Workplace Bullying-Nursing or 7th Grade?

[rbs105]

I just posted a blog and wanted to share it here because of the reactions I've gotten...this has become a topic of great interest for me in nursing and it is being tied to patient safety. If you have an institution where this has been successfully stopped, please comment.

My 12-year-old daughter has recently been having problems with other kids at school. It's the usual, I-can't-figure-out-who-I-am-so-I'm-going-to-torment-you, 7th grade problems.

Unfortunately, many similarities exist between 7th grade bullying and workplace bullying. You'd expect that maturity would kick in, but I have found that sadly, even though the setting has changed, the behavior has not.

A few months ago, I discovered the book called The No ******* Rule-Building a Civilized Workplace and Surviving One That Isn't by Bob Sutton I do not receive any benefit for plugging this book, but I have to highly recommend it-regardless of your profession.

I am typically an outgoing person, but as an OR nurse working with a small staff, I found myself being torn down to the point where my self-worth was squashed, and my motivation became non-existent. My bullies were referred to as the Triangle of Terror- three women who did what they could to tear down, intimidate, and spread rumors about others. I have to mention that each member of this Triangle had worked there for an extensive amount of time and were very skilled at what they did. Their talent and seniority ensured their value to the department and many surgeons preferred to have them in their case.

It started at the beginning of my employment. Nit-picking my skills, telling my manager that I should have never been hired. If I presented an idea, it was quickly shot down or mocked by one of them. If I worked well with a surgeon, they would loudly point out my imperfections-sometimes right in the middle of the case. After time, I began to believe them. I should have never been hired. If I did well, it must have been a fluke-surely a failure was right around the corner. My paranoia grew as I was certain they were sharing every faulting detail with anyone who would listen.

I had allies, and I was not the only target. Frankly, these friends are what kept me coming back each day. However, because of the environment of fear, even though they witnessed the bullying, and knew it was going on, no one wanted to stand up. Speaking out only reserved your spot as the next victim. It was best to just come, do your job and go home.

The ripple effect from their behavior was crushing. I took my stories home and dumped them on my husband. He could do nothing but helplessly watch and try his best to keep my spirit alive. My attitude and mood were sour every day when I came home and I'm certain my children felt it. My health took a hit and my sick days were used to the max.

After 19 months of being slowly broken, the best thing I did was to quit-even though I was stepping away from my benefits and a job that I loved (I didlove the job itself). Nearly two years after leaving, I think I am finally healing. Writing about it, hearing the experience of others and knowing what they went through has also helped.

Workplace bullying is rampant. From my experience, the same stress, insecurity and competition that drove the 7th grade torment has the ability to manifest it's ugly head in adults-and for some WRONG reason, especially in nursing. In writing this, I am hoping to bring comfort to those who are bullied and awareness to those who might be bullying others. If you've ever wondered if you might be the problem, I encourage you to test yourself and find out! Share your story, speak out and support others....you never know who may be experiencing the same pain, or who you might be able to help!

[Spidey's mom, ADN, BSN, RN]

If I had known what nursing was like I would probably have chosen a different career but I'm too old now.

Honestly, it happens everywhere. Nothing special about nursing.

My own daughter is lamenting how simply awful kitchen staff are to women who are trying to be cooks - including the chef who trains her. This was after she quit cosmetology school due to the backstabbing she encountered there.

Kitchen staff is mostly men. Cosmetology school is mostly women.

This stuff happens - everywhere.

(Just to add - my daughter's new job with a brand new restaurant and a brand new chef so far is going well).

[MECO28, BSN, RN]

To clarify; I love nursing but hate the environment I have found myself in.

[Spidey's mom, ADN, BSN, RN]

I just remembered what she said after a working interview she did a couple of weeks ago with a different restaurant.

"I felt very out of place and discouraged to the point of tears the whole time. Nothing I did was good enough. I'm getting more of an idea of the caliber of restaurant I want to work at and that is a place which takes pride in their work and employees but doesn't go Gordon Ramsey on me."

I mentioned how mean she thought hairdressers were when she quit cosmetology school and she said "I don't get it either. It's a horrible way to teach. Completely wipes out confidence. Luckily I have thick skin! And yea, the salon is child's play compared to a professional kitchen".

[SWM2009]

"Just stand up for yourself" is easier said than done for many especially when retaliation happens, and you are unsupported by management because they like the bullies. Then you have the co-workers who look the other way because they themselves are not being bullied.

[Alnitak7]

Incident reports? This has never been suggested to me before.

I remember leaving notes on the DoNs door and being discouraged from doing this.

Telling the charge nurse can be hard when they're busy. I only had one charge nurse say, "Come and tell me...."

