Don’t Ya Wish You Had a BSN Like Me?

Bullying in the form of educational snobbery runs amok in healthcare settings.

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

 

 

 

 

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  1. #1 by Columba Lisa on July 2, 2011 - 4:53 AM

    Interesting! My ex is a nurse. I had sort of picked up on this type of thing.

    • #2 by Samantha Gluck on July 2, 2011 - 6:42 PM

      Lisa,

      First thanks so much for stopping by. What kind of nurse is your ex? According to my sources, the male nurses do not endure the level of scrutiny and bullying that the female nurses experience. Of course, as with everything in this fallen world, I’m sure exceptions exist. Once i write the follow-up piece to this one, I will then interview some male nurses regarding their experiences with bullying and any bullying they may witness in the course of their daily work duties.

      Samantha

  2. #3 by Hot Air Balloon Mom on July 5, 2011 - 11:11 AM

    I’ve experienced emotional bullying in the corporate world and just read an interesting and well-researched book about emotions in the workplace, It’s Always Personal, by Ann Kreamer.
    I suppose we shouldn’t be surprised it carries over into medicine; however, how sad! Thanks for bringing attention to this.
    Anna, VB

    • #4 by Samantha Gluck on July 5, 2011 - 4:50 PM

      Thanks for visiting and commenting Anna. It is sad that this has carried over into the medical profession. What’s more, the young nurses I interviewed had become very disenchanted with their chosen profession because of the bullying and emotional strife they experienced at work. A couple of the nurses changed their careers entirely. Nurses see patients on a personal level more than anyone else in the healthcare system. Their emotional well-being frequently dictates their performance in this regard. To sabotage this by hurling snippets of educational snobbery and put-downs is profoundly selfish and belies an underlying emotional issue within the bully herself. I like the title of that book because we all know — It’s Always Personal!

      Samantha

  3. #5 by Christina on July 10, 2011 - 1:40 PM

    Having been a nurse for 17 years, I’ve experienced this over and over again. I’ve gotten it from doctors, nurses, you name it. During the 5 years I worked in the cath lab, I was repeatedly bullied. Once a contaminated temporary pacer wire was even thrown and hit me in the face (there were consequences for that one). It just shouldn’t happen. Ever. But nurses “eat their young” and I’ve even taken classes about it, but I don’t know how to change it. I’m at the point where I’m completely disenchanted with being a nurse and don’t want to return when I am finally better.

    I never really noticed as much of the BSN looking down on the ADN, but I see the LPN. I have my BSN (and am working on my MSN), but I don’t think it makes me any better of a nurse. I’ve always said that I didn’t learn a thing about being a nurse in school – I learned it all on the job.

    Thank you for bringing such an embarrassing topic to light (I find it embarrassing to be part of a profession that bullies it’s members!). The only way to change it is to acknowledge it.

    Christina

    Visit me at Spilled Milkshake

    Visiting from voiceBoks!

    ♥ xoxo

    • #6 by Samantha Gluck on July 10, 2011 - 6:33 PM

      Christina,

      Thanks for your input. I agree — having a higher degree doesn’t make people better nurses, it just makes them better educated. The bullying that goes on crushes the morale of these nurses; thus, crippling their ability to nurture and care for patients in the way they could have. It’s disturbing to me that these nurses with more education don’t, instead, take these women (or men) under their wings and inspire them to move forward in their careers, rather than sabotaging their hopes and dreams.

      Samantha

  4. #7 by Shanda Oakley on July 14, 2011 - 4:06 PM

    I have nurse friends who have spoken so much on bullying, and a couple even quit work because of it. Very interesting point to make thought that, with that this type of profession, you would think they would be more loving and nurturing.

    • #8 by Samantha Gluck on July 14, 2011 - 5:40 PM

      Indeed. Most RNs and others enter the nursing profession not only for the steady pay and job, but because they have an inherent gift of healing and nurturing. It’s sad that our culture and the medical industry has allowed this to become so rampant.

      Samantha

  5. #9 by Testosterone Therapy on July 22, 2011 - 8:52 PM

    This IS surprising – out of all professions in the world, you would think that nurses wouldn’t fall victim to workplace bullying. Thanks for spreading the word, I am definitely not going to look at my doctor’s office the same again!

    Lizzy

    • #10 by Samantha Gluck on July 22, 2011 - 11:55 PM

      Lizzy,

      This sort of thing is rampant in the healthcare profession. And it’s not always just limited to nurses. The administrative staff at many facilities gets involved as well. The nurses I spoke to were really losing their drive to nurture the way they dreamed. Thanks for your thoughts.

      Samantha

  6. #11 by tomblogue on July 27, 2011 - 3:44 AM

    Really interesting article. It’s such a shame that some healthcare workers don’t realize “do no harm” should extend to their coworkers as well.

    I wonder how this impacts patients, both in terms of outcomes but also perceptions of quality of care. If I witnessed those kinds of interactions I’d be nervous about the care I was receiving!

    • #12 by Samantha Gluck on July 27, 2011 - 2:40 PM

      Dear Tom,

      According to the nurses I interviewed (about 6), the quality of care does suffer. When they have emotional upsets like the ones caused by the incidents described, their ability to nurture and to focus on patient needs does begin to suffer, It seems to me that these “professionals” would seek to encourage these nurses in their work and give them some praise for performing mundane tasks that they don’t want to do. These nurses empty bed pans, bathe patients, clean wounds, etc. I can’t imagine a doctor or a nurse with a higher degree stooping to do those things in a regular health care situation. I know many physicians and BSNs who certainly would do these things in acute situations (like a natural disaster or war), but in the normal course of life, these “diploma” nurses serve them in big ways — ways that allow them to get to the business of doctoring or nursing in their higher capacities.

      Thanks for dropping by.

      Samantha