fast either by the nurse it's launched at or by the unit manager. The men I work with have been great and after a while I don't look at them as men, they are nurses.

Each area of specialization in nursing attracts different personality types. The OR and ICU seem to attract Alphas or nurses who are percieved to be bully's by others. Post-partum, which you would assume to be a very nurturing place attracts some very interesting passive-aggresive types. Pysch nurses are a whole other breed. Most general floor nurses seem to have an unlimited ability to suck up hard work and being treated like a used ostomy bag by families and management alike. Out patients and clinic nurses seem to be the most well adjusted ones, regular hours and no shifts. Unfortunately, those jobs take forever to obtain and they could probably tell their own horror stories. LTC nurses are often percieved as saints because of the population they work with and overall they seem to have fewer bullies in their ranks (at least in my experience, often their NAs are plain diabolical).

I talked my children out of nursing. I wouldn't do it again. There is no prestige in nursing. It's not a guaranteed job for life and considering what we do for our money, it's a hard way to earn a living.

Specializes in Home Care.

There are bullies in every work place, not just nursing.

I think it is deeply unfortunate that those in the managerial positions failed to mediate the bullying. It is true that workplace bullying occurs in all professions. In my past work as an office clerk, I have also witnessed workplace bullying. It is no surprise to me that I found many of the victims' work performance consequently degraded. But I think for those in the healthcare profession, such impacts would be far more severe. After all, a mistake in the office could cost the company thousands of dollars, but in healthcare, a mistake could result in patient disability or even fatality.

I should indeed clarify what I said about LPNs being less specialized than RNs, for example. I want to stress that I had not intended to belittle LPNs, and I do believe their work is very crucial in a comprehensive healthcare system. However, I think I am right to say that by primary training, LPNs are generalists relative to RNs. That is not to say LPNs cannot develop into specialists. I am aware that there are many advance specialty programs for LPNs, as there are for RNs. As you mentioned, a dialysis LPN specialist would indeed possess advance knowledge in the field than a regular floor nurse. Likewise, an RN trained in anesthesia (CRNA in the U.S.) would be more educated in anesthesia care than a medical doctor who has completed regular MD curriculum. When I claimed that LPNs are less-specialized, I should have emphasized that the context I set was to compare all healthcare professionals who have completed their primary training in their respective profession.

Currently, I am a volunteering in the emergency department of a hospital (I have not received any nursing education yet. I have recently been accepted to a nursing program starting in August this year). I have only heard that male nurses are more often directed to take on tasks involving heavy lifting. Personally I would not consider this a mistreatment, but it is the only difference I have heard between male and female nurses so far. I have also heard complaints from one volunteer that one particular RN had been verbally churlish toward said volunteer. Report was made and it was resolved. I like to think in many cases it is personality inclinations that leads to bullying, but from what I can now only assume, RN is a highly stressful profession.

Interesting... I am intending to specialize in perioperative nursing upon graduation...

[quote=ericleeericlee;6507382....

I should indeed clarify what I said about LPNs being less specialized than RNs, for example. I want to stress that I had not intended to belittle LPNs, and I do believe their work is very crucial in a comprehensive healthcare system. However, I think I am right to say that by primary training, LPNs are generalists relative to RNs. That is not to say LPNs cannot develop into specialists. I am aware that there are many advance specialty programs for LPNs, as there are for RNs. As you mentioned, a dialysis LPN specialist would indeed possess advance knowledge in the field than a regular floor nurse. Likewise, an RN trained in anesthesia (CRNA in the U.S.) would be more educated in anesthesia care than a medical doctor who has completed regular MD curriculum. When I claimed that LPNs are less-specialized, I should have emphasized that the context I set was to compare all healthcare professionals who have completed their primary training in their respective profession.

Currently, I am a volunteering in the emergency department of a hospital (I have not received any nursing education yet. I have recently been accepted to a nursing program starting in August this year). I have only heard that male nurses are more often directed to take on tasks involving heavy lifting. Personally I would not consider this a mistreatment, but it is the only difference I have heard between male and female nurses so far. I have also heard complaints from one volunteer that one particular RN had been verbally churlish toward said volunteer. Report was made and it was resolved. I like to think in many cases it is personality inclinations that leads to bullying, but from what I can now only assume, RN is a highly stressful profession.

