The concept of bullying in nursing is not a new one. I remember hearing the phrase “nurses eat their young” as I started my career. I had to admit, I didn’t believe it. I wondered how it could be true that someone who had dedicated their life to caring for others could be capable of causing harm to a coworker on purpose.
As I entered the workforce, I quickly understood what kind of behaviors represent bullying. They included intimidation, belittling, and shaming. I experienced bullying at all levels, from the physician team to nurse leaders and other coworkers, and sometimes even from patients. I was young and inexperienced (as well as very introverted), so it took me years to really discover the best way to reconcile this and understand how to best manage bullying behaviors on a personal and professional level. I’m still learning. Bullying remains a pervasive problem in nursing (and in the workplace in general).
Defining the Problem
The American Nurses Association (ANA, 2015) defines bullying as “repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient.” This was the ANA formally recognizing the problem “in black and white” and stating that the nursing profession was not willing to tolerate violence of any kind from any source.
It’s important to remember the ANA’s Code of Ethics for Nurses (ANA, 2015) also states that nurses are obliged to “create an ethical environment and culture of civility and kindness, treating colleagues, coworkers, employees, students, and others with dignity and respect.” Even so, a recent survey of nurses found around 45% reporting having been bullied by other nurses, with 41% reporting verbal harassment or bullying from direct managers or administrators (Edmonson et al., 2019). Another report found that over 50% of nurses have left their job within the first 6 months because of bullying (RNnetwork, 2017).
Behaviors that represent bullying can range from shaming and ostracizing to humiliating comments, or unfair treatment that is repeated over time. This might include situations such as unfair assignments or scheduling, degrading comments directed at a person, and intimidating behaviors meant to harm or humiliate another. The emotional toll caused by this type of behavior can be devastating.
Why does this happen? Sometimes, nurses are acting based on group norms for accepted behaviors, bad role models, or peer pressure from others. Often, the behavior is ignored, normalized, or simply not reported out of fear. As a profession, we owe it to ourselves and future nurses to take action to address bullying behaviors in a way that creates a sense of trust and respect among nurses.
Steps to Take
Knowing how to manage bullying will put you in a place where you can feel comfortable taking on the behaviors when they occur. Each person’s situation is different, but here are a few ideas that may help.
- Be proactive. Seek out experiences with positive role models and teams that are focused on positive and respectful interactions as peers. It is helpful to also join interdisciplinary team projects to get experience at all levels. These peers will serve as a source of support if and when you need it.
- Learn conflict resolution techniques. Even if you have not experienced bullying or a toxic workplace, it’s a great idea to learn how to confront and address conflict. Look for conflict resolution trainings or continuing education courses on the topic of workplace violence. Seek out ways to respectfully confront and respond to behaviors in practice.
- Document bad behaviors. If you feel that you are being bullied, keep notes on the dates, times, and conversations or behaviors. This can be helpful for both your own reflection and to provide to your human resources department if you proceed with a formal complaint. It’s important to collect this information to confirm your complaint. Facts are hard to deny. Make sure to note others who may have witnessed the behavior as well.
- Confront the person. It’s not easy to do, but sometimes the best way to stop the behavior is to confront the person who is bullying. Set your boundaries. Do this only if you feel that it’s safe to do so. If you feel calm enough to manage your emotions, you could make a statement such as: “Your behavior is not professional and is not acceptable. I’d like it to stop.” If you think that the person is not aware of their behavior, you might call them out by saying something like, “I’m not sure if you realize it, but your words (or actions) are really hurtful.” You should also call out bad behaviors that you witness directed at others. Too often, people are willing to just let these behaviors go and not deal with it.
- Talk to your nurse manager, administrator, or human resources department. If bullying continues, talk to your nurse manager or your HR representative. Have your documentation ready, with facts to present to them. They can help you navigate the formal process of addressing and resolving the conflict.
- Seek out a new assignment. If your manager or leader is part of the problem, or the HR team is not supportive, ignores the situation, or otherwise allows the behavior to continue, you may want to consider seeking out a more positive work environment.
Bullying should never be considered okay or normal. Remember that it is not your fault. Everyone deserves to work in an environment that is positive and supportive. That is what a healthy work environment should reflect. As nurses, we also have an ethical obligation to our profession to address (not ignore) any pervasive problem such as bullying in the workplace.
American Nurses Association (ANA) (2015). ANA position statement: incivility, bullying, and workplace violence. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/
Edmonson C & Zelonka C. (2019). Our own worst enemies. Nursing Administration Quarterly, 43(3), 274–9. doi:10.1097/NAQ.0000000000000353
Hartin P, Birks M, & Lindsay D. (2020). Bullying in nursing: how has it changed over 4 decades? Journal of Nursing Management, 28(7), 1619–26. doi:10.1111/jonm.13117
Parchment J & Andrews D. (2019). The incidence of workplace bullying and related environmental factors among nurse managers. Journal of Nursing Administration, 49(3), 132–7. doi:10.1097/NNA.0000000000000726
RNnetwork. (2017). Portrait of a modern nurse survey finds half of nurses consider leaving the profession. Retrieved from https://rnnetwork.com/blog/wp-content/uploads/2017/02/Modern-Physician-Survey-Final.pdf
Schmidt K. (2017). How to recognize and prevent bullying in nursing. Nurse.com. Retrieved from https://www.nurse.com/blog/2017/08/23/how-to-recognize-and-prevent-bullying-in-nursing
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