Sexual Harassment by Patients: What Every Nurse Needs to Know

Sexual Harassment by Patients: What Every Nurse Needs to Know

Especially since the #MeToo Movement began, sexual harassment has been in the spotlight. We spoke with nurses who have been harassed, legal experts, and nursing professionals to determine what you should and can do if this happens to you.

Celia,* RN, a longtime hospice nurse, remembers it like it was yesterday. A younger man, at least younger for hospice, had been admitted with terminal cancer. While Celia says she recalls other nurses talking about the patient having made “inappropriate comments,” she had never experienced it herself.

Until she did.

The patient had been angry and struggling with what he deemed the unfairness of dying young and leaving his wife and child—and knowing that he wouldn’t be able to take fun trips or do things with his daughter. Because he had a trach, which requires frequent suctioning and medication, he felt like the staff was treating him like a leper—when actually, they were simply following all safety precautions.

“Once trach care was completed, I sat down, took my gloves off, and offered him a hand to hold—this is standard practice between hospice staff and patients, and it’s not frowned upon,” says Celia. At the time, the patient held her hand, cried, and expressed gratitude for the time to talk. “I felt we had a nice, professional, and therapeutic rapport.”

A few weeks later, a couple of days after Christmas, Celia was caring for the patient, and he asked if she was married. When she responded that she was in a long-distance relationship, he asked how she took care of her sexual needs—and asked using inappropriate, graphic sexual language.

Celia replied, “One—that is none of your business. And two—It’s not appropriate conversation between a patient and a nurse!” Then, Celia calmly informed him that this was harassment and abuse. With one word to her managers, she told him, she would never have to be his nurse again. She says that the patient was contrite and apologized. Celia passed it off as a one-time thing and let it go.

Unfortunately, that wasn’t the end of the harassment. After a couple of weeks, Celia was the patient’s nurse again. While taking care of his trach, she talked with him. When he could speak, they discussed their favorite kinds of music. She recalls, “It was a nice interaction, as I grew up in a musical home, and discussing this was special to me.”

Near the end of the treatment, though, everything changed. The patient told her lots of things that he would like to do with her sexually, in graphic detail.

Celia recalls, “I was horrified. I was angry. I felt nauseated. I felt ashamed about my body, and I wanted to cry. I was shaking, inside and out.”

She told the patient that he was so far out of line. He was shocked that she was so rattled and tried to justify it by saying that it was a compliment. Celia left his room immediately.

The first thing she did was post on the staff’s white board that she would no longer care for this patient. When she calmed down, she emailed her managers and then communicated with them in person the next day.

Celia’s managers were supportive. She never saw the patient again, and he left the facility a few days later.

Harassment is Prevalent

A Medscape.com survey published last year revealed that the majority of nurses—71%—say that they had been sexually harassed by a patient. Of those responding, 90% were female nurses, 10% male.

But male nurses get harassed as well. They may, however, be even less inclined to report it. In the same survey results, it states, “By gender, female nurses…were much more likely to say they had been sexually harassed than their male counterparts (73% for female nurses vs 46% for male nurses).”

No matter the gender of the nurse who experiences it, sexual harassment is wrong. That said, how do you decide if what a patient is doing or saying is sexual harassment?

If it Looks Like a Duck and Quacks Like a Duck

According to Trista Long, RN, DNP, MBA, ON-C, a nurse manager for an inpatient med/surg unit with Blessing Health System, it is easy, most times, for nurses to differentiate between behavior that is appropriate or inappropriate. “The first sign of inappropriate behavior is when patient’s actions or conversation makes the nurse uncomfortable. Patients who are making inappropriate comments will first ‘test the waters’ by making inappropriate jokes or mild comments to gauge the nurse’s response. If the nurse dismisses the comment, the patient will likely continue with the inappropriate conversation or actions.”

If a patient exhibits inappropriate verbal behavior, it’s often easy to recognize, says Long. “Nurses know what crosses a line and what doesn’t,” she says. Because of the physical nature of nursing, however, Long says that inappropriate physical behavior can sometimes be more difficult to recognize.

“I often tell my staff that—again—inappropriate touch is anything that makes them uncomfortable…it’s no different than being in public and having someone touch you inappropriately. Just because you are in a hospital does not give another person the right to touch you,” explains Long. “Most patients will want to hold your hand or touch your arm, but they will not go any further than that. An action or remark could be considered harassment if the nurse directs the patients to stop, but that direction is ignored.”

