DiversityNursing Blog

A More Caring Response to Nurse Bullying

Posted by Erica Bettencourt

Wed, Jul 09, 2014 @ 10:47 AM

By Vivien Mudgett

Nurse Bullying 02.jpg

Chances are, if you have been a nurse for more than six months, you have been exposed to bullying or disruptive behavior. Research shows that more than 82% of nurses have been a target of bullying or have witnessed it. Over 60% of new nurses who experienced bullying are planning to leave their jobs. The frightening part of these statistics is that bullying is underreported!

Defining Bullying

Bullying is not an isolated incident. It is deliberate, rude, inappropriate, and possibly aggressive behavior of a coworker(s) to another coworker. The behavior is repetitive in nature, and may be overt or covert. It can also reflect an actual or perceived imbalance or power or conflict.

Bullying and disruptive behavior has been recognized as a threat to a nurse’s well-being and a threat to the safety of our patients. When a care team cannot get along, errors are made, patients feel the tension, and patient outcomes suffer.

As nurses, we are all working today in a very stressful environment with heavy workloads. More demands are being added on almost a daily basis. We are struggling to take good care of our patients and the stakes are high. Adding bullying to this equation makes the situation worse.

The paradox of bullying in nursing is that we all joined this marvelous profession because we are caring individuals. We want to show our compassion and be a healing presence to others. So how is it that this behavior is so prevalent in nursing? Research shows that the behavior continues because nurses are afraid of retaliation, normalize the behavior, don’t like conflict, and don’t really know what to do.

Here are 3 steps you can take to address this uncaring behavior in a caring way:

  1. Stop and breathe!

    Separate yourself from the behavior for a moment and realize that YOU are not the cause.

  2. Diffuse the situation.

    Do not react. Sometime reacting too fast can cause you to behave unprofessionally as well. As calmly as possible, ask to talk in private. If the behavior continues, be prepared to be the one to walk away.

  3. Address the behavior.

    Find a private place to openly discuss the behavior and address the conflict.

    Two open ended discussion starters can be:  

    “When you yelled at me in front of the patient (or our co-workers), I felt humiliated. It was unprofessional and now the patient’s trust in the healthcare team has eroded. Was that your intent? Can we agree that in the future, if you have a problem with me, you will address it with me privately?”

    “Are you OK? Help me to understand the situation. I’ve noticed a conflict between us and I think it’s affecting the way we work, can we talk about it?”

In a perfect world, these 3 steps can alleviate and resolve the conflict between nurse co-workers. However, be prepared that it may take further discussion and possibly, include your unit supervisor or nurse manager. By addressing uncaring behavior, you are standing up and choosing not to be a victim.  

If you see someone else being bullied, don’t be a passive bystander. Stand next to the person and use supportive phrases while helping the person being bullied. This is especially if they are not able to speak for themselves at that moment. Most importantly, and most difficult to do: Stay calm, be confident, and always behave with integrity. Take the higher road.

Have you dealt with nurse bullies in the past? How did it go? Let us know in the comments.

Source: nursetogether.com

Topics: nursing, bullying, hospitals

When 'Mean Girls' Wear Scrubs

Posted by Alycia Sullivan

Fri, Jun 28, 2013 @ 02:57 PM

By Alexandra Wilson Pecci

Source: Health Leaders Media 

For many nurses, leaving high school doesn't mean leaving the bullies behind. Bullying has been called nursing's "dirty little secret," but judging by the numbers, it's hard to believe it could be kept secret at all.


Cheryl  Dellasega, PhD, RN, CRNP


Cheryl Dellasega, PhD, RN, CRNP

Most women can relate in some way to the 2004 Lindsay Lohan movie Mean Girls, in which her character encounters a group of bullying high school girls who say things like this: "Half the people in this room are mad at me, and the other half only like me because they think I pushed somebody in front a bus."

But while most women can leave memories like this behind when they graduate from high school, for those who enter nursing and become victims of nurse-on-nurse bullying, leaving high school hasn't made the mean girls disappear; they're just wearing scrubs now.