[HarryTheCat, MSN, RN]

Bullying is rampant in nursing, and in most cases it stems from a lack of management skills, where nurse managers fail to identify the problem and quickly and effectively put a stop to it. One old saying often holds true, that "nurses eat their young", and the typical pattern is that of new nurses being bullied by those older nurses in established cliques that resent anyone new coming onto their turf. You will often find that there is one "arch bully" in the group whose position in the hierarchy is maintained over her acolytes through fear that they too will be bullied. To avoid her wrath they will often just go along with or participate in the bullying behavior.

Many organizations have a formal process for reporting (or "writing up") instances of bullying, and it is useful to focus the incident report not on a personal level but rather on the effect that such behavior has on the patients who often have to witness such behaviors. Don't report "she was mean to me", but state the facts of the incident and how they relate to standards of patient care and safety, and to the therapeutic environment. If the environment becomes too toxic, with no possible change in sight, don't waste time trying to change it. Just move on to a place where you have a supportive nurse manager with a low tolerance for this sort of behavior.

[WGHRN14]

As many of you stated, bullying really does take a toll on you mentally, emotionally and physically. I have noticed that most bullying occurs in work environments such as clinics and private practices- where SENIORITY is important. I worked for an outpatient clinic and due to having a hard time landing an RN job where I moved, I was more than HAPPY to accept it and began work.

The Nurse Mgr at the time of my hiring was also the lead nurse and she was the kind of bully who LOVES to be NICE, HAPPY, and QUIET (she was petite woman with a mousy voice). She's been there for quiet a while, therefore the MDs and Corporate has grown to love her. She was also the smartest and most educated when you compare her to the others. To make a long story short, she and her lackeys decided it was time for me to leave. They nit pick everything I did, wrote things I did wrong and would report it to the our oncoming nurse mgr (she was stepping down due to pregnancy).

They would leave me in the middle of the chemo room with patients and huddle behind closed doors so they can talk crap about me. (and I could hear one of them!) I NEVER felt so LOW and incompetent in my life. Mistakes I made were NOT fatal (i.e. I picked up the wrong syringe in the med room, no where near a pt)--- while other RNs administered the wrong chemo! (they were NEVER written up). I was once written up because I charted 1 day late (a common practice in the clinic.) When I tried to ask for justification as to why it was not acceptable for me to chart late, while Nurse X and her pals do it on a daily basis... My oncoming MGR says "because they've been here for a while. You're just starting". Didn't make sense then and doesn't make sense now. I put up with the unethical and unprofessional behaviors for 4 months until I gave up.

I was a confident and competent RN when I walked in that clinic, and I wasn't going to allow them to destroy me. Standing up for myself made me a bigger target and Management nor Corporate was going to take my side over nurses who have been there 5 plus yrs. I was going to try to stick it out because I've grown to LOVE my patients and they LOVED me. But after all that has been said and done, I knew it was time to go. I left and found a new job and much happier. This experience has made me weary of new work environments now though. It's hard for me to open up now. I know in time, it'll go away. But as many of you have said, bullying have long term effects. If you know you are right, stand up for it. :-) If NO ONE wants to listen, then maybe it's time to go. No job is worth your sense of self and being mentally destroyed.

[silver2009]

I am a Charge Nurse in an ED trying to combat Horizontal Violence (HV). I am one of the nurses getting bullied. They have gone all the way to the CNO with reports that I don't have the necessary certifications for my position. (I do.) They have started rumors about my family and me. (My spouse is having an affair. I am having an affair.) They are bullying one of my nurses to the point that she is experiencing sever physical ailments. I have tried to address it. I have documented and reported each of my experiences. I had the nurse document her experiences; talk to the Director; talk to the CNO. Her story is harrowing. So far nothing has happened to change it. I love my job, and it is great when those nurses aren't there, but I am considering leaving my profession because this is not how I want to live my life.

I am currently trying to deal with a strategy to implement in my work environment to address the problems. I figure that if I focus on solving the problem I may be more inclined to stick it out until it is better. Has anyone seen anti-bully programs that work?

[Alnitak7]

One of my charge nurses was constantly telling me to say, "please," every time I talked to my residents.

Even this can be a form of bullying.

Most of these people don't care if you're not saying, "please," and "thank you" in every other sentence.

They're only listening to your tone.

