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Saturday, March 7, 2015

How to Deal With a Nurse Bully

Nurse, self help, bully, negative, toxic, job, work environment, new nurse, nursing student, inter-professional, hospitals, new graduate

When Nurses Eat Their Young: How to Deal With a Bully


Here's a sad truth about being a nurse; there are bullies. 

82% of nurses say that they have been a victim of a bully.

We encounter them often. In the classroom when you ask a question and a peer snickers. In simulation when you mess up and the instructor berates you. On your first day of clinicals when a more experienced nurse belittles you.

I started my path to become a nurse 6 years ago and promptly changed my degree because of the bullying I witnessed. Eventually I was drawn back into nursing. This time a little older, a little wiser, and ever so slightly tougher.

Here's how to recognize, understand, and change your toxic environment when you are in the company of a bully.

The nursing profession continually ranks as one of the highest trusted professions in the US. It's foundation is based around compassion and caring for others. Yet, we seem to not respect or care much for one another. 

I don't like it and I want to change it.

How to Recognize a Bully


Like anything in healthcare, the first step to finding the solution is to find the problem. What does bullying look like in the healthcare industry?

Bullying can be:
  • Yelling
  • Criticizing- Not in a constructive manner, and probably excessive
  • Demeaning- "You're new. You don't have experience. You don't know anything. You're just a baby."
  • Gossiping- "Eww. Look at her hair."
  • Eye rolls
  • Sabotage- setting you up to fail
  • Refusing to help

If you're reading this, you might want to check out Renee Thompson. She's great at this. (I'll post a link below.) She says that there are two types of bullying.

It can be done in an overt manner- in which is seen and easily identified. Such as yelling in your face, or physically pushing you.

Or in a covert manner- in which it occurs after you've left the room, behind your back, etc. Or this could be the nurse you stay away from and never seek help from because he/she will bite your head off and eat you alive. So you don't even bother.

You might be wondering how to tell the difference between a bully or someone having a bad day. Someone having a bad day who snaps at you will most likely realize that behavior was unwarranted and will apologize for their behavior. A bully will make an excuse to justify their behavior. 

Understanding Bullying


Now that we recognize it, why does it happen? Well, partly I do believe that it is human nature. Nursing isn't alone in having a problem with bullying. Teachers, police officers, lawyers, politicians, servers-- really every profession has a problem with bullying. But I'm not excusing it. 

Bullying in the healthcare setting will fluster the healthcare professional and can result in a medical error. We've all had to read "To Err is Human" multiple times throughout our nursing career. We know that medical errors are MAJOR issue. We have teams in each hospital delegated to work on improving our systems to limit human factors and reduce errors.

There are four types of people on a nursing unit:
  1. The Bully- this is the aggressor that pushes people around. The person that lowers everyone else's self esteem. This person will cause more medical errors to be made on their unit through their actions alone.
  2. The Victim- this is the target of the aggressor. Generally its a person that is passive in their demeanor. The person that doesn't want to "rock the boat" so they say things like, "Whatever you guys decide is fine by me. I don't care." This person wants to avoid conflict, and usually is target for bullies.
  3. The Bystanders- these are the coworkers that don't say anything. They recognize the bully but they don't stand up to the bully. Usually this is done out of self-preservation. They don't want to stand up to the bully and become the next victim.
  4. The Changer- This person wants to make changes. This person will recognize the bully and call him/her out on it. They want to change the work environment to end bullying.
I've been the victim. I've been the bystander. I've been the changer. I don't consider myself to have ever been a bully. I come across very meek, which always helped out when playing sports. The other team didn't expect me to be much of a threat, however neither did my coaches initially. So it's not exactly a good thing to come across as a lost puppy dog.

Changing Bullying in Nursing


Bullying not only can (and will) increase medical errors it also leads to a loss of self-esteem, a loss of confidence, and can cause the victim to become physically ill from the mental anguish.  

If that doesn't speak to you, then possibly money will. 26% of new nurses leave their job in the first year. Sure, there are many reasons. That first job was probably not that new grad's dream job. They might have had to take a position on night shift and a day shift opened up somewhere else. Or they were in a toxic environment and decided to leave for their mental well being. (And I don't blame them one bit!) Nurses who decided to leave their job- left within 6 months of contemplating about leaving. Hospitals put forth so much money to train new hires. Leadership really needs to wake up and take notice that toxic units may be decreasing their retention rates. 

What we need in the field of nursing is for people to stand up and say that bullying is not okay. Even if it is widespread- it is NOT okay. We need zero tolerance policies in healthcare, but that will take some time. That will also take having an organization with a backbone. Also, it would take some proof. Proving that there is a bully on your unit can be a bit hard. Just like I said earlier, there's one type of bullying that is done in a covert manner.

Here's what YOU can do.

  • Stand up to the bully when you see those behaviors taking place. I find it much more easier for me to stand up for others than I am able to stand up for myself, but I need to learn how to stand up for myself.
  • Don't accept bullying. Reject it. Don't say things like, "Don't ask Susie. She's mean. That's just the way she is. Ask someone else." You know what? Forget that, Susie! You should be kind too and don't get to fall back on the "I'm just mean. That's my personality," excuse. No. The buck stops here. (I have an aunt named Susie and she is as sweet as can be. Sorry, Susie!)
  • Don't talk passively. This is my biggest challenge. I don't want to cause conflict so I don't speak up often in meetings. Partly because I'm a student and I feel as if I'm a child and my instructors/institution has been very much the type to say, "Children should be seen, not heard." That is exactly how I feel in my current position, which is not okay. I need to speak up. I need to be more assertive. But be aware and don't cross that line and become too aggressive.
  • Build up other's confidence. I want you to start complementing each other. Recognize when one another handled an event well. We need to build each other up instead of tearing each other down. Nursing is predominately female (as is teaching, which also has large amounts of bullying and politics). Us ladies aren't often to kind to one another. We see each other as competition, which is silly. We need to be better towards each other. Show each other the compassion that we show our patients.
There are many, many resources out there to help you in educating yourself about bullying in general, as well as bullying as it specifically pertains to nursing. I want everyone to succeed and have happy healthy careers and live lives that we are all proud of. Renee Thompson does a wonderful job over at RT Connections
Be Kind Always.
 And just so you know I'm not pulling stats out of my butt....

Flinkman, M., Bouret, U., & Salantera, S. (2013). Young professional nurses' intention to leave the profession and professional turnover rate in early career. ISRN Nursing. 

You might want to check out my post on 6 Tips to Become More Positive if you've been feeling a little down and out over a toxic environment.

Have you ever been a victim of bullying? Have you ever been a bully? How did you cope with it? Leave us a comment below!! We would all love to learn and grow from your experience.

Xoxo,

Nightingale

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