Bullying has been called nursing's "dirty little secret," but judging by the numbers, it's hard to believe it could be kept secret at all.

Twice as many nurses as other Americans have experienced bullying in the workplace. According to study of 612 staff nurses in theJournal of Nursing Management, 67.5% had experienced bullying from their supervisors, while 77.6% had been bullied by their co-workers. Compare that to the 35% of Americans outside healthcare who've reported workplace incivility, says the Workplace Bullying Institute.

Not only is bullying among nurses an issue, it's one that most nurse managers aren't equipped to handle properly, according to Cheryl Dellasega, PhD, RN, CRNP, co-author with Rebecca Volpe of the new book Toxic Nursing: Managing Bullying, Bad Attitudes, and Total Turmoil.

Bullying "is a huge problem now in the workplace," Dellasega tells me. "I think a lot of nurse managers don't get a lot of training in conflict resolution."That's especially true when they have little more management experience than any of their co-workers but were promoted to the role because they have a bachelor's degree and a few extra years of seniority, Dellasega says.

Dellasega's new book is a follow-up her to When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Nurse Bullying, and aims to help managers and administrators understand and deal with bullying among their nurses.

In order to write the new book, the authors not only conducted a literature review, but also reviewed hundreds of blogs written by nurses about situations of conflict. By doing so, Dellasega and Volpe were able to identify key themes and scenarios that are common to bullying, as well as which groups of people were commonly involved in bullying.

Finally, the authors interviewed nurse management experts to give insight into dealing with such situations. "There were different pockets of nurses who seemed to be really engaged in the situation, as either a victim of the aggressor," Dellasega says. For example, new nurses are often victims.

"I think that brand new, young nurses [are] sort of the classic targets," Dellasega says. Often, these nurses are idealistic about their work and excited about how they're going to make a difference, but the older, established, more jaded nurses engage in bullying to knock them down a little. In fact, Dellasega says, sometimes the young nurses' preceptors are the ones who are doing the bullying because they feel like the role is a thankless one.

"I know that even…the literature…supports that preceptors often don't feel well prepared to do the job and often don't want to do the job," she says.

Another group of nurses who are often bullied are part-time, agency, or floater nurses who are picked on because they're not part of the regular nurses' clique.

Yes, clique. Dellasega says the regular nurses who are in the clique often make rude or sarcastic comments to or about the new person, or even go so far as not sharing supplies. Even nurses who come in from other floors can be left of out, even though they're just there to help.

Dellasega says that the cliques and bullying in a hospital comes with the same kind of baggage that most of us thought we left behind in high school. But for nurses, there's the added stake of patient safety. Although studies haven't explicitly linked increased bullying to decreased patient safety, research does say that happier nurses do their jobs more effectively. (Conversely, nurse burnout is linked to higher healthcare-associated infection rates).

"It's not a big leap to figure that when you go into work… if there's a toxic environment… you won't be able to give your full attention to patient care," Dellasega says.

Bullying also leads nurses to call in sick more often in order to take mental health days. Abusive behaviors can even cause nurses to develop post-traumatic stress disorder, anxiety, depression, or insomnia, a Joint Commission survey has found. Hospitals can also lose valuable employees to bullying and many nurses have left their jobs because of it.

"Things get to a point where they just can't take it," Dellasega says. Sometimes nurses feel like they're "going into the battle zone every day."

Nurse managers shouldn't let things get to that point. Managing relationships should be day-to-day work, not something that only happens during moments of high tension.

"Don't wait for it to get to the point that there's explosive conflict," Dellasega says.

Just as Dellasega discovered which nurses and situations tend to breed bullying, she and her co-author also discovered which environments are healthy. Bullying is rarer when there is a sense of teamwork, collaboration, and authentic communication with coworkers.

Dellasega says the ideal nurse manager is transparent, letting the staff ask questions and answering honestly, even if the answer is "I don't know, but I'll find out."