Interesting... I am intending to specialize in perioperative nursing upon graduation...

Hmm, there is so much that is so wrong in what you've said that I won't even go there.

Get your first three semesters under you belt and then review your posts.

Nursing in general is a stressful occupation. Doesn't matter which level of nurse you are.

I think you need to spend more time reading the Canadian forums for nurses and less time in the US/general board. There are very few "CRNA" level nurses in Canada. They are not even used in my province. Any nurse in the OR setting has a very basic level of anaesthesia training to be able to assist the team. So in that regard they have more knowledge than the unit staff.

Several provinces have changed their PN education programmes. In AB and ON, the PN now completes the old diploma RN education.

The Canadian nursing education educates everyone as general duty nurses. Specialization only occurs after graduation and usually some general floor experience. Most ICU nurses I know had at least three years on surgical floors before making the move. Most services have a few training spots for new grads but they are few and far between.

These days, it's hard enough to get hired in many major cities that you can't hold out for your dream job, you take what you can get just to get into the system.

:(

If you don't mind, I would like to hear corrections on what you think I said wrong again, so I don't further inflame this LPN vs RN flame war, or at least correct or defend my initial claim that LPNs are less-specialized than RNs.

I simply think that LPNs and RNs received different basic training, with RNs having more indepth training in specific areas, hence the training-length and legal difference betwewen LPNs and RNs. Given that practical nurses now receive identical training to previous registered nurses in some provinces as you've said, and that recent registered nurse candidates are required to have a baccalaureate degree, I will assume the lengthened training time must indicate more is taught.

Whereas if one completed advanced specialty training (as you wrote, usually after years of experience), I believe they are more knowledgeable in their specialized area than their peers who have not received additional training in the area. Which is why I gave the example that CRNAs (in the United States) would be more knowledgable in anesthesia than someone who graduated from medical school but has not yet taken any specialized medical residency program. Similarly, LPNs who have taken advanced specialty program will be more specialized in their specialist subject than RNs who have only received primary training (ie. general duty nurses).

I do thank you for your advice and your real world observation. Personally, I intend to work in northern municipals and take advantage of the B.C. loan forgiveness program, as well as the increased employment opportunity in less urbanized and underserved parts of the province. After which I will hopefully be able to specialize in my preferred field.

Specializes in Home Care.

Eric, please tell us why you decided to become a nurse. Perhaps this can guide us in answering your questions.

here is what i think fiona might be thinking is wrong with what you said:

i should indeed clarify what i said about lpns being less specialized than rns, for example. i want to stress that i had not intended to belittle lpns, and i do believe their work is very crucial in a comprehensive healthcare system. however, i think i am right to say that by primary training, lpns are generalists relative to rns. that is not to say lpns cannot develop into specialists. i am aware that there are many advance specialty programs for lpns, as there are for rns. as you mentioned, a dialysis lpn specialist would indeed possess advance knowledge in the field than a regular floor nurse. likewise, an rn trained in anesthesia (crna in the u.s.) would be more educated in anesthesia care than a medical doctor who has completed regular md curriculum. when i claimed that lpns are less-specialized, i should have emphasized that the context i set was to compare all healthcare professionals who have completed their primary training in their respective profession. lpn/rpns have a very similar scope of practice and even identical in some areas, the only difference may be a leadership role (in case of fire ect). the rns have more theory and there is more opportunity to go into areas that are higher skilled. until you see what the lpn/rpns do, you shouldn't be making such statements. this idea that one is a generalist and one is a specialist is bolognaise.

currently, i am a volunteering in the emergency department of a hospital (i have not received any nursing education yet. i have recently been accepted to a nursing program starting in august this year). right there, you said you have no nursing, not even student experience, so you lost some credibility. i have only heard that male nurses are more often directed to take on tasks involving heavy lifting. personally i would not consider this a mistreatment, but it is the only difference i have heard between male and female nurses so far. being asked to do anything based on gender is "mistreatment". i have a male nurse friend who left a job after being abused by his coworkers by always getting the heavy pts and expected to do it on his own. men can be injured just as easily. i have also heard complaints from one volunteer that one particular rn had been verbally churlish toward said volunteer. report was made and it was resolved. i like to think in many cases it is personality inclinations that leads to bullying, but from what i can now only assume, rn is a highly stressful profession. nursing and health care in general is highly stressful.

interesting... i am intending to specialize in perioperative nursing upon graduation... good luck, i wish you all the best.

in general i disagree with your first post. that it iscompassion fatigue that causes lateral violence. i believe that stress cancause some to snap at times. however those who are always nasty, are alsorather cold to the pts as well.

