With today’s news about a hospital shooting in Boston, workplace safety for nurses is again foremost in many nurses’ minds.
And while nurses often run the risk of workplace injuries like muscle pulls from moving patients to something as serious as a needle stick, the idea of a hospital shooting is almost unthinkable. As today’s news shows, it happens.
How can nurses remain protected from workplace violence?
It goes without saying that being aware of your surroundings and what is happening in your environment is standard safety protocol. Nurses know that things happen fast in a hospital and that seconds matter. Practice being aware of your surroundings in all kinds of scenarios. For a challenge, note the descriptions of people around you, of family members accompanying patients, of clusters of people, or even of out-of-place bags or objects. Make a habit of it and soon it will become second nature. Awareness is critical to your safety.
Trust Your Instincts
Do you ever get a funny feeling when something doesn’t feel quite right to you? That’s your instinct telling you to pay attention – trust it. If a situation feels like it is getting out of control, call in help and notify your colleagues. It’s better to call attention to something harmless than not mention something or someone that is potentially threatening.
Know Your Workplace Security Procedure
Do you have security on staff or do you rely on local police for problems? Review the procedure for different scenarios with your staff or request it from your supervisors. You should know what to do in all kinds of situations – an agitated patient, an armed family member, unrest outside that overflows into your workplace, a fight. All those situations have the potential to turn violent in an instant. Your protection comes from knowing what to do.
If your workplace is lacking in basic workplace violence prevention measures, demand change. Find out what will help protect you and your colleagues and bring your ideas to the attention of your supervisor and administration. Ask your legislators to support workplace violence prevention laws and programs. And always report any incidents of violence in your workplace.
Workplace violence is such a hot topic that the Centers for Disease Control even has a course for nurses. The Workplace Violence Prevention for Nurses addresses the unique nature of violence in a health care setting. Work with local nursing organizations and local and national government officials to make workplace safety in a health care setting a priority. Consider taking a personal safety course so you know how to protect yourself if needed.
Workplace violence can happen anywhere, but nurses know the unique atmosphere of a health care setting can change rapidly and without notice. Keeping yourself safe is the best way you can help yourself and your patients.
Ever heard the expression “Nurses Eat Their Young”? Somehow it’s meant to be humorous, though those who’ve experienced that abuse know it’s anything but.
Perhaps you, right now, are a victim of a of bullying from other health care “professionals.” Where can you turn? First, take a look at what Brittney Wilson, RN, BSN, the blogger behind thenerdynurse.com, has compiled on the topic.
She has been researching and sharing her findings about the topic ever since experienced nurse-on-nurse bullying during her three years as a floor nurse, many years ago. Now it is one of her areas of expertise.
It’s important to start in the right place on the Nerdy Nurse’s comprehensive site, so you don’t get lost. (It also covers technology topics – thus the name – as well as items of interest in the day-to-day life of nurses, such as the most comfortable shoes for men and women).
My pick for where to begin your research is this post, called “Nurses Eat Their Young: Resources for Lateral Violence” because in it Brittney curates from all over the web and beyond. These are resources that she herself found or that readers submitted to her – all are useful.
You can go to the type of resource that appeals to you: books, scholarly articles, posts from around the blogosphere, discussion forums, and CE credit offerings from professional organizations. And the list of options under each category is not skimpy – I counted 12 articles.
For a detailed resource on lateral violence and nurses, you may want to choose from these three books that Brittney recommends:
- Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces – By Beth Boynton RN MS
- Ending nurse-to-nurse hostility: why nurses eat their young and each other- By Kathleen Bartholomew
- From Silence to Voice: What Nurses Know and Must Communicate to the Public – Suzanne Gordon & Bernice Buresh
For my money, the personal experience posts on The Nerdy Nurse site itself are the most instructive (she also lists them under their own category). You get a blow-by-blow (excuse the term) account of a young nurse’s life was made a living hell by a group of hostile co-workers, and how she overcame the abuse.
In one blog post (titled “Respect and Dignity”) Brittney gives this overview of her situation – it’s gripping:
“I was being called a liar, incompetent, and made to look a fool. At the most difficult point in my young life, pregnant, postpartum, the death of my mother, and as a new grad nurse, I had this lovely stressful nugget to add to my plate. Everyday I had to make the best of the situation where the other nurses refused to help my patients and I suffered. Unlike many, I did speak up, and often. Yet for fear for the loss of my job, and the livelihood of my family, I kept continuing to go to an unsafe work environment in the hopes that eventually, somehow, it would stop.”
