Becker's ASC Review

33 QUALITY & ACCREDITATION 8 Things to Know About Nurse Bullying By Alyssa Rege T he nursing profession has consistently ranked No. 1 in Gallup's annual poll of Honesty and Ethical Standards in Pro- fessions 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 suf- fered intense bullying. According to a 2017 blog post by Pittsburgh- based Select International Healthcare, rough- ly 85 percent of nurses have been abused by a fellow nurse and approximately one in three nurses have considered quitting the profes- sion 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 admin- istrators. Some nurses (38 percent) even reported having been verbally harassed or bullied by physicians. More than half of the nurses who reported work harassment indi- cated they were considering leaving the pro- fession all together.f 2. While some forms of bullying nurses experi- ence are overt, like verbal harassment, threats or physical violence, other forms are more sub- tle. Researchers refer to this subtle harassment as "incivility," a form of bullying commonly brought upon young nurses by their more experienced counterparts. Renee ompson, DNP, RN, said incivility can take on many forms, including sabotage, withholding infor- mation, excluding others, unfair assignments or downplaying accomplishments. 3. For some nurses, incivility can wreak hav- oc 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 Chris- ti — 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 aer sta- bilizing 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, aer liing her clothes with a tongue de- pressor, discovered a bloody syringe. "My first thought was, 'is could be attempt- ed 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 bul- lying or harassment in the workplace oen do not report their concerns. If they do re- port 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, stat- ing they "[couldn't] fire 14 people for one nurse," according to the report. Christi said she decided to leave the health facility aer management did not allow her to change shis 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 pit- ting nurses against one another. "eories suggest that age-old female 'competition' [in the medical field] has shied from competing over a man to competing over status, respect and position in the nursing environment," said Dr. ompson. "e 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 administra- tors begin to combat incivility and bully- ing? Nurses thshould, 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 profes- sional 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 rec- ognizing 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 es- tablishing civility charters, co-creating norms of desired behavior, implementing policies and rewarding civility" because their actions "set the tone for the types of professional in- teractions 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. ose protocols in- clude 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. n "Theories suggest that age-old female 'com- petition' [in the medical field] has shifted from competing over a man to competing over status, respect and position in the nurs- ing environment." -Dr. Renee Thompson

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