We have a duty to address the nurse bullying culture

Nurses eat their young. If this sounds strange, you may be unaware of a silent epidemic: Nurse Bullying Culture.

Defined: Nurse bullying is a systemic, pervasive problem that begins well before nursing school and continues throughout a nurse’s career.

In 2018 a national study in health care found 60 per cent of all nurses experienced bullying during work hours, 28 per cent described the bullying as severe. One 2017 study showed a staggering 78 per cent of students experienced bullying within the first six months of nursing school.

One half of nursing students reported they witnessed and/or experienced one-on-one bullying during clinical rotations.

A 10-year RN Work Project Study found 17 per cent of newly licensed RNs leave their first nursing job within the first year, 33 per cent leave within two years and 60 per cent leave within eight years.

Why does this matter and how does this affect us all?

Bullying culture increases a risk to patients, creates a poor work environment for nurses and significantly affects the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Rising nurse turnover rates can cost a hospital $4M to $7M each year.

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What does nurse bullying look like?

Bullying can run the gamut from incivility and exclusion to physical violence and death threats.Overt bullying is the easiest to recognize. Examples include name-calling, direct threats, extreme micromanaging, insults, and criticism. Covert bullying is more passive aggressive and includes unfair assignments, withholding information, gossip, rumors, sabotage, discrimination, and undesirable tasks as punishment.

Who is doing the bullying?

Nurse bullies can be identified by three traits: they’re good at their job, oft referred to as ‘experts’ and are likely to be promoted; they do not play by the rules and might lie, cheat and sabotage staff; they need targets to survive. Without targets, a bully cannot thrive.

These three traits are key in identifying the six archetypes of nurse bullies. The PGR nurse uses put downs, gossip, and rumors (PGR) to bully other nurses and is often quick to take offense to a neutral remark. The resentful nurse develops and holds grudges, encouraging others to ‘gang up’ on the victim and creates drama, polluting the work environment. The green-with-envy (GWE) nurse shows bitterness to others who have something she/he does not. This can be social status, material possessions, physical appearance, and personality. Most victims of a GWE nurse do not realize they are being singled out as targets.

The “supernurse” is the most experienced and specialized nurse. Supernurse will display superiority via an elitist persona and attitude, speaking in a condescending manner and ‘corrective comments’. The backstabbing nurse is ‘two-faced’ and will befriend their victims with the intention to betray wielding personal information as a weapon.

Finally, the cliquish nurse. This nurse uses exclusion as a means of aggression, displaying favoritism to some while ignoring others.

Often in society nurses are held with high esteem going so far as to be revered as heroes. This enables the nurse bully to continue bullying other staff and patients by reinforcing their approach and behaviour. “Nursing is stressful. Nurses work long hours. Patients are rude.” These words may be used as bandaids for inexcusable behavior leading to further problems such as hospitals hemorrhaging good nurses as a fallout effect of nurse bullying.

Over the past 18 months I have spoken with 146 patients of Kootenay Boundary Regional Hospital (KBRH) ranging from ICU, ER, maternity and pediatrics.

Each one of these 146 people had one complaint in common. On varying levels of severity, they all say they encountered one of the six nurse bully archetypes.

I found this hard to believe so I did some research online, starting with Google reviews of KBRH.

Tracking three reviewers by name and online trail, I found each to be current KBRH staff. The majority gave one star and their reasons for doing so.

I find this shocking, leaving a bad taste in my mouth.

However, I am sure there are many good instances at KBRH.

Sadly, it will always be the reinforcers who speak up rather than the victims.

KBRH has recently undergone mass reconstruction, I can only hope this facelift includes addressing and tackling the bullies who may slip room to room each day, undetected.

NURSING TV

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