I read yet another post about nurse bullying: Mean Girls of the ER. It comes on the heels of other materials meant to draw attention to the issue, such as Alexandra Robbins’ book The Nurses (Amazon link here). Although Robbins’ book is not focused specifically on bullying issues in nursing, reading it gives a fairly accurate impression of how mean people are in the field.
Just as when the weather gets hot there are more assaults, as the healthcare environment heats up there is more bullying. More work, sicker patients, fewer nurses…all lead to people taking it out on someone else. And just as beating someone up doesn’t solve anything, neither does the more passive-aggressive form of assault we call “bullying.”
In fact “bullying” is really a soft sell on the concept. The behavior I’ve seen and experienced from other staff nurses, supervisors, and physicians should be accurately termed “assault.” Objects have been thrown; yelling is common. Gossip and name-calling are run-of-the-mill.
And we are supposed to be taking care of increasingly sicker and more complicated patients while all of this is going on. Never has it been more important for nurses to stick together and act like a team. There is simply too much work. Adding verbal or physical assault by coworkers to a heavy workload, which itself often involves verbal and physical assault by patients and/or their families, is enough to cause nurses to snap. They just stop caring. They work just hard enough not to get fired.
Is that what we want from our profession? A bunch of burned out, angry nurses who no longer care about their patients?
On an individual level, the problem goes much deeper. Being subject to bullying/assault on a regular basis causes depression, anxiety, a higher incidence of substance misuse (as also treated in Robbins’ book), and, I would wager, a much higher incidence of sentinel events and errors. If you are so burned out that you no longer care, you’re logically not going to take the extra time to double- and triple-check what you’re doing.
I find that when anyone tries to address bullying in healthcare, particularly when it involves physicians, there is a 90% chance that “it’s always been this way” will come up. So? People have always raped and murdered each other, too, but we don’t shrug those acts off and say, “well, people will be people.”
For those who haven’t noticed, we are in a healthcare crisis right now, and that includes our health, our care, and the entire system in place to address both. Management that allows bullying and harassment to continue or, as often occurs, actually bullies and harasses is sinking another nail into the coffin of the US healthcare system. Nurses are the backbone of the system. We must insist on courteous treatment: from our coworkers, our supervisors, and our collaborators in other parts of medicine (physicians, respiratory therapy, phlebotomy…). Supervisors must be held accountable by their supervisors for their own behavior and that of their employees, and so on up the line.
“Zero tolerance” right now means “zero tolerance for complaining about bullying.” It has to stop.