“A ‘reasonable person standard’ is generally used to determine if conduct is motivated by prurient interests or for a person’s sexual gratification,” says Debra W. Levin, counsel in the health law group at Brach Eichler. She previously served as counsel to the New Jersey State Board of Medical Examiners and was the Assistant Section Chief responsible for legal services provided to more than 50 licensure boards, including the New Jersey Board of Nursing. “If a reasonable person would be offended, then it can be determined to be sexual harassment. Because the standard is subjective, it is often hard to determine.”

“Sexual harassment is generally any unwanted sexual direct or indirect physical contact or comments. Of course, some physical contact may be more overtly ‘sexual’ than other contact, but much of the time, the intent will be evident,” says Jessica T. Ornsby, LL.M., Esq, managing attorney with A+O Law Group. “A good rule of thumb is whether the contact is objectively appropriate under the circumstances. For example, if a nurse is taking a patient’s blood pressure, is it necessary for the patient to place his or her hand on the nurse’s thigh? Probably not. But if a nurse is helping a patient into bed, that patient may need assistance stabilizing himself/herself and may rest his or her hand on the nurse in a way that would otherwise not be necessary.”

She adds, “Sexual harassment is basically a step down from sexual assault. If the action/contact involves force or any kind of penetration, that is most likely assault and should be addressed accordingly.”

What to Do if It Happens to You

Suppose a patient sexually harasses you. What do you do?

“Experts believe that sexual harassment is significantly underreported in health care. For that reason, I believe the best defense for nurses starts with reporting these types of incidents,” says Jennifer Flynn, CPHRM, risk manager at Nurses Service Organization. “No matter who the harasser—whether it be a supervisor, coworker, or a patient—nurses can take steps to address harassment in their workplace.”

“While working in a hospital, the first step is for the nurse to address the behavior. The nurse should tell—not ask—the patient to refrain from the inappropriate comments or actions and to stop immediately. The nurse should then report the behavior to his/her manager so that the leader can be aware. If the behavior stops, it typically will not need to go further,” says Long. “It is imperative that the nurse set boundaries with the patient immediately once s/he recognizes the behavior. If the action is severe or violent, the nurse should report it immediately, and the leader should address it. If the nurse is uncomfortable caring for the patient, the patient can be reassigned to another nurse. There have been times when I have assigned only male nurses to a patient who was harassing the female nurses.”

There may be times in which a patient won’t stop. In this case, Long says that the leader should talk with the patient and stress that the behavior won’t be tolerated and must cease. “If the behavior continues or if the nurse is uncomfortable caring for the patient, the patient should be reassigned to another nurse, and the leader should engage the Risk Management Department and/or the Security Department to assist. Many times, a Security Officer will be asked to speak with the patient and direct them to stop the behavior. Since they are often in uniform, it can be a show of added authority and the behavior will stop. If it does not, the Risk Management Department can speak to the patient and explain any legal consequences to their continued inappropriate behavior,” says Long.

Ornsby says that each work environment, ideally, should have some kind of policy with regard to sexual harassment. “Nurses should make note of these policies and earmark them for future reference,” she says. “If the policy does not specify to whom to report the incidents—ask. If a patient’s behavior…is making you uncomfortable or causing you to feel unsafe, leave the situation immediately. Your personal safety and well-being are the most important. Federal laws on sexual harassment apply regardless of whether the harassment is taking place at a hospital or a doctor’s office.”

Levin agrees that health care organizations should have policies in place. “Larger or licensed facilities may have staff to counsel the patient regarding harassing behavior. Additionally, in regard to patients, the patient can be transferred to another’s care, a chaperone can be provided, and the patient can be counseled. In dramatic situations, the patient can be discharged/terminated from the practice or facility. State-specific laws apply that govern termination of the doctor/patient relationship/discharge so that the patient is not abandoned, and there is a transition of care,” she says.

The American Nurses Association has challenged nursing professionals to end sexual harassment in the workplace by adopting a zero-tolerance policy. “Much has been written lately about the importance of nurses engaging in self-care. Not tolerating sexual harassment is an integral component not only for self-care, but also for self-respect, vital for professional effectiveness. Speak up when sexual harassment occurs and facilitate a civil work environment,” Flynn says.

