Nurse Bullying is Real

From the Radical Nurses Group/Royal College of Nursing Archive, Edinburgh

In my almost 40 years of nursing, I have heard about, read about, and taught about nurse bullying, but I had never experienced it directly—until yesterday while working as a Covid vaccinator in a hospital setting.

The American Nurses Association (ANA) defines nurse bullying as “repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient.” As I write that, I wonder why they include “unwanted” in the definition. Who in their right mind would want to be bullied? And even if that were the case, it would not make bullying okay. The ANA includes bullying in its statement on workplace violence. They point out that nurse bullying threatens patient safety, diminishes quality of care, and contributes to nurse burnout/staff turnover. Nurses who are bullied suffer a host of physical and emotional repercussions, including higher rates of depression and suicide.

“Nurses eating their young” is an oft-repeated phrase when referring to nurse bullying. I imagine that Florence Nightingale was quite the nurse bully. It seems to be ingrained in our profession and treated almost like a necessary rite of passage. Nurse bullying can begin in nursing school, with students being subjected to humiliation and intimidation by professors, clinical instructors, and school administrators. In some studies (see references below), over half of graduating nursing students report having witnessed (bystander) or been the recipient of nurse-on-nurse bullying in clinical rotations. The vast majority of nurse bullying happens in hospital settings, perhaps perpetuated by the high stress, high stakes clinical outcomes, heavy workloads, and low job autonomy of nursing within the rigidly hierarchical hospital setting.

I know that many frontline hospital nurses across our country and in other countries hard hit by the pandemic are burned out and angry after over a year of treating patients with COVID-19 and seeing so many of them die. Many nurses are tired of being portrayed as “angels on earth.” And, of course, the pandemic is far from over despite the rollout of safe and effective vaccines. Perhaps the vaccine clinic nurse manager yesterday is one of those burned out, pissed off nurses. It doesn’t excuse the bullying behavior she threw my way (I’ll spare you the details but it went way past incivility) and to a patient who, post-vaccination, asked to use the restroom (located next to the clinic) and she told him curtly that he had to wait the full 15 minutes of post-vaccine observation. Seriously, a patient is a person who has the right to use the restroom. I’d had enough and escorted the patient to the bathroom, waited outside to make sure he was okay, and then excused myself from the presence of that nurse bully. And reported her behavior in the hopes that she will be removed from that specific role and offered professional coaching of some sort. But I’m not going back to that setting, at least not as a clinician. I’ll find a better place to volunteer as a nurse vaccinator.

I’m attempting to turn this distressing experience into a teachable moment, for myself, and for students I teach. I now know from direct experience that nurse bullying is real.

References:

Theresa Brown, “When the Nurse is a Bully,” NYT Well blog, February 11, 2010.

Cole Edmonson and Caroline Zelonka, “Our Own Worst Enemies: The Nurse Bullying Epidemic,” NURS ADMIN Q. 2019, vol 43(3):274-279.

Note: I received this message in response to this post:

“As I’m sure you know, workplace violence is a critical issue affecting not
only nurses, but patients and their quality of care. That’s why ANA
launched #EndNurseAbuse – a nationwide initiative to eliminate physical and
verbal abuse, sexual harassment, and bullying in the workplace.
#EndNurseAbuse galvanizes nurses, health care stakeholders, and consumers
across the nation to reduce violence and harassment against nurses. Visit the
#EndNurseAbuse resource center to see the video that brings to life actual
accounts from real nurses who have experienced various forms of violence and
abuse on the job. While you’re there, please take a minute to sign the #ENA
pledge and share!

Here’s the link to ANA’s official statement:
https://www.nursingworld.org/news/news-releases/2021/ana-applauds-passage-of-workplace-violence-prevention-legislation/

ANA Applauds Passage of Workplace Violence Prevention Legislation by U.S. House of RepresentativesMEDIA CONTACTS: Keziah Proctor. 301-628-5197 keziah.proctor@ana.org . Silver Spring, MD – Today, the American Nurses Association (ANA) applauds the U.S. House of Representatives for passing the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1195).This legislation, approved by a vote of 254-166, will help to better protect all health care professionals and …www.nursingworld.org

Once a Nurse

Always a nurse, or so the saying goes. Events of the past year, and especially of the last week, have taught me the truth of that saying, at least on a personal level.

I am and have been over the course of my 39-year career (counting from when I first started nursing school), a public health nurse (TB and hypertension control nurse with the health department in Richmond, Virginia), an inpatient stroke/neuro ward nurse, a rehabilitation nurse, an HIV/AIDS nurse at an LGBTQ community clinic, a Health Care for the Homeless nurse and family nurse practitioner. I have been (still am) a nurse researcher, a nursing professor, and a writer who happens to be a nurse. Always a somewhat skeptical/critically-thinking nurse (still am), questioning our healthcare system, our profession of nursing, and our socio-political system as a country.

Ever since the COVID-19 pandemic became a reality over a year ago, like many people throughout the world, I have reassessed my professional roles. What’s essential and what’s not? Essential: teaching population health and health policy as well as possible to our future nurses; becoming even more politically engaged to speak up on important issues like racism in health care, gender-based violence, and hate crimes against LGBTQ people/people living homeless/Asian-Americans; growing my network of politically engaged, progressive nurses across the country; spreading evidence-based public health information about the pandemic/pushing back against the cacophony of mis-information and outright lies; thinking and acting like a public health nurse, which I have realized is the kind of nurse I have always been. Not essential: university internal politics; worry about being productive with the usual expectations of grant-writing and peer-reviewed journal writing. My pandemic mantra has and continues to be: accomplish less, experience more.

This past week, the day after my two-week post second Pfizer COVID-19 vaccine dose, I began volunteer work as a COVID-19 vaccinator at a local public hospital. I asked for and received an excellent nurse practitioner mentor to shadow at first to get up to speed on the proper vaccination protocol, then sat down at my assigned station and began talking with patients and giving them the vaccinations. Yesterday, the vaccination clinic nurse supervisor introduced herself (both of us behind masks, of course) as one of my public/population health students years ago. She said she is an acute care nurse who has been working on the frontlines of the pandemic “since day one.” I thanked her for her work as a hospital nurse and as a nurse supervisor for the vaccine clinic, and gently reminded her that she is doing vital public/population health nursing.

I told my husband and family members (all, except my two-year-old granddaughter vaccinated now), that working as a volunteer public health nurse at the COVID-19 vaccination clinic feels like the most important and personally satisfying work I have done in my entire nursing career. Spread the word: These vaccines save lives and livelihoods. They give us hope.

(Please note: the photograph here was ‘staged’ and contains no patient or provider information.)