The nursing profession ranks very high in honesty and ethics when Americans are polled. In a 2016 Gallup poll, “Nursing” was the #1 most trusted profession in U.S. culture, even scoring higher than doctors, teachers, police officers, and clergy! That is why nurse bullying/hazing is so shocking, and odd to talk about.
Nurse bullying can be verbal/physical harassment or threats, but it usually is not. Actual threats of violence or physical abuse from nurse to nurse actually rank toward the bottom of actual measured behavior. Nurse bullying is usually less overt, but equally detrimental to nursing teams. Researchers refer to this workplace phenomenon as ‘incivility in the workplace.’ According to a questionnaire by The Journal of Nursing Administration, this is how nurse bullying is present in the workforce, in order:
Most Common to Least Common
1) Being Ignored or Excluded/ Opinions being ignored
2) Responsibilities being removed/Ordered to work below competence
3) Being given unreasonable tasks or targets/Unmanageable workload
4) Information withheld
5) Being gossiped about/ Ridiculed publicly
6) Persistent criticism of work/ Being reminded of errors or mistakes/ Downplaying accomplishments
7) Being pressured not to use job benefits
8) Accusations made against a nurse
9) Being shouted at/ Insulted remarks
10) Being hinted at to quit
11) Excessive teasing and sarcasm/ Practical Jokes
12) Threats of violence, physical abuse
For some nurses, incivility can be tough on their self-esteem, and can be havoc in a unit. And nurses often do not report concerns after they happen. Some researchers think in a female-dominated profession that competition plays a hand in this phenomenon. It could also be that healthcare and long hours are inherently stressful and can lead to rudeness. Amplification of small issues turn into big issues in high pressure situations. Understanding that hospital environment could contribute to nurses experiencing incivility and bullying is a big part in stopping nurse bullying. Staffing, breaks, and vacation are easy ways to help staff recharge and renew.
Nurse Managers play a role in recognizing and combating nurse bullying. Their role in creation and sustainment of a healthy work environment is crucial. They can encourage their staff to disconnect from work to help with stress levels. Hospital executives and nurse leaders can implement regulations to address it, and all occurrences should be documented. The establishment of trusting relationships with staff, and support of staff perspectives should be included within daily activities. A healthy work environment can address stress, burnout, and ultimately bullying, and can have a positive impact on patient outcomes and HCAHPS scores.
The Relationship Between and Factors Influencing Staff Nurses’ Perceptions of Nurse Manager Caring and Exposure to Workplace Bullying in Multiple Healthcare Settings, Lynda Olender, PhD, ANP, RN, NEA-BC, The Journal of Nursing Administration October 2017 The first step to eliminating nurse bullying, burnout in hospitals, Beckers Hospital Review and ASC Communications, June 29 2017 8 things to know about nurse bullying, Alyssa Rege, Beckers Hospital Review and ASC Communications, April 18 2017