The Bottom Line

“If the organization is not responsive to the nurse’s claims, s/he should consult legal counsel or their union. No one should be subjected to sexual harassment in the work place,” says Levin.

Long says that harassment, whether physical or verbal, has been perceived in health care as “part of the job.” But it’s not and never should be seen as such. “It is never acceptable to be harassed by anyone at any time. Nurses are an integral part of the health care team and should command the same respect as every other profession,” says Long. “Unfortunately, nurses have been depicted in a sexual manner for ages and that has demeaned the profession. Being a nurse does not negate my rights as a human being to not be verbally or physically assaulted.”

“I took an oath to care for others, but that does not mean that I have to sacrifice my physical or mental well-being,” Long adds.


* not her real name

Q&A with Nursing Now’s Barbara Stilwell

Q&A with Nursing Now’s Barbara Stilwell

Barbara Stilwell, PhD, RN, FRCN, is the Executive Director of Nursing Now, a three-year global campaign seeking to raise the profile of nurses.

Dr. Stilwell recently talked with Minority Nurse about what she hopes Nursing Now will accomplish before the campaign ends next year.

What follows is an edited version of our interview.

Nursing Now's Barbara Stilwell

What do you hope to accomplish?

The campaign ends in 2020 and by then we aim to achieve the following:

1. On investment: There is greater investment in the nursing workforce—in education and professional development, standards and regulation, and employment conditions as well as in numbers in training and employment.

Measurement: that there are increases globally in investment in nursing and in the numbers of nurses in training and employment, and that a trajectory has been established and progress is being made towards eliminating the shortfall of nine million nurses and midwives by 2030, tracked through the State of the World’s Nursing report.

2. On policy: The health workforce generally—and nursing and midwifery specifically—are more central to global and national health policies.

Measurement: that all global and national policies on health and health care acknowledge the role of nursing in achieving their goals and include plans for the development of nursing. That national plans for delivering UHC make specific proposals for enhancing and developing the role of nurses as the health professionals most able to deliver patient centred UHC to individuals, families, and communities.

3. On leadership and influence: There are more nurses in leadership positions where they are able to influence policy and decision making and more opportunities for leadership and development for nurses at all levels.

Measurement: at least 75% of countries have a CNO or Chief Government Nurse as part of their most senior management team with the longer term aim of all countries having such posts; there is an increase in the availability of senior leadership programs for nurses; and a global nursing leadership network is established. More young nurses have access to leadership development programs.

4. On evidence: There is more evidence available to policy and decision makers in forms that are understandable about: i) the impact of nursing and where it can have most effect, ii) the barriers that currently prevent nurses from practicing to their full potential, iii) practical methods for addressing these barriers, iv) and that there is more research underway.

Measurement: There are increasing numbers of articles on aspects of nursing in peer reviewed journals that reach an audience broader than nurses; there is a coordinated global network on research on nursing; and there are innovative methods tested of bridging the evidence to policy gap in nursing.

5. On effective practice: There is more dissemination and sharing of effective and innovative practice in nursing and improved methods for doing so.

Measurement: that there is a coordinated global portal allowing access to examples of effective practice and innovation that is supported by nursing organizations and available to nurses and policy makers globally.

What has the campaign accomplished so far?

We now have 170 Nursing Now groups in 77 countries and growth continues. We are a social movement that works through its groups and networks to change the culture of nursing, and feedback so far suggests that the campaign has come at a moment when nurses are ready for change.

What do you hope to have happen in the next year?

WHO has declared 2020 will be the Year of the Nurse and Midwife and is preparing a State of the World’s Nursing Report—the first one ever. While there is support at WHO for nursing and midwifery, the presence of a global campaign has highlighted the significant issues in nursing development if Universal Health Coverage is to be achieved.

Our Nursing Now groups are spearheading initiatives to tackle today’s health issues—for example, how to achieve universal health coverage, the health of homeless people, gender-based violence, men in nursing, the image of nursing and midwifery, and many more.

How can nurses and/or health care providers become involved in it?

We have a great web site which invites comments and case studies. Please explore it and contact us if you have ideas. This is a movement that belongs to all nurses.

To learn more about Dr. Stilwell and the global campaign, visit www.nursingnow.org or check out the radical advocacy special issue of Creative Nursing.


NOBC Wants More Nurses Serving on Boards: Here’s Why

NOBC Wants More Nurses Serving on Boards: Here’s Why

In 2017, the Nurses on Boards Coalition (NOBC) was founded with the mission “to improve health in communities across the nation through the service of nurses on all types of boards.