You’ll find a lot of value in reading Brittney’s other posts about how her story twists and turns, first to another shift (away from her tormentors), and then into a new direction — clinical informatics.
How about you – do you have a favorite resource that helps you deal with a hostile work environment? If so, we’d love to hear about it.
Jebra Turner is a health writer in Portland, Oregon. Visit her online at www.jebra.com.
Many nurses are sensitive to bullying behavior from others in the workplace – fellow nurses, doctors, administrators, and even patients – but not to that of their own. Bully or bullied, it’s no fun to experience a hostile healthcare workplace.
For example, though it’s often said that “nurses eat their young.” Those same recent grads may find themselves more competent in some areas than older nurses, such as being tech-savvy.
They then don’t hesitate to give their elders abuse about discomfort using new technology, say. They may use the impatient, hostile voice, or rude body language (eye rolls?) that they may suffer in their first years on the floor.
Sometimes a nurse can be both a victim and a perpetrator at the same time. Or in different situations. Or with different co-workers. Or on a different shift. Or with a different nurse manager. Or when especially stressed.
It pays to look honestly at how you relate to others in your workplace so that you can stamp out your own bullying behaviors.
Laura A. Stokowski, RN, MS, provides a detailed list of bullying behaviors that many experts have identified in A Matter of Respect and Dignity: Bullying in the Nursing Profession on Medscape Nurses, Here’s a short excerpt from that piece:
- Refusing to speak to a colleague, being curt, giving the “silent treatment,” or withholding information (setting someone up to fail);
- Unwarranted or invalid criticism, excessively monitoring another’s work;
- Physical or verbal innuendo or abuse, foul language/swearing;
- Raising one’s voice, shouting at or humiliating someone;
- Treating someone differently from the rest of the group, social isolation;
- Asking inappropriate and/or excessive questions about personal matters or teasing about personal issues;
- Gossiping, spreading rumors, assigning denigrating nicknames.”
If any of these behaviors seem familiar because you yourself tend to resort to them, that’s probably an uncomfortable realization. Give yourself credit, though, for admitting to the truth. Now you can go about fixing the problem, because in the final analysis — even bullies don’t like bullies.
Jebra Turner is a health writer in Portland, Oregon. You can visit her at www.jebra.com.
Brittney Wilson, RN, BSN, also known as “The Nerdy Nurse,” blogs at thenerdynurse.com and authored The Nerdy Nurse‘s Guide to Technology. But a love of technology wasn’t the genesis of her blogging journey.
“What led me to starting my blog was a negative experience as a floor nurse. I was bullied by most everyone in the department. I complained to everybody I could, but nothing happened,” she remembers. “Then I went online to see if anyone had experienced some of the same things and could maybe help me. I started compiling information on lateral violence in nursing, and sharing it on my blog.”
Wilson worked on that floor for three years, and finally did see improvement in the bullying situation. But it came after she’d decided to train in clinical informatics as a way of combining her interest in both nursing and technology.
What turned things around? Plenty of difficult conversations with her manager and HR. “My boss got disgruntled with me when I brought up the term harassment. But then she backed off. Basically, when I let her know that I felt she was allowing the situation to occur, and that legally it was an issue, then her tune changed,” she explains.
“Also, I was ultimately moved to night shift. Getting away from the toxic nurses really made a big improvement, and I think being on night shift and being ‘out of sight/out of mind’ of the manager made things much easier for me.”
Wilson encourages nurses who are being bullied to speak up. Ask co-workers and even patients who witnessed the harassment to speak to management, but don’t count on it. Ask your manager to conduct an investigation into your claims by interviewing other staff members.
What if that doesn’t improve the situation? Wilson suggests a bullied nurse first start with “their manager, then director, then DON, and possible even the CEO. A nurse must make sure he/she has attempted to follow the chain of command before involving someone from outside the organization.”
After that, consider then involving your nursing organization (if a member), state board of nursing, accrediting agencies, and news organizations.
Wilson believes that blogging about her personal experience of being bullied helped make her stronger as a person and as a nurse. (Sometimes growth is painful.)
Though the treatment she experienced from the bullies on her floor could never be excused, it ultimately led to her new career in informatics and a blog that’s helped other tormented nurses to survive – and thrive.
