Nursing has a hierarchy of power and experience like any other profession; it also has a hierarchy that sometimes feels akin to the laws of survival on the savanna or in the jungle – the herd mentality at work.
Have you ever observed that the less experienced and more vulnerable nurses frequently get left on the outside, often falling prey to bullies and “predators”? This is the herd mentality at its worst, and many novice nurses are taken down by bullies and power-hungry colleagues who eat them alive when they’re demonstrating the slightest weakness.
Protection and Predation
Out on the African savanna, herds of gazelles keep watch for lions, one of their most fierce predators; the culling of the pack is a natural phenomenon, and lions need to eat just like anyone else. However, some naturalists notice that the sicker, older gazelles are left outside the herd, vulnerable to predation and outside of the safety of the circle. Young gazelles are naturally kept on the inside, their parents and elders protecting them and keeping them close, with the innate understanding that they are the carriers of the gene pool which need to survive into adulthood so that the species can thrive in the future.
In the healthcare environment, we often see a herd mentality; in this scenario, the experienced nurses make up the bones of the innermost circle of safety, and survival of the fittest is frequently the name of the game. But what about the newer nurses? Where are they in the hierarchy?
A Med/Surg Herd
Let’s consider a large Med/Surg unit where we find a mix of older, highly experienced nurses, some nurses two to five years into their careers, and several fresh-faced novice nurses in their first year.
Now let’s imagine a bully in the mix; she’s a nurse with 25 years of experience, a toxic personality, and a stranglehold on the unit culture. The administration is afraid of her, the nurse manager turns a blind eye to her egregious behavior, and most nurses keep their heads down and hope she doesn’t pick on or single them out.
The older, more experienced nurses may be relatively safe from the bully; they’ve known her a while, put up with her toxicity, humor her, or perhaps ignore her as much as they can to not call attention to themselves. Their silence is essentially complicity, and some may play into the bullying and tacitly empower her aberrant behavior. A bully can sometimes be a younger nurse who bullies older nurses, too; this power dynamic can work in both generational directions.
The New Nurse: Falling Prey to the Lion
Meanwhile, the newer nurses are fresh blood for the bully/lion/predator; they are unsure of themselves, need to ask questions, and are vulnerable to being singled out and stalked by the bully and her minions.
If the members of the nursing herd try to stay out of the bully’s way – or support her in being the bully – what does that mean for the newer nurses? It generally means they are kept outside the circle of protection and safety, left to fend for themselves against the nurse predator.
If you think of the nurses on the unit as a herd, the young are left outside to fend for themselves. The elders are primarily held in the center, cushioned against the attacks of the predator/bully; however, an elder nurse can also be deemed weak by the “herd” and thus ostracized to the fringes.
The calculus of this situation is untenable and unhealthy, with certain nurses receiving the short end of the stick; vulnerable novice nurses need nurturing and support, not the feeling of being thrown to the lion(s).
Extending the Circle of Safety
To counteract a situation that lends itself to the burnout and attrition of newer nurses (as well as those seasoned nurses who are vulnerable to bullies), the circle of safety needs to extend its protection to everyone. Rather than leaving more vulnerable colleagues to be picked off the edge by predators and bullies, the circle closes around those needing its reassuring sanctuary, whether older, younger, or somewhere in between.
Dr. Renee Thompson, one of the world’s foremost experts on nurse bullying and incivility in the healthcare workplace, has documented and communicated the subtleties and vicissitudes of this scourge through books, blog posts, articles, podcasts, keynote speeches, videos, social media, and the powerful work of the faculty of her Healthy Workforce Institute. As Dr. Thompson informs us, we must learn to speak up in the face of bullying and to protect those members of our team who are susceptible to a form of professional predation that sends many a nurse running for the exit, often leaving the profession altogether.
We must reject the adage that nurses eat our young; we can create and embrace a new paradigm where nurses nurture and empower their young instead.
This isn’t rocket science, but we nurses need to learn the skills that will help us to bully-proof ourselves, speak up in the face of bullying, end nurse predation, and enclose our colleagues in a circle of safety that keeps the lions on the outside and the vulnerable protected from harm.
We can make different choices, and it’s our daily decision regarding our path. I implore you to extend the circle of safety, protect the vulnerable, and bring a sense of community, safety, and symbiotic togetherness to your corner of the nursing world.
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.