Laurie Benson, BSN, Executive Director of NOBC says that “The vision of NOBC was created in direct response to The Institute of Medicine’s 2011 landmark report, ‘The Future of Nursing: Leading Change, Advancing Health,’ which called for nurses to play a more pivotal decision-making role on boards and commissions. NOBC represents national nursing and other organizations working to build healthier communities in America by increasing the presence of nurses on corporate, health-related, and other boards, panels, and commissions.”

Benson answered some questions about NOBC.

Why is it important for nurses to be a part of boards? What do they bring to the table that other health care workers don’t?

All boards can benefit from the nursing perspective. Nurses possess a wide range of skills including strategic planning, critical thinking, quality and process improvement, communications, human resources, finance, and complex problem solving.  Accustomed to working in teams, nurses fit naturally into the boardroom environment. Always connected to the mission, they understand the challenges, opportunities, and implications of decisions on many levels.  Other health care workers certainly make important contributions to the boardroom as well. Nurses welcome the opportunity to serve alongside colleagues and other leaders to make a collective impact.

With 3.6 million nurses in our country, nurses represent the largest segment of our health care workforce.  It simply makes good business sense to have the nursing perspective representedin all placeswhere decisions and policies affecting health are made including corporate, governmental, nonprofit, advisory, governance boards, commissions, and panels or task forces that have fiduciary or strategic responsibility. 

Is this just to encourage NPs to be on boards or nurses of any rank and experience level? Why?  

There is a place in the boardroom for nurses across the continuum. While certain boards require specific rank and experience, many seek candidates at a variety of levels of experience and practice, especially with the increased emphasis on bringing diverse perspectives into the boardroom. Boards are most interested in how a candidate will contribute and bring value to discussions in the boardroom. With each board opportunity, NOBC makes sure we understand the profile of the ideal candidate and then match the opportunity with the skills, experience, qualifications, and interests of those registered in the NOBC database as interested in serving.

A few recent examples include a doctoral graduate who was invited to serve on a nonprofit board for an organization that provides respite care for parents and families of children with daily medical needs; another nurse (BSN, RN) with less than 5 years of experience was invited to serve on an advisory board for a national company who was seeking wider generational representation; and a faculty member (DNP, RN, CNE, NEA-BC), who will soon be retiring, was selected to serve on the board of a national health care start up organization focused on care of the aging.  There are unprecedented opportunities for nurses to serve on boards in every community across our nation!

Has this been started more because nurses weren’t seeking board positions, boards weren’t seeking nurses as members, or both? Please explain.  

NOBC wasn’t started for nursing, it was started by nursing. National nursing association leaders came together with one purpose in mind—to work together to improve health for all. However, not all boards are necessarily aware of the growing interest, demand, and impact of nurses serving on boards. NOBC members, partners, sponsors, state contacts, and others are doing a great job in increasing the awareness and visibility of the expansive and exceptional nurse candidate pool that is available to all boards.

What are nurses’ roles on boards? 

Board governance is an extension of leadership.  As leaders, nurses can serve effectively in all types of governance roles based on the structure and specific needs of each board. Nurses serve as Board Chairs, Board Committee Chairs, Committee members or at-large members—wherever the need matches with their skills, interests, and their ability to contribute value. The varied roles for nurses on boards are the same as for others serving on the boards. Boards contribute collectively, not based on the individual board members. Nurses especially thrive when serving on high performance boards, serving as a contributor toward the good of the whole.

Suppose a nurse would like to join a particular board. What should he or she do to pursue it?

Nurses who are interested in serving on a board should start with your passion! Next, conduct a self-assessment and prepare a one-page board biography. Build your skills through nursing leadership resources and talk to other nurse leaders to learn from their experience. Let others know of your interest in serving on a board and contact an organization whose mission aligns with your interests. Register on the NOBC website at www.nursesonboardscoalition.org to be included in the database for consideration for future board opportunities and to access many resources to support you on your board journey.

Be bold! You don’t need to wait until you have all the answers to pursue a board opportunity. Remember, there will be others on the board who have complementary skills and experience to round out the board composition. While you will be providing a valuable contribution through your board service, nurses always tell us they get so much more from the experience than they could ever hope to give.  Create an action plan today to raise your voice in a boardroom that is right for you!

