There is a disturbing truth within the nursing profession that few would readily admit nor would the general public understand: nurse bullying and other forms of incivility are widespread phenomena.
While nursing still holds the distinction of being voted year after year in the Gallup Poll as the most honest and ethical profession, that trust could be severely undermined if the public knew how poorly nurses treated one another. After all, would patients truly feel so trusting if they knew that nurses were regularly sabotaged and abused by their own colleagues? Such destructive behavior calls into question the very mission of the profession.
Excluding the eradication of bullying from healthcare environments, nurses must at the very least understand how to respond when on the receiving end of such spurious conduct.
The reality of bullying
According to “Our Own Worst Enemies: The Nurse Bullying Epidemic,” a 2019 article published by Nursing Administration Quarterly, “60% of nurse managers, directors, and executives in a 2018 study said they experienced bullying in the workplace, and 26% considered the bullying ‘severe.” Another study elucidated that up to 78% of student nurses reported being bullied. Related studies reveal that over half of nursing students report witnessing nurse bullying during rotations, and as many as 60% quit their first nursing job solely due to the aberrant behavior of coworkers.
“Bullying is rampant in many toxic work environments,” sharesSharon Weinstein, MS, CRNI-R, RN, FACW, FAAN, CSP, a nurse, author, consultant, and keynote speaker. “It seems to be hierarchical when it comes to the healthcare professions. While bullying was at epidemic proportions prior to the pandemic, the stressors associated with COVID-19 have placed an even greater strain on staff and systems.”
According to Weinstein, “nurses have been referred to as ‘the oppressed oppressors’ (seethe qualitative study published by Rooddehghan and colleagues in 2015). Breaking down barriers is long overdue; is it a power struggle or the concept of being ‘not good enough’?”
Weinstein continues, “I recall a time during my initial three-year program when the perpetrators were the night supervisors. As a 19-year-old, I perceived a certain supervisor as ‘The Wicked Witch of the West’; when she entered the unit and snapped her fingers, everyone (including the residents) jumped. We all lived in fear of Miss S. Now, decades later, I realize that sometimes the bully has been bullied at one time or another; the vicious cycle continues until sometime puts a stop to it.”
In the presence of an ongoing nurse shortage, it is a sobering fact that numerous nurses are driven from their workplaces — or perhaps from the profession itself — due to the maltreatment received at the hands of colleagues.
Pushing back against bullying
In terms of responding to bullying, Weinstein postulates: “There is no doubt that bullying contributes to the shortage. The so-called ‘Great Resignation’ has impacted many industries, including healthcare. By creating a culture of accountability, nurse leaders can go a long way in developing a zero-tolerance rule for bullying and incivility. Participating in structured team training to avoid disruptive behaviors contributes to stronger teams. Bullying drains energy, impacts retention, and contributes to poor outcomes. By implementing a reporting system, leaders can educate staff regarding codes of conduct, hold others accountable for their actions, and demonstrate respect.”
“If a nurse is being bullied, they can walk away, maintain their cool, and find a safe space,” according to Weinstein. “When a nurse witnesses a colleague being bullied, they can listen, be there, be supportive, and report the behavior.”
Walking away from a bully is easier said than done, however. Most facilities have policies and procedures to address workplace bullying and harassment. Always document any instance of bullying. Keep copies of emails, notes, or text messages from the alleged bully as well as a time-stamped diary of events to include:
Date and time of incident
Name of the alleged bully
Name of witnesses
Describe the incident in as much details as possible
Include any physical or verbal threats or assault
Report each incident and keep documentation of your report, including the outcome. This documentation can prove to be invaluable when dealing with a bully or abusive behavior later.
Nurse, author, consultant, and filmmaker, Candy Campbell, DNP, MSN-HCSM, RN, CNL, FNAP suggests specific strategies if a nurse witnesses a colleague being bullied: “One frequently effective method is to make eye contact with another nurse nearby (if possible), stand behind the nurse being bullied and say something to disarm the situation, like ‘Whoa, that sounds harsh; what’s going on?’ If the bully tells the supporting nurses it’s none of their business, there are phrases that can be used to further disarm the situation, for example, ‘I’m just saying that even if we disagree, we have a responsibility to speak kindly to each other.’”
Campbell continues: “The research in change management shows that adults change behaviors when the reward is great enough to alter the attitude towards the steps that are needed to make the change. In my experience, the most effective way to combat bullying behavior is to offer applied improvisational exercises that facilitate relationship-building and emotional intelligence skills in a non-work environment.” (Read more about Campbell’s research: Improv to Improve Healthcare: A System for Creative Problem-Solving.)
Taking responsibility
In the final analysis, those on the receiving end of such noxious behavior hold responsibility to not allow the bullying individual(s) to control the situation. Colleagues witnessing a peer being bullied also bear responsibility to speak up and step in since their silence could be taken as complicity by all concerned.
Leadership must make it easy for nurses to report bullying. Nurse managers, executives, and others in leadership must have the foresight to create cultures where nurses know their psychological well-being and job satisfaction are prioritized. If attrition is triggered by the presence of a bully and no consequences result, morale and retention will plummet and patient care and outcomes will suffer. Abusive staff must be held accountable, disciplined, and removed if they cannot change.
As the very connective tissue of the healthcare system, nurses must be afforded work environments in which they can thrive and practice to the highest possible level in order to elicit the patient outcomes that all desire to realize. If bullying and incivility are not allowed to flourish, such goals are much more likely to be within our grasp, as is the retention of excellent nurse clinicians.