Who doesn’t admire a hard-working nurse? Gallup polls tell us nurses are consistently named the #1 most trusted, ethical, and honest profession in America. It makes sense; nurses help us get through some of our worst hours with their compassion and expertise. But that’s the patient experience. The nursing experience isn’t always so simple. Being a nurse can be gratifying and transformative – but it can also involve bullying.
One recent study found that 78% of nursing students experienced bullying over a six-month period; another study found that 60% of nurses leave their first job within six months due to negative behavior from their coworkers. Still another found that 72% of nurses reported unprofessional behavior from a provider in the last year.
The stereotype depicts older nurses bullying new nurses, something our Chief Nursing Officer Brenda Rojas admits is sometimes true. But the mistreatment can go in multiple directions. 60% of nurse managers, directors, and executives said they currently experienced bullying, with 26% saying the bullying was “severe.” Registered nurses (RNs) might bully licensed practical nurses (LPNs), or staff in a specific unit might ostracize nurses in another unit.
Nurses also face bullying from patients and their families, including physical and verbal assaults. A 2020 review of healthcare workers found 61.9% experienced some form of workplace violence.
“Some patients will spit on you, kick you, throw stuff at you, or pinch you. Their families might call you names,” Brenda said. “Some intoxicated patients in the ED have tried to grope nurses.” She noted that such behavior can come from frustration and fear over a loved one, but emphasized that “being berated and belittled is not part of the job.”
From Staff Sabotage to Nursing Shortages
Multiple nurses report bullying from physicians and hospital leaders. Some report being consistently tasked with the toughest, dirtiest work, with other staff refusing to help. Brenda mentioned instances when she’s observed providers refusing to help lift or restrain patients; in one emergency department, she saw a physician laugh as a patient fought against a nurse.
In some fast-paced environments, busy nurses may resent being asked to help onboard new staff. Brenda recalled a moment in her career when she started at a new facility, only to have the nurse supervisor tell her bluntly, “I don’t have time for you” and leave her at the nurses’ station. In another case, she witnessed current nurses refusing to help a new nurse navigate their system. In yet another, a veteran nurse told locum tenens staff, “Why are you even here? We don’t want you here.”
“I tried to put a stop to it immediately,” Brenda said. “Yes, we’re all busy, but you can’t complain about being burned out if you don’t help new nurses join your team.”
Toxic environments can do more than ruin a nurse’s shift – they can drive nurses out of the profession and exacerbate the growing nurse shortage. They can also impact patient care. Good medicine is collaborative, facilitated by smooth teamwork and support on the front line and back end. Nurses who find their work disrupted by difficult patient families and hostile colleagues will struggle that much more to deliver exceptional care.
“I tell everyone it’s our job to always remain professional,” Brenda said. “We don’t have to like each other but we have to respect each other.”
5 Anti-Bullying Tips for Nurses and Facilities
Nurse bullying may be destructive, but it’s not inevitable – or rather, it doesn’t have to be. At Tribal EM, our mission isn’t just about a better patient experience. We elevate workplace cultures for healthcare professionals as well. Here are a few practices we’ve found effective for improving hospital and clinical environments.
- Learn to recognize the many faces of bullying and harassment. Rudeness, physical violence, sexual harassment, and threats are overt. But bullying can also include malicious gossip, assigning undesirable tasks as punishment, extreme micromanaging, passive-aggressive remarks, and insulting a nurse’s background, race, religion, or identity. Cyberbullying – posting cruel remarks or rumors in private chats or on social media – is just as damaging, even if the bully does so at home and not at the facility.
- Create and share documented policies that clearly define bullying and harassment. A supervisor who only recognizes overt forms of bullying might dismiss a legitimate complaint. Help all staff understand when a comment or action is appropriate and when it falls under the harassment umbrella.
- Appoint a task force to oversee bullying complaints and create improvement programs. If reports stop with different supervisors, it can be hard to get an accurate big picture of your culture and the extent of the problem. The team can begin with a survey, launch new antibullying campaigns, and measure progress over time.
- Develop training and educational modules. While your hospital probably already has anti-harassment onboarding videos, consider developing modules that focus specifically on helping people recognize and address bullying in every role – victim, witness, supervisor, and bully. Breakroom posters, newsletter articles, coaching, and annual training refreshers can help staff be more mindful of their behavior.
- Create and communicate clear reporting pathways. Too many nurses suffer in silence because they don’t know who can help them or they’re skeptical that anything will change. Brenda’s recommendation is to always report bullying to the correct supervisor. “Speak up – don’t take it,” she said. “I’m available 24/7 for Tribal EM nurses, but if I’m not informed, there’s not much I can do to help.”
Empowered Nurses, Healthier Patients
Patient care is as good as the people providing it. Confident, secure nurses are more likely to offer a reassuring patient experience than nervous or unhappy nurses who feel they can’t trust their colleagues. Tackling nurse bullying may never have a 100% perfection rate, but it can improve the workplace experiences for many healthcare staff – and keep more nurses in the profession.