What else is important about the Coalition and its mission that is important for our readers to know?  

We are experiencing great momentum and success! The NOBC current thermometer count is at 5,724 board seats toward our key strategy of 10,000 by 2020. I invite you to join us in this important work.  Please contact me at [email protected] to explore how we can collaborate to make a significant impact, together, where you live and work.

Lastly, if you serve on a board, please consider a nurse as a candidate for your next board seat!

Six Ways CRNAs Can Manage Risk

Six Ways CRNAs Can Manage Risk

Certified Registered Nurse Anesthetists (CRNAs) provide important anesthesia care for many different types of surgeries and services. However, as they gain more and more autonomy, their risk for facing malpractice lawsuits increases as well.

“CRNAs practice with a high degree of autonomy, and they play a critical role in patient outcomes,” says Georgia Reiner, Risk Specialist, Nurses Service Organization (NSO). “This also makes them more vulnerable to a malpractice lawsuit if anything goes wrong.”

According to Reiner, although most states still require that CRNAs work under physicians’ supervision, some states—and the number is growing—are allowing them to practice independently. The good news is that, as Reiner says, CRNAs have been able to provide a lot more anesthesia care in more rural areas of the U.S. that otherwise wouldn’t be able to—such as including obstetric, surgical, and trauma services. “CRNAs are also trained and qualified to treat pain patients. With the ongoing opioid epidemic in the U.S., and with millions of patients still suffering from chronic pain at the same time, the services CRNAs provide are essential to promoting safe and effective pain management,” explains Reiner.

As for the top risks that CRNAs face, Reiner says, “According to claim metrics from NSO’s underwriter, CNA, some of the top allegations made against CRNAs in malpractice lawsuits involve improper treatment or intervention during a procedure, medication errors, inadequacies in the anesthesia plan, and failure to monitor the patient’s condition. CRNAs encounter these liability risks on a daily basis, so it is important for them to identify and manage these risks to protect their career and livelihood while also improving outcomes for their patients.”

The NSO recently reviewed two case studies and then identified six ways that CRNAs can manage risks. They are as follows:

1. Maintain competencies (including experience, training, and skills).

Competencies should be consistent and up-to-date with the scope of authority granted by state law, the needs of the CRNA’s assigned patients, patient care unit, and equipment.

2. Obtain and document informed consent for any planned anesthetic intervention.

Patients or the patients’ legal guardian must be informed of the potential risks, benefits, and alternatives to the planned anesthetic intervention and surgical procedure(s). CRNAs should verify that informed consent was obtained by a qualified member of the patient’s health care team and documented in the patient’s health care record prior to any intervention.

3. Document pertinent anesthesia-related information in the patient’s record.

Review the patient’s clinical history, including relevant social and family history; evaluate the patient and determine if they are appropriate for anesthesia and the proper method of anesthesia. CRNAs should document this process, including their rationale, and any discussions with the patient.

4. Communicate in a timely and accurate manner initial and ongoing findings regarding the patient’s status and response to treatment.

It is essential for CRNAs to report changes in the patient’s condition, any new symptoms displayed by the patient, or any patient concerns to the practitioner in charge of the patient’s care in a timely manner. Document patient responses to treatment, whether positive or negative.

5. Provide and document the practitioner notification of changes.

In addition to communicating any change in the patient’s condition or symptoms, or any patient concerns, CRNAs also need to document the practitioner’s response and/or orders in the patient’s health care record.

6. Report any patient incident, injury, or adverse outcome.

CRNAs should report any patient incident, injury, or adverse outcome, and the subsequent treatment and patient response to their organization’s risk management or legal department. If CRNAs carry their own professional liability insurance, they should alert their insurance carrier to any potential claims, as timely reporting ensures that an incident, if it develops into a covered claim and is not excluded for other reasons, will be covered.

“Facing a malpractice suit can be stressful and overwhelming because it is a long, unpredictable, and costly process. One step I recommend for CRNAs to take is maintaining their own professional liability insurance to help protect their careers,” says Reiner.

How Friendships Between Nurses Can Reduce Stress

How Friendships Between Nurses Can Reduce Stress

Nurses have intense experiences that most other health care workers don’t. As a result, they tend to have a great deal of stress. Having friendships with other nurses tends to alleviate it and help in more ways than you might imagine.

