It is generally agreed that a vast majority of nurses choose the profession because they find fulfillment in being of service to others in their time of need. 

Compassion, empathy, and kindness are hallmarks of what “nursesness” is all about, and even members of the general public are likely to associate those characteristics with nurses. And by now, we’re all aware that nurses have been at the top of the Gallup poll as the most trusted professionals in the U.S. every year for two decades.

In light of the mystique of compassion and kindness that surrounds nurses like a golden aura, why is it that stories of nurses being unkind to one another are so rampant? What about nurses making us treat one another so poorly, leading many nurses to leave the profession altogether?  

Incivility Abounds

Stories of incivility, bullying and other unfortunate experiences are ubiquitous among nurses, and common refrains repeated again and again within the nursing sphere tell us that something is wrong out there.

  • A new grad nurse tells the story of a preceptor who seems determined to sabotage her orientation period, assuredly setting her up for failure and job loss.
  • A quiet, hardworking nurse becomes the undeserving target of rude and demeaning behavior by the “queen bully” on her unit. Other nurses follow the bully’s lead when it comes to treating this nurse with disrespect.
  • Several student nurses realize that their clinical instructor has it in for them, ignoring their requests for help during clinical rotations and harshly criticizing them in front of patients and peers.
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Nurse Bullying: What's Going On?

Nurse bullying has received significant study, including the National Library of Medicine’s documentation of this unfortunate phenomenon:

Nurse bullying is a systemic, pervasive problem that begins well before nursing school and continues throughout a nurse’s career. A significant percentage of nurses leave their first job due to the negative behaviors of their coworkers, and bullying is likely to exacerbate the growing nurse shortage. A bullying culture contributes to a poor nurse work environment, increased risk to patients, lower Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores, and greater nurse turnover, which costs the average hospital $4 million to $7 million a year. Addressing nurse bullying begins with acknowledging the problem, raising awareness, mitigating contributing factors, and creating and enforcing a strong antibullying policy. Nurses and stakeholders also must actively work to change the culture, and understand that bullying has no place in the nursing profession or anywhere else in health care.

These statements are sadly true, and the problem is too well documented to ignore.

A Cultural Transformation

Within the nursing profession, a cultural transformation is desperately needed. Rather than nurses internalizing their oppression and taking it out on one another, members of this most trusted profession could choose to individually and collectively examine how they feel oppressed, mistreated, and otherwise overlooked. This type of examination can lead nurses to band together to create workable solutions without turning on one another like crabs boiling in a pot.

In terms of nursing education, schools of nursing need to confront bullying and incivility head-on. And since schools are so keenly focused on NCLEX preparation, this topic needs to become a part of the licensing exam curriculum so that schools have no choice but to talk about it. This ever-present reality must be thoroughly acknowledged, and schools should teach nursing students how to recognize such behavior and respond appropriately. And if clinical instructors and nursing professors are identified as perpetrators, they should be disciplined and fired if their behavior does not change.

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Quit Your Job and Keep Your Professionalism

There is no silver bullet that can singlehandedly change these dynamics overnight. However, one action by a nurse, executive, instructor, or manager can have a significant ripple effect. Nursing is uniquely positioned to be the largest segment of the healthcare workforce. We can squander or harness our potential power for our well-being. Nurses join collective action, striking for safe staffing, patient safety, or other needed changes. Positive change can be hard-won, but the camaraderie and unity it engenders are priceless.

Nurses deserve better from one another, and we can only effect change if we’re willing to do the work to dismantle a professional culture that looks the other way. Unfortunately, ignoring the problem won’t get rid of it, so let’s tackle it head-on and stop the hemorrhaging of nurses who would likely remain on the job if they were simply treated like the valuable human beings they truly are. 

Minority Nurse is thrilled to feature Keith Carlson, “Nurse Keith,” a well-known nurse career coach and podcaster of The Nurse Keith Show as a guest columnist. Check back every other Thursday for Keith’s column.

Keith Carlson
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Nursing Career Change and the Soul
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