Feelings of empowerment are also important to reduce bullying and satisfaction. And upper hospital management should provide appropriate training for new nurse manager about how to effectively and positively deal with bullying.

Finally, Dellasega says nurses managers should monitor their own behavior to ensure that they're not engaged in bullying themselves, even if inadvertently. For example, sighing heavily after someone speaks could be interpreted as negative. Other behaviors to watch out for are favoritism, certain body language, gossiping, and speaking in a raised voice.

"I think nurse manager have to really monitor their own behavior and be cognizant of anything they might do," Dellasega says. "The nurse manager sort of sets the standards.

Topics: nurses, burnout, bullying, Mean Girls, coping

'Ambient' Bullying in the Workplace

Posted by Hannah McCaffrey

Wed, Aug 01, 2012 @ 10:49 AM

From Human Resource Executive Online By Katie Kuehner-Hebert

It's one thing to be bullied by a co-worker or a boss, but simply witnessing the behavior in the workplace can be enough to make a worker call it quits, according to a study of "ambient" bullying.

Researchers at the University of British Columbia in Vancouver, Canada surveyed 357 nurses in 41 hospital units and found a statistically significant link between working in an environment where bullying was occurring and a desire to leave the organization. The study was published last month in the journal Human Relationsby SAGE.

"We underestimate the power of the impact of just being around bullying in the workplace," says Sandra Robinson, a professor at UBC's Sauder School of Business and one of the authors of the study.

office bully"For those seeking to influence problematic behavior, they need to be sensitive [to the fact] that the impact of such behavior transcends the person or the group . . . actually being bullied, and that there may be other victims who are impacted by the harmful behavior, whether it comes from their supervisor or co-workers," Robinson says.

Marianne Jacobbi, senior editor at Ceridian/Lifeworks EAP programs in Boston, says research has shown that ambient bullying, or "indirect bullying" is pervasive -- 70 percent of employees say they have witnessed other people being bullied or mistreated at work.

"Bullying has a negative effect on team relationships, which creates a toxic work environment," Jacobbi says. "When [people] witnesses bulling, they think, 'This could be me next,' particularly if it's their boss."

Indeed, research has also shown that 72 percent of all bullies are bosses, she says.

HR managers should encourage an environment in which people feel safe to discuss bullying they've witnessed, and assessed that their comments will remain confidential whether they come to their boss, the HR department or the organization's employee-assistance program, Jacobbi says.

"The most important thing is creating a climate where people feel they have someplace to go when they feel uncomfortable," she says.

Ken Zuckerberg, director of training at ComPsych Corp. in Chicago, says HR managers not only have to watch out for employees with low morale after witnessing bullying, but also employees who try to appease the bully and make bad business decisions to avoid getting on their bad side.

When dealing with bullying behavior, organizations should treat it as a performance problem first and foremost, Zuckerberg says. A common mistake that HR managers often make in these situations is to take on the role of a counselor and try to figure out what is going on in the bully's life to cause them to act that way.

"One word of caution ? you want to continue to manage performance, but you don't want to be diagnosing mental-health issues," he says. "Most HR managers are not clinicians and they instead, should refer the bully to their EAP for help in uncovering what might be core issues behind bullying."

Seymour Adler, a partner with Aon Hewitt in New York and an organizational psychologist, says some people who witness bullying in the workplace feel they've been put in "a totally untenable situation of whether or not they need to try to be a hero."

"Who knows what the consequences will be if they do something about it, so they end up being passive about it," Alder says. "That can really be very corroding to their self-esteem, to how they view themselves as human beings."

If top-level managers are bullies, HR managers need to risk confronting them for the sake of the rest of the organization, he says.

"[HR managers have] the responsibility for the motivation, effective use and treatment of all of the human capital within their organizations," Adler says. "They need to be true to their value system, even if it ends up costing them their job."

Topics: management, unity, diversity, Workforce, nursing, nurse, bullying, community, career

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