Only nurses understand what other nurses truly go through, says nurse practitioner, former attorney, author, and career/lifestyle blogger Meika Mirabelli, JD, MSN, FNP-C, founder of BeautyinaWhiteCoat.com, which helps both health care students and professionals live balanced, successful lives through sharing career and studying tips. Mirabelli knows firsthand how having friendships with other nurses can make a huge difference in the workplace—and how not having them can hurt.

“I have experienced horrible treatment by nurses who were in the field of nursing longer than I have been. During those times, I would have to lock myself in the bathroom to hide and cry. I would count the days until I was done with that job and celebrated when I turned in my resignation,” Mirabelli recalls. But the good has outweighed the bad. “I have also worked with great nurses with whom I still have a bond today. My experience with those wonderful nurses definitely reduced stress and made me a better nurse and a better person. I have thoroughly enjoyed my shifts when I have coworkers that I could call my friends. I also was able to sleep better at night and looked forward to going to work.”

Research has shown that friendships between nurses can reduce stressful situations. A 2016 study published in PLOS ONE found that the “degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses.” The study concluded overall that the “strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress.”

While it’s important to understand what research has discovered, it’s just as—if not more—crucial for nurses to know how this can help them in real-life situations.

Why Friendships Help

“There will always be bonds and friendships forged when you work with people in close proximity for long periods of time,” says James LaVelle Dickens, DNP, RN, FNP-BC, FAANP, who serves in the U.S. Department of Health and Human Services regional office in Dallas, Texas, as the senior program manager officer for the Office of Minority Health. “Having strong friendships at work is known to reduce stress. A study by Gallup found that people with a best friend at work are seven times more likely to be engaged with their job.”

“I can think of many times when friendships with other Nurse Practitioners (NPs) have made a difference in my life,” says Dickens. “Sometimes, it’s having someone lift our own spirits after we’ve delivered a difficult diagnosis to a patient. Sometimes, it’s offering a younger colleague with coaching to help them be the best professional they can be.”

“Nobody really understands what a nurse does like a nurse, so those relationships provide support, and that support helps bring stress down,” says Benjamin Evans, DD, DNP, RN, APN, PHMCNS-BC, president of the New Jersey State Nurses Association.

Evans explains that what makes nurses so different from other health care professions is that they are with patients more than anyone else. Other health care professionals may come and do a test, treatment, or procedure on a patient, but then they leave. The nurses are the ones who stay behind and help the patients cope with their stress, pain, or fear resulting from these processes or their conditions.

But this is just one example of why nurses have so much stress. Dickens says that other reasons are heavy caseloads, interactions with patients and their family members who may not recognize the significant challenges of their complex health conditions, and dealing with death.

“Oftentimes, the families are more demanding than the patients,” says Evans.

“Every decision a nurse makes affects the health status of their patients,” says Judith Schmidt, RN, MSN, ONC, CCRN, CEO of the New Jersey States Nurses Association. “The public doesn’t realize how stressful these areas can be. If a nurse makes a mistake, it can mean a patient’s life. You have the life-and-death situations with the patients, their families, and the administration.”

“Nurses have the type of job that requires a lot of mental clarity, physical demands, and empathy towards patients and their families,” says Flo Leighton, MS, RN, PMHNP-BC, a board-certified psychiatric nurse practitioner in private practice at Union Square Practice as well as an adjunct faculty member at New York University Rory Meyers College of Nursing.

The difficult work, both physical and mental, is why having friendships is necessary. It’s also great to have others who completely understand you.

Friends “Get” You

Erin Parisi, LMHC, CAP, owner of Erin C. Parisi Counseling & Consulting, LLC, learned about nursing friendships while working as a therapist in a residential treatment setting alongside nurses every day. “My biggest takeaway has been that having friends who are ‘in the trenches’ with you helps manage stress. In nursing, not only are you coping with the system you work in, with a boss/manager you may or may not like, and office politics, but you also have a really specialized knowledge that not everyone has,” says Parisi. “In a system where not everyone you work with is in the same role, you might end up feeling a little more alone in your job. Non-nurses who don’t have the same or similar training may not understand your jokes or fully wrap their heads around your stressors.

“A lot of nurses have a dark sense of humor, which not everyone has an appreciation for. Not only is the friendship of a fellow nurse providing stress relief, but being able to make dark/weird/gross jokes to someone else who will understand and also think it’s funny can reduce stress in a big way,” explains Parisi.

