8 things to know about nurse bullying

The nursing profession has consistently ranked No. 1 in Gallup's annual poll of Honesty and Ethical Standards in Professions for the past 15 years — which makes the rampant bullying and hazing that persists among nurses that much more surprising.

Judith Meissner, RN, MSN coined the phrase "nurses eat their young" in a 1986 article to describe the hostility young nurses face at the hands of their more experienced coworkers. In a follow-up article published 13 years later, Ms. Meissner said "students, new graduates and even experienced 'new hires'" still suffered intense bullying.

According to a 2017 blog post by Pittsburgh-based Select International Healthcare, roughly 85 percent of nurses have been abused by a fellow nurse and approximately one in three nurses have considered quitting the profession due to bullying.

Here are eight things to know about nurse bullying.

1. Forty-five percent of nurses have been verbally harassed or bullied by other nurses, according to a 2017 survey by employment agency RNnetwork. Forty-one percent of those surveyed said they have been verbally harassed or bullied by managers or administrators. Some nurses (38 percent) even reported having been verbally harassed or bullied by physicians. More than half of the nurses who reported work harassment indicated they were considering leaving the profession all together.

2. While some forms of bullying nurses experience are overt, like verbal harassment, threats or physical violence, other forms are more subtle. Researchers refer to this subtle harassment as "incivility," a form of bullying commonly brought upon young nurses by their more experienced counterparts. Renee Thompson, DNP, RN, said incivility can take on many forms, including sabotage, withholding information, excluding others, unfair assignments or downplaying accomplishments.

3. For some nurses, incivility can wreak havoc not only on their self-esteem, but on the health and well-being of their patients. In an interview for Marie Claire, 27-year-old Christi — who declined to provide her last name to the publication — said about four months into her job as an intensive care unit nurse at a North Carolina hospital, a group of nurses refused to help her care for a patient who had suddenly lost consciousness. A week after stabilizing the patient on her own, a friend told Christi not to go into her locker and to call a manager. Christi said she opened her locker and, after lifting her clothes with a tongue depressor, discovered a bloody syringe.

"My first thought was, 'This could be attempted murder' … because I didn't know what was on the needle that I would have contracted if it stuck me," she told the publication.

4. Nurses who have historically faced bullying or harassment in the workplace often do not report their concerns. If they do report the bullying, managers may do little to remedy the situation. During a September 2016 discussion hosted by the Association of periOperative Registered Nurses and streamed live on Facebook, Linda Groah, MSN, RN, CEO of AORN, cited a survey in which only 38 percent of managers said they attempted to address complaints of bullying brought to their attention. Christi told Marie Claire she asked management to investigate the situation involving her locker. She said management refused, stating they "[couldn't] fire 14 people for one nurse," according to the report. Christi said she decided to leave the health facility after management did not allow her to change shifts or transfer departments, according to the report.

5. Some researchers speculate that because nursing is generally a female-dominated profession, competition plays a role in pitting nurses against one another. "Theories suggest that age-old female 'competition' [in the medical field] has shifted from competing over a man to competing over status, respect and position in the nursing environment," said Dr. Thompson. "The same behaviors once witnessed between two women fighting over a man are the ones witnessed today in the behavior of bullies."

6. Given the apparent pervasiveness of the issue, how do hospitals and administrators begin to combat incivility and bullying? Nurses should, first and foremost, document any type of harassment inflicted upon them, Dr. Thompson said. "If you are being bullied, start a documentation trail. Keep a small notebook with you and write down dates, times, witnesses, verbatim comments and any behaviors you believe undermine a culture of safety and a professional work environment," she said. "Keep growing this documentation trail until you are at the point where you can file a formal complaint."

7. Nurse managers also play a vital role in recognizing and preventing bullying. According to some experts, it's up to the nurse manager to "[share] information about incivility and its harmful effects and [to] take the lead in establishing civility charters, co-creating norms of desired behavior, implementing policies and rewarding civility" because their actions "set the tone for the types of professional interactions that are expected in the workplace."

8. Additionally, hospital executives and nurse leaders can implement protocols outlined under the acronym L.I.S.T.E.N to address nurse bullying. Those protocols include beginning to investigate the situation as soon as a complaint is issued and to never share their own opinion on the issue with any of the participants to remain unbiased.

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