Jebra Turner is a health writer in Portland, Oregon. You can visit her online at www.jebra.com.
Nurse-on-nurse bullying. Lateral violence. Hostile work environment. These are common terms for what’s sadly a common situation in many health care environments.
If you’re being bullied, it can help to have a “script” that helps you face your harrasser. Peggy Klaus, a Berkeley, California, a leadership and communication coach, has taught courses on difficult conversations for nurses, physicians, and medical students.
Here she offers some recommendations but doesn’t propose a one-size-fits-all solution. “We each have our own level of tolerance,” explains Klaus, “You have to be vigilant and see how it’s affecting you, and how it may be impeding your effectiveness. That’s especially important when you’re working in the crucial role of a nurse.”
1. Talk to your supervisor. Assume that nursing leadership is going to want to be helpful. (Many hospitals are anxious to put a stop to employee-to-employee harassment, if only because it places them at risk for lawsuits, for allowing a hostile workplace or retaliation if they a nurse who has made a formal complaint.)
One possible script from Klaus…
“Have you ever been bullied? What did you do to solve the problem?”(Makes the conversation more personal, and you’ll be more likely to elicit empathy from your supervisor.)
“I’m concerned because If nurses aren’t being collegial, it greatly affects the hospital.” (Don’t emphasize your own distress as much as downsides your supervisor can relate to.)
“Patients don’t get the kind of care they need, our evaluations as individuals and as a group will suffer. I’ve been thinking a lot about this problem. I would be doing my group a disservice if I didn’t bring this up.”
2. Ignore the bullying. If that’s a possibility for you, you can decide to play along, be civil and respectful, and just go about your business.
“Don’t play low status, though,” says Klaus, “which comes out in verbal and nonverbal behaviors such as having slumped shoulders or ending sentences with an upward inflection as if asking a question or seeking approval.”
3. Confront the bully. Be direct, assertive, and respectful and talk alone in a private, confined space, such as a conference room. Group confrontation doesn’t work, so talk first with the lead bully, and if necessary, repeat with the others.
One possible script from Klaus:
“I’ve recently noticed behavior or signs that you’re trying to bully me and I want it to stop.” (Give a couple of examples and say how it affects you.)
“I really want to work this out between us and not involve higher ups or human resources.”
Ask for the bully’s input and end on a positive, affirming note: “I look forward to working well with you.”
If the behavior changes, but then the bully slips and starts up again, go back and have the conversation again.
“You know, things had gotten better but I noticed that this is increasing and it’s got to stop.”
4. If the bullying doesn’t stop, go higher up the chain of command until you get relief.
Jebra Turner is a health writer in Portland, Oregon. You can visit her online at www.jebra.com.
It’s common knowledge that bullies are mean, manipulative and moody. But do you know what to do when the bully is your boss?
Bullies exist in every workplace, but when nurses harass other nurses their harmful behavior can also affect patient care and safety.
Bullying is described as acts perpetrated by one in a higher level of authority, according to the Center for American Nurses. Workplace bullying includes verbal abuse and offensive conduct such as work sabotage. Abusive behavior from your supervisor or colleagues can make you feel like you are walking around with a bull’s-eye on your back. Being berated repeatedly by a co-worker erodes confidence, leads to mistakes, breeds burnout and affects your health.
So how do you fight back without mimicking the bullying behavior? Here are steps to take to deal with abusive behavior on the job:
• Speak up. Don’t suffer in silence. Ask for help. Go up the chain of command. Report the harassment to human resources if you have exhausted all recourses.
• Learn your organization’s policies about bullying.
• Keep your emotions in check. Bullies enjoy making you lose your cool. Remain rational.
• Protect your health. Take care of yourself to deal with on-the-job stress. Make time to engage in a hobby or an activity that relaxes you. Eat well, exercise regularly and get a good night’s sleep. Doing so will help you better cope with the negativity at work.
• Write down everything. Document incidents and problems. Save emails and other correspondence. Do not leave this information at work.
• Keep interactions professional. Limit your encounters, if possible.
• Create a supportive network at work. Having colleagues to talk to can minimize stress. They may also serve as witnesses.
• Confront the bully. Doing so may send a message that you are not an easy target. When standing up for yourself, try not to act like a bully with your response.
Nurses need a supportive work environment. Do your part to make sure bullies have no place on the job.