THANK YOU, Daisy.

I work with old school hospital trained, diploma, and degree level nurses. The consenus is that the degree prepares them no better for real world work than any of the previous training programmes. Back in the '70s, the degree was brough about to give RNs the ducation to advance into management and educator roles. Now all it does is weed out those with less than 85% in their sciences.

The fact that the OP is missing (due to his inexperience in the world of nursing) is that during his education he will be handed over to nurses of both grades to learn his trade. We actually had a UNE refuse to be buddied with an LPN because "I'm an RN and that's an LPN" Exact quote. She was remined by the unit manager that she is a student and not a nurse of any description yet. Guess who isn't being offered employment after the end of summer? The woman may be able to write great essays and get the marks to get into the degree programmes but common sense? It just isn't there.

My initial question was and is about bullying nurses, namely its whats' and hows', and I appreciate Fiona59 and Daisy_08 for their helpful responses to my enquiry, as well as clarification on LPN/RN differences. Given the explanation, I will redact "less-specialized" and replace with "differently-trained" for better accuracy. Although my initial example was LPN, my intention was to question whether bullying was also particular between colleagues of different levels/specialization/training. I will again stress that recognizing and exploring differences is not synonymous with prejudice, since I feel there is suggestion that I undervalue LPNs in relation to RNs. I certainly wouldn't mind receiving training from LPNs and working alongside LPNs, and I am certain I have never indicated otherwise, I only held the belief that they are trained differently which led me to believe one would be more specialized than the other.

What was indeed biased of me was my view that labourious tasks for male nurses is not mistreatment. As pointed out by Daisy_08, it was a gender based assumption that males are better at lifting things than females, which cannot be true for every individual, although I personally would not mind it as long as the tasks are reasonable.

As for my personal interest in nursing, it started sometimes last year during work, when I was gradually becoming dissatisfied with my obligated tasks. Due to the nature of my position, I feel I often had to make decisions and actions that were ethically questionable, or at least incongruous with my personal views, despite being perfectly legal. At that time, I started looking into other career options that were particularly morally and technically rewarding (I like working with machines/technology). Through talking with few friends who were involved in the healthcare sector, I agreed on a healthcare profession. Ultimately, I decided on nursing because of the aforementioned aspects, and that I am able to work with my hands and get involved with equipments (partly why I am interested in OR). Another big draw for me is the geographical flexibility of nurses. I enjoy moving from places to places, and unlike other professions which may be most available in urban centres, or in resource-rich regions, I believe nursing is needed wherever there is settlement and healthcare. I would enjoy changing the scenery once every few years.

This is the first time I came across compassion fatigue, which is a very good term for explaining what I was looking for. In the same way that I worry I would eventually become emotionally stoic after witnessing so many traumas in a hospital setting.

Specializes in Acute Care, Rehab, Palliative.

Be aware that in nursing you may also find yourself "making decisions and actions that are ethically questionable or incongruous with your personal views despite being perfectly legal". Politics plays a huge role and you will sometimes find yourself having to do things you don't agree with.You can also become bored with your obligated tasks.

As for bullying I have not experienced any overt bullying and none related to differences in position/qualifacations. Usually bullying is personality driven not based on education.

You do become emotionally stoic.You care but you can't fall to pieces.You do what you have to do as a professional.

So true lori. Nothing beats keeping a 99 yo alive because the family can't say goodbye. The look of pain and fear in their eyes will haunt you forever. The body wears out as does the spirit, buy hey, "we're sure, Nana wants to be tube-fed, and wear incontinence products and be a full code while suffering from dementia"

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