Nurse Bullying: What It Is & How To Stop It
We spoke with Renee Thompson, DNP, RN, CMSRN, CSP, of the Healthy Workforce Institute to share her thoughts on how to put a stop to nurse bullying in the workplace.
Image via Unsplash.com/Brina Blum
More than one in six new nurses leave their first jobs within a year. The high-stress and fast-paced environment of many healthcare facilities can be tough when you’re first starting out. But it’s not just the pressure coming from doctors or patients that can lead nurses to leave the profession. Nurse-to-nurse bullying can push people out, too.
What Is Bullying in Nursing?
Sometimes referred to as “eating their young,” (yes, it’s really called this among some nurses!) nurse bullying is when nurses repeatedly try to intimidate or harm their peers in an effort to discredit, humiliate, or hurt them in some way. It primarily seems to affect nurses who are just starting out, but it can happen at any point in their careers and in all different kinds of healthcare environments.
Why Do Nurses Bully Other Nurses?
Nurses can start bullying other nurses for a wide range of reasons, many of which have to do with their work environments. These can include:
- Stress: No one has to tell you that your job can be stressful. Shifts can be long, and the stakes are high. Without effective coping mechanisms, stress can bring out the worst in some people.
- Control: Nurses typically don’t have a lot of say over what happens in their profession. Many of the decisions made regarding rules and processes impacting nurses are being decided by other groups, such as physicians, hospital administrators, or politicians. It can be frustrating and lead some nurses to redirect that frustration and desire for control in the form of bullying.
- Insecurity: Nurses who don’t feel like they’re competent or like they belong might try to compensate by excluding or berating others. By making others look bad, they make themselves feel better.
- Personal Bias: Nurses can have differing opinions about what makes someone a “good nurse,” and that can lead them to have prejudices against those who don’t fit their description.
- Culture: Some nurses bully other nurses because they were bullied themselves. It’s a cycle that leads older nurses to bully new nurses because that’s just how it’s done in that environment.
What Are the Signs of Nurse-to-Nurse Bullying?
Not every negative comment is bullying, says Renee Thompson, DNP, RN, CMSRN, CSP, an anti-bullying expert and CEO and president of the Healthy Workforce Institute. Nurses work in high-stress environments, and bad days happen. She says real, legitimate bullying tends to be targeted, harmful, and repeated. Here’s what she means:
- Targeted: The negative behavior is aimed at a specific person or group of people. New nurses tend to be more vulnerable to bullying, Thompson says, but so can teams working for “rival” departments (e.g., nurses in intensive care can bully those in the emergency department).
- Harmful: For it to be bullying, there has to be harm done, Thompson says. Subtle eye-rolling isn’t harmful, she says, but berating a nurse in front of patients is because it could hurt their reputation.
- Repeated: Lastly, it can’t just be a one-time thing. True bullying happens when a harmful behavior is repeated over and over again.
Thompson says it’s important for nurses to recognize the differences between incivility or criticism and bullying. Getting constructive feedback isn’t bullying; it’s someone helping you be a better nurse, she says. People can be curmudgeonly or have grumpy dispositions without targeting someone or repeatedly trying to do them harm.
The Difference Between Hazing and Bullying
Hazing new nurses happens in a lot of different groups, and it’s not that uncommon for more experienced nurses to be a little harder on new ones, Thompson says. The behaviors can look a lot like bullying, with one key difference. The point of hazing is to include new nurses and welcome people into the fold, while bullying is explicitly meant to exclude them. Examples might include giving the new nurse a screaming patient or pairing her with a difficult physician.
The difference here is that these hazing scenarios become “tests,” and you gain credibility after passing the test. But with nurse bullying, these assignments would not stop and the new nurse wouldn’t get a “good job!” upon passing.
5 Examples of Nurse Bullying
Nurse-to-nurse bullying can come in a lot of different forms. Some of the most common include:
- Always giving you the worst assignments or schedule: You’re always being scheduled for Friday nights, or you’re consistently assigned the most challenging patients.
- Purposefully withholding information: A nurse passes you her patient but doesn’t tell you crucial information — like that they just got a lumbar drain — just to see if you can figure it out yourself or to purposefully make you look bad in front of the physician.
- Saying derogatory things about you: They berate you or say awful things about you, especially in front of patients or supervisors, in order to hurt your reputation or make you look incompetent.
- Excluding you from the group: Conversations, collaborative opportunities, casual gatherings — you name it, you are purposefully and consistently being left out of the fold.
- Actively trying to turn other nurses against you: They gather their posse to pile on or keep the bullying up when they’re not around.
What a lot of these scenarios have in common is that the bully is deliberately trying to make you look bad or set you up to fail. It’s workplace sabotage.
What You Can Do If You Think You’re Being Bullied
Being the target of these behaviors doesn’t just affect your mental health or career prospects, it can also negatively impact your patient care. It’s not just part of the job, and it shouldn’t continue. If another nurse is bullying you, here’s what you can do:
1) Get a second opinion.
You might be not be seeing the whole story. Before you confront your bully, try to talk to someone who isn’t directly involved but who knows the players and environment well. This could be a coworker or mentor, and it could help provide some clarity or context for what’s really happening, says Susan Pasley, MS, BSN, RN, and vice president of Nursing at Bravado Health. It could also help validate your feelings and give you encouragement to confront the bully directly.
2) Name the behavior.
Sometimes nurses don’t even realize what they’re doing is bullying. Calling out the specific behavior (don’t just call it “bullying”) can help them see what it looks like from your perspective. Some examples of ways to do this, according to Thompson, include:
- “You’re berating my work in front of other people.”
- “I overheard you talking about me behind my back.”
- “Three days in a row you’ve given me patients in isolation; no one else has.”
3) Choose a script.
Because emotions can run high when you’re being bullied, Thompson recommends putting together a script you can use to address someone who’s bullying you. Practice beforehand — roleplay can be helpful, Pasley says — so you’re not struggling to figure out what to say in the moment. Try these:
- “I’m offended by that comment.”
- “I’m concerned about this assignment.”
- “Help me to understand… When I took over the patient last night, you didn’t tell me the patient had just had a lumbar drain. That’s a really important detail. What happened?”
4) Be honest and respectful.
Don’t fight fire with fire. You can stand up for yourself while still being respectful. Just be honest about how you feel and what you want your coworker to do. Here are some examples:
- “Time out. It’s not OK how you’re treating me right now.”
- “Sometimes you come across as abrasive. Can we talk about this?”
- “This is a professional environment, and I am your colleague. Our patients depend on us to work together as a team.”
5) Write it down and report it.
Bullying in nursing is often under-reported, and that’s a problem, Pasley says. Documenting what’s happening in detail and reporting it can help those with power (e.g., administrators, managers, etc.) acknowledge the problem and work harder to stop it. Even if you don’t want to report it because you fear retribution, writing it down can help you better prepare for when you bring your concerns to your bully.
6) Pursue change.
Nurse-to-nurse bullying won’t stop overnight. It will take systematic and widespread change to overcome many of the root causes of bullying behaviors in healthcare. Pasley recommends nurses be a part of the change by mentoring newer colleagues, calling out bullying behaviors when you see them — especially when they aren’t happening to you — getting involved in committees to provide anti-bullying education and policies at your institution, and serving as an example of kindness and professionalism in the workplace.
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