[jayebug]

I realized, rather recently, that I have been bullied for most of my life. The only place I didn't feel bullied was when I worked in California. That was what kinda clued me in. I was bullied all through high school, but not so much in college because I didn't live on campus and attended classes part time. I've even been bullied by my own family. I know it sounds crazy, but I think my past treatment caused me to become a target, like I have this personality that bullies seem to gravitate towards, and I just accepted it because I felt like it was the norm. I'm a travel/agency nurse too, so that doesn't help. I'm automatically the outsider. At my last assignment, I was in my manager's office every week. Sometimes for things that weren't even my fault, like they told me my documentation was incorrect on a patient I had never been assigned to. And it was mostly petty stuff too, like not specifying a Heparin drip on the I and O section of the flow sheet when I had documented it in the IV med section, and in my computer charting. I admit I missed some things, and I own that, but it was never anything that placed a patient in imminent danger, like once I forgot to place an ID band on a patient who had been transferred from another facility within the same health system. It was so horrifically busy that night, and at change of shift the patient still had on the ID band from the other facility (it's not like he had NO patient identifier whatsoever, and he was even transferred from the other facility via the health system's own ambulance). They made me feel like this horribly incompetent nurse. And I realized that other people were making the same mistakes, or even worse ones, but somehow they managed to stay out of the manager's office. I guess my biggest fault was that I would take their complaints and mull them over, wondering if they were correct in their assumptions before I defended myself. Once they see they've shaken your confidence, I think it's more difficult to keep yourself from becoming a permanent target.

[rbs105, ADN, MSN, RN]

To everyone who has responded, thank you. As I stated, I originally posted this somewhere else and got a TON of feedback from other professions. Your comments are not only personally comforting, but strongly backing my project with the evidence-based proof that this is going on in multiple areas, professions, and specialties. In addition to nursing, this bullying exists physician to physician, physician to resident, resident to resident, med student, so on and so forth.

In response to silver2009, we are working on a program to address this on the physician and staff level and have been successful with buy in from hospital staff in 2 hospitals. The physician level has been the toughest part, but we are steadily pushing forward-especially since this is something that can be tied to error and increased cost for facilities. I would encourage everyone to continue posting your experiences-examples of being bullied by physicians, residents, and other staff are very helpful. We have a few universities that are interested in collaborating on our project and collecting data and implementing trial changes. In the meantime, I have used resources from Vanderbilt-Dr. Gerald Hickson has pioneered the way in dealing with disruptive behavior. I also base a good deal of the program we are trialling on the Joint Commission Sentinel Event #40 that explains the tie between this bullying and disruptive behavior to errors and cost.

To those of you who have insinuated that this is part of the job, that you should just 'deal with it', or that there should be any level of acceptance of this behavior, I would challenge you to search within yourself and determine if you are part of the problem, or if you are in a state of denial that this is going on. That can be the hardest part. The situations that I and so many others have mentioned are never acceptable. If you are someone who is enabling or facilitating this to go on, please read these stories and do what you can to commit to making a change at your facility.

Thank you all for your input-I will keep you posted! We are hoping to have a program rolled out to multiple facilities by the end of the year!

rbs105

[RNGuy12]

One of my nursing friends new to the profession recently said that nurses were among the most unpleasant, rude individuals she ever had the displeasure of encountering, and I was disappointed to only be able to argue that that was not true of all nurses, though I think the rude unpleasant nurses are beginning to out number the good hearted nurses.

My experience with bullying in the workplace has had to do with belittling, questioning my skills and judgment in front of patients or other healthcare providers, etc. The big thing is that my facility values teamwork above most all else. It's an ingrained concept from hire to orientation to actual work. It's almost a fanatical culture centered on the concept of teamwork. The problem with that is such a culture creates two types of workers: those who are actually team players and those who appear to be team players.

I found myself being approached constantly and given "jobs" to do by my colleagues when I was new to the unit. The jobs involved the unpleasant aspects of patient care and when I would state that I was too busy with my own patients or offer to trade tasks I would be scolded for being a poor team player. I wasn't being a team player if I refused to do their jobs for them and I wasn't a team player for attempting to compromise and trade patient care activities because I "needed to learn the job." I was constantly being summoned into the clinical director's office to discuss my lack of team work and how I needed to be a better team player. Eventually, I left that unit and transferred to a new one where the bullying is reduced. There is only 1 bully and everyone complains about how she treats them, but no one reports her unprofessional behavior.

I agree with previous advice to document incident reports regarding unprofessional or disruptive behavior, but word the report in a clean, detached and objective manner. This creates a paper trail and provides data to the facilities administration, so that maybe someone higher up will address the issue of bullying. In my opinion the bullying problem persists because of equal parts ineffective management and equal parts silence from the bullied. The disruptive behavior is not reported, so it doesn't get addressed. If everyone who felt victimized by a bully filed incident reports on the issue the administration would have no choice, but to aggressively address the problem.