“Sharing a laugh in the midst of a stressful day lowers your blood pressure and helps put everything in perspective,” says Dickens. Having someone else who understands what makes nurses tick and what makes the profession unlike any other serves as the backbone of these types of relationships, he adds. “Having that support network and camaraderie does an NP’s mental health a ton of good.”

Shanna Shafer, RN, BSN, nursing expert, managing editor, and strategic communications manager at BestNursingDegree.com has spent ten years in the nursing field working in everything from home health, hospice, a community health center to vascular access, and in a burn intensive care unit. At the burn unit she says, “Friendships with other nurses blossomed and were essential to my own survival and mental health.” The bonds that nurses develop in various situations are amazing, she adds.

Parisi adds that nurses witness and work on a daily basis with experiences that most people do not. While everyone else in a nurse’s group outside work—non-nurse friends, family, spouses, and significant others—can provide support, they simply can’t connect with nurses like other nurses or coworkers can.

“Given the fact that nurses spend so much time at work—sometimes even more time than at home with loved ones—having friends at work can help make a shift more enjoyable. Nurses who work with you know what the day-to-day struggle looks like on any given shift,” explains Leighton. “The ability to get perspective from a work friend who understands how to handle on-the-job situations builds resilience and normalizes stressful situations. It makes us feel like we’re understood and not alone in the tasks that challenge us.”

Having someone who “gets” you, can reduce stress and make you feel better in various workplace situations. “Research has shown that social health is an importance factor in stress management. Therefore, friendships among nurses could influence rewarding benefits in processing work-related stressors,” says Amy Moreira, LMHC, owner of More MH Counseling, LLC. “The nursing field is a challenging, demanding, and rewarding job with its own characteristics that are, at times, not fully understood by the general public…A nurse who finds friendship with other nurses can benefit from their shared direct experience, allowing themselves to feel better heard and understood—which is an important part of healing in stress management. Potential solutions can be offered from a different perspective with a more solution-focused outcome than advice from other friends and family. Workplace friendships among nurses allows for in-the-moment support and allows for open processing without the need to explain certain contextual aspects.”

Nurses Eat Their Young

There’s the old adage that “Nurses eat their young.” Some more experienced nurses have been known to let the young ones flounder. Nurse.org, though, has a new campaign to dispel this adage called “Nurses support their young.” The campaign is significant because when nurses are friends, the stress of the entire unit, floor, or facility can decrease.

“It’s important for nurses to friend new nurses to allow for effective learning and adjustment on the team, including the patient,” explains Moreira. “Establishing friendships and aiding newer nurses can contribute to a more positive workplace environment and job satisfaction. Friendships between nurses can allow for a more experienced nurse to take on a ‘coaching’ role that enables stress-free learning with laughter, support, and understanding. Working past any frustrations associated with newer nurses lacking knowledge can often be processed when reflecting upon past mishaps in the experienced nurse’s own career.”

“It makes for a healthy work environment when there are coworkers whom you work with whom you can be friends with and discuss difficult issues and challenges that you couldn’t to someone outside the profession,” says Schmidt.

And a healthy workplace will influence other people and environments as well.

The Ripple Effect

When nurses are friends, they aren’t just nice to each other, but they look out for each other. While working as a staff nurse, Leighton developed a core group of nursing friends. “We collectively pitched in to make sure that if someone needed a day off or a last-minute shift coverage, we helped one another. It was an unspoken understanding that we took care of one another,” she recalls.

“While I think that friendship is important in all aspects of our lives, we do know that workplace friendships are tied to higher levels of job satisfaction, engagement in work and performance, as well as overall team cohesion,” says Dickens. “I wholeheartedly believe that a support system at work and in our personal lives is key.”

Nurses who have friends in their workplace can also assist each other during stressful situations by giving each other someone to vent to. “It can put that nurse who is stressed in a better frame of mind. It almost permeates an entire unit if one nurse is stressed and could cause others to become stressed,” he says.

Dickens adds that if a nurse is stressed, patients can sense it in the nurse’s voice and body language. But the opposite is true as well: a happy nurse can make a happy patient.

And sometimes a happy nurse, can just make a happy nurse. That can be essential enough. Nurses who are less stressed because of friendships can have improved mental, emotional, and physical wellness, says Moreira. “Nurses with reduced stress often prioritize self-care, which allows them to give their best selves to others.”