How Nurse Bullying Affects Patient CareThis is part one of a four-part series. Conflict is an inevitable part of your professional life. This multi-part series will explore the roots of conflict and suggest methods for effectively managing difficult situations.

Nurses Eat Their Young

Earlier this year, Marie Claire magazine called attention to nursing’s dirty little secret, in a feature story called Mean Girls of the ER: The Alarming Nurse Culture of Bullying and Hazing. The article related several anecdotes from the point of view of younger nurses who were treated badly by a clique of older, more experienced nurses. Sadly, we’ve all seen it happen. In fact, within the nursing profession there’s a troubling old saying that “nurses eat their young.” It refers to a problem sometimes called lateral violence or, more simply, bullying.

In essence, this is negative behavior that’s directed at a colleague within the same level of the nursing hierarchy. Among nurses, this kind of bullying can take many forms: verbal insults, emotional abuse, a condescending attitude, eye rolling, ostracizing someone, scapegoating, unwarranted criticism, gossiping or spreading rumors, refusing to mentor, or withholding information or assistance in a way that sets someone up to fail—possibly at a patient’s or colleague’s expense.

There’s no doubt this kind of bullying happens across professions, in all industries. But it’s especially troubling when it occurs among nurses. Nurses have dedicated their lives to caring for other people, with a holistic approach that considers a person’s physical, mental, spiritual, and emotional health. And it’s only logical that we should do this not only for our patients, but for our co-workers as well. When we act in ways that may drive young nurses out of a job or out of the profession, we weaken the entire healthcare system.

There are both individual and systemic factors at play when it comes to bullying. Individuals who lack strong interpersonal or conflict management skills are more likely to take out their frustrations on others, in disruptive ways, when they are caught up in a stressful moment. But the administrative hierarchy can also be a contributing factor in some hospitals—if nurses consistently feel oppressed or powerless, they may act out against their peers.

What’s worse, nurses who survive bullying early in a career are likely to promote the culture, either by bullying themselves or standing by silently as others are bullied. As the cycle perpetuates itself, it can manifest as low morale and burnout within a nursing unit or hospital. Everybody loses; nobody wins.

The Effect of Bullying to Patient Care

In 2008, the Joint Commission issued a sentinel event alert regarding behaviors that undermine a culture of safety in healthcare. Not surprisingly, the report centered on bullying, intimidation, and similar disruptive behaviors, calling for healthcare organizations to address the root of the problem. It acknowledged the negative effect disruptive behavior can have on the organization’s ability to recruit and retain nursing staff, as well as on patient safety.

When nurses aren’t supporting each other and collaborating on patient care, patients are at greater risk of harm. The first step in eliminating bullying is to acknowledge it as the profession’s dirty little secret and stop tolerating it. For too long, nurses have accepted these disruptive behaviors as part of the culture, which means they’ve promoted that culture instead of taking steps to change it.

If you are being bullied, or are witnessing a bully in action, you have the power to reject that behavior as unprofessional, unethical, and unacceptable. Have the courage to call out the bully, and to report what you’ve seen through the appropriate channels. And don’t ever be that nurse who has no patience with a new employee or who acts resentful when asked to mentor someone less experienced.

Working to promote a positive work environment and a culture of collaboration and safety is a sign of strong professionalism and leadership. Do you want to make a difference in the lives of your patients? Empower yourself with knowledge through an online RN to BSN or RN to BSN/MSN degree. American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in case management, infection control, and executive leadership.

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