It might seem surprising that nurses – whose entire career focuses on healing, compassion, and empathy – frequently bully one another as well as feel the brunt of bullying from a superior, such as a physician. Some measure of bullying occurs in virtually every profession, but those who witness it or experience it first hand in the healthcare profession seem afraid and reluctant to voice their concerns – especially publicly for fear of retaliation.
What is workplace bullying?
Workplace bullying involves a type of psychological violence that abuses the power of one person over another. The proverbial schoolyard bullies frequently use physical violence and intimidation, criticism, and demeaning language to manipulate and control to demean other students. Similar to the schoolyard bully, workplace bullies use many of the same psychological tactics, but without the physical violence.
Nurses speak out
Two nurses working in Cleveland, Ohio facilities came forward to speak about their bullying experiences when the Medtopicwriter team began seeking those willing to convey first-hand accounts of bullying in their healthcare facilities. I changed the names of both the victims and the bullies in this account to protect all involved.
Tina Jones, R.N. told the following account, illustrating an instance of what she claims is simply one of many experiences with bullying she and others often endure in her particular facility:
“Two weeks ago, I’m shadowing the circulator during a bilateral salpingo-oophorectomy (BSO) and panniculectomy. The attending OB/GYN surgeon came in first to complete the BSO. That went fine. Matter of fact, this particular surgeon, while forward and direct, is always professional and explains the reasoning behind her demands…two plastic surgery residents came in to start prepping the patient for the panniculectomy. They thought the patient’s positioning was fine and proceeded with the incision. Later, the attending plastic surgeon (we’ll call him Dr. D) came into the room…twice he received a call into the room. Each time, I called his name. He did not move or acknowledge me. So each time, I put the caller on speakerphone so they could speak with him directly. I’m not going to pass along a message to a man who won’t even acknowledge my presence,” explained Jones.
She continued saying, “Midway through the surgery, Dr. D asks the CRNA [Certified Registered Nurse Anesthetist] to lower the foot of the table…the CRNA is not able to lower the foot of the table to his satisfaction. This is because…the table has sensors, regulating how much weight can be shifted to either side. He becomes agitated, ‘The patient needs to be moved up on the table.’ Everyone looks at one another. Dr. D does not offer to help. He’s standing with his arms folded. The residents remain quiet. Moving this patient without contaminating the sterile field is going to be a task. The circulator calls for an attendant to help with the move. Then Dr. D turns to the CRNA and says, ‘Where’s the rest of your anesthesia team that’s always in and out of the rooms giving breaks? Why don’t you get all of them out of the break room to move this patient/’ She looked dumfounded for a moment and then she said, ‘That’s not right.’ He didn’t respond. I’m sure she felt belittled. Her face was flushed. The kicker is that Dr. D left the room while the patient was being moved. He never came back to assess whether enough skin had been removed. The residents didn’t do it either.”
Finally, Jones remarked, “It feels like a game sometimes. The game is called, ‘How can I make you feel this small?’”
Sarah E. Graham, LPN works for a medical device company and assists with clinical trials for a well-known healthcare facility. She recounts her experiences and the demoralized workplace attitude the experiences foster.
“At a long-term care facility, on a Sunday, I noticed that one of the elderly patients was not herself. She was lethargic and seemed confused. Her speech was not normal. It was a stark difference compared to her normal behavior. I kept taking her vitals and charting her; I felt something was wrong. I needed her physician to issue an order to transfer her to the ER [emergency room]. I paged the doctor; he called me right back, listened intently to my concerns and then he let me have it saying, ‘How dare you page me on a Sunday! I’m in the middle of a golf game. When I’m done, I’m going to have dinner with my family.’ He stopped abruptly as if he realized that he had stepped over the line. He did issue the transport order,” recounted Graham.
Graham continued, “There is a lot of nurse-to-nurse bullying that goes on too. Educational snobbery relating to the letters behind your name. The RN/BSNs [Registered Nurses with a Bachelor of Science in Nursing] look down on the RNs, who look down on the LPNs and on down the line. I overheard some RNs referring to LPNs as ‘little diploma girls’ as a way of putting them down since they did not hold a two-year degree like they did. What’s more, part of our curriculum in school teaches us to respect those, like doctors, who have a much higher education level than we do by referring to them as Dr. Smith or Dr. Green. There is one doctor where I work that all the female nurses refer to as, let’s say, Dr. Matthews, but to most of the male nurses, he is just ‘Mark’. It’s getting to where you have to have a four year BSN to get anywhere in the nursing profession. All of these put-downs and condescending experiences have given me a negative mental attitude toward my future as a nurse. I am proud of my LPN and I worked hard to get there. Now I’m back in school and working toward a four-year degree in management. I hope to get a position in administration where I can stop the bullying that occurs in the nursing world.”
Nurse bullying is everywhere
The Medtopicwriter team interviewed nurses in three different states that all complain of nurse-to-nurse bullying and doctor to nurse bullying in their healthcare facilities. Future articles will feature the interviews with the other nurses who participated in this project. Nurses represent the lifeline of healthcare; the care they give greatly affects patient satisfaction and engagement. They spend more face-time with patients than any other healthcare provider. Allowing this to continue contributes to nurse turnover and a demoralized nursing workforce, ultimately degrading patient satisfaction and facility reputation.
Editor’s Note: Image courtesy of crisisprevention dot com