Nurses push for halt to workplace bullying
Old saying: ‘Nurses eat their young’
Bullying is in the headlines: Kids are standing up against bullies, schools are setting tougher rules, and documentary films reveal the pain caused by the ongoing acts of a tormentor. Now, even the “caring profession” is acknowledging that bullying exists among its ranks — and needs to be stopped.
Bullying creates stress, increases the risk of injury, and causes nurses to leave their jobs, says Joy Longo, PhD, RN, assistant professor in the Christine E. Lynn College of Nursing at Florida Atlantic University in Boca Raton, FL, and author of a new booklet published by the American Nurses Association. It also affects patients, she says. “We have to pay attention to how we behave and how that’s going to affect our patients,” she says.
Bullying in the Workplace raises awareness and provides nurses with advice about handling bullying situations. Bullying is “epidemic in healthcare settings” and constitutes a form of workplace violence that involves emotional and verbal abuse, it says.
The ANA also points out that hospitals have mandate to address bullying. The Joint Commission accrediting body acknowledged the “intimidating and disruptive behaviors” that “undermine a culture of safety” in a Sentinel Event Alert in 2008. In 2009, elements of performance were added to the leadership standards that require hospitals to develop a code of conduct and a process for managing “disruptive and inappropriate behaviors.”
That inappropriate behavior can include verbal outbursts, refusal to answer questions or return phone calls, or condescending language. “The presence of intimidating and disruptive behaviors in an organization... erodes professional behavior and creates an unhealthy or even hostile work environment,” The Joint Commission said in its alert.
From hierarchy to team work
Hospitals have traditionally had a culture guided by hierarchy. There’s a saying that “nurses eat their young” – that instead of mentoring new recruits, older nurses humiliate them. Nurses also may take out their frustrations against each other because they can’t respond to intimidating behavior from physicians, managers or others higher in the hierarchy, says Longo.
Hospitals need to enforce their code of conduct across the board, says Longo. And they need a mechanism for addressing physician behavior, she says. “The physicians are the moneymakers for the hospital,” she says. “Does the hospital back down and say, ‘We know it’s a problem but we don’t want to say anything?’”
Taking a team approach to care and providing mentoring for newer nurses may help prevent bullying, she says. Hospitals also should give employees a safe, confidential way to report their concerns, she says.
“Oftentimes, [the bullies] are the most experienced nurses on the unit. They’re very competent, and they’re very good with patients. They’ve gotten away with these behaviors so long that people have learned to work around those behaviors,” she says. “Because people are so afraid of them, they really empower them to continue that behavior.”
Inappropriate behavior is most likely to happen in the most stressful units, such as the operating room, emergency department, and intensive care unit, says Rebecca M. Patton, MSN, RN, CNOR, FAAN, Atkinson Scholar in Perioperative Nursing at Case Western Reserve University in Cleveland and past president of ANA. Lack of adequate staffing also makes it more prevalent, she says.
To some people, eye-rolling or a sharp tone of voice is just a matter of incivility. But even minor actions can escalate, notes Patton. “We need to call it what it is. It’s bullying. That will help people identify it,” she says. “We all know that bullying is wrong. Don’t be afraid to label it correctly.”
Having strong policies on bullying and inappropriate behavior can help with recruitment and retention, says Patton. Current nursing students have high standards for their future workplace, she says.
“I think this generation of students is going to be the greatest generation of nurses,” she says. “They have zero tolerance for some of the things us older nurses tolerated. That will help change behavior.”
[Editor’s note: The publication, Bullying in the Workplace: Reversing a Culture, is available from the ANA at www.nursesbooks.org/Homepage/Featured-Items/Bullying-in-the-Workplace.aspx.]
Bullying is in the headlines: Kids are standing up against bullies, schools are setting tougher rules, and documentary films reveal the pain caused by the ongoing acts of a tormentor. Now, even the caring profession is acknowledging that bullying exists among its ranks and needs to be stopped.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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