Nurse bullying is a big problem in the profession, but it’s under reported and not addressed as effectively as possible. And the reason isn’t as simple as nurses not wanting to speak up.
Sometimes nurses aren’t even sure the horrible behavior they are being subject to is actually bullying, says Dr. Renee Thompson, DNP, RN, CMSRN, and CEO and president of RT Connections, LLC, and author of “Do No Harm” Applies to Nurses, Too!,.
Bullying behavior can be quite obvious, but it’s just as often something so subtle the target isn’t even sure if the actions are intended. “Bullies will test the waters,” she says. “They will do something and see the reaction they get. If they are resisted, they will usually, but not always, stop it.” But if the behavior isn’t addressed immediately, the bully takes on power and the behavior can escalate.
What are some things to watch out for?
True nurse bullying behaviors and unintended coincidences can be separated by the pattern and the repetition you will see over time.
The most obvious, and for some nurses easiest to deal with, bullying is the in-your-face colleague who is yelling at you and insulting you. There’s no doubt what’s going on there.
But other things are much harder to really pin down. Dr. Thompson recalls hearing a story from a nurse who won an award and soon found herself with the most acute patients and more cases than any other nurses on the floor during her shifts. The nurse wasn’t sure if she just had a bad luck of the draw, but then she overheard a charge nurse indicating that it was on purpose to bring her down a few notches from her award. Startled, the nurse identified what was really happening.
Other times, nurses create situations to have other nurses fail. Maybe during hand off you weren’t given all the information you needed. “They set you up to make a mistake and then write you up for it,” says Dr. Thompson.
And what about the times when all the nurses wear the same jacket or they all order out lunch together and exclude one person? Or if a few nurses gossip at work and spread rumors? All these behaviors seem petty, but they really happen at some workplaces.
If you have ever seen or experienced these behaviors, Dr. Thompson says it’s a good idea to track what you see. Carry a small notebook and jot things down over a couple of weeks. “You are looking for a pattern,” she says, “not a one-time incident.” Even if you end up doing nothing with the information, Dr. Thompson says the very act of documenting can help you because it can help you establish a clear pattern of bullying. It can be a relief to know it’s not just your imagination.
Then you can choose a few options. You can confront the person in a respectful manner that’s supported with facts (which you now have thanks to that handy notebook!). You can say something like, “I noticed this is the fifth time in a row when you were in charge that I got all the patients with the highest acuity. Can you help me to understand why that is?”
If you aren’t comfortable going to your direct supervisor, you can consider going to your supervisor’s supervisor. You can also approach human resources, says Dr. Thompson. Check your company’s policy on destructive behaviors so you can present a clear case on what specific behaviors have been violated.
And, of course, if you can relate what is happening to how it impacts patient safety or patient care, you have a greater chance of someone doing something about it, says Dr. Thompson. If you went to a charge nurse at 2 am and asked about a patient in crisis and were told to handle it yourself, you have a clear example of how the actions are impacting patient care.
And Dr. Thompson doesn’t wear rose-colored glasses when it comes to nurse bullying. If your boss is best friends with the VP of human resources or with everyone in her line of command, you might want to just leave. “Get out,” says Dr. Thompson. “It’s just not worth it and you can go find a better place. You deserve to work in a great place.”