When Will the Bullying in Nursing Stop?

By Rose O. Sherman, EdD, RN, FAAN

The wrist band above is available at www.stopbullyingnurses.com

It broke my heart to read an assignment from one of my graduate students about her experiences with being bullied as a new nurse. She wrote, “I was demeaned by my preceptor for being stupid. She told me I did not have a brain. I was afraid to speak up. It resulted in many sleepless nights, callouts and emotional stress for me.” This would be serious enough if it was an isolated incident but unfortunately the behavior she describes is still widespread in nursing today. In a new survey of over 2,000 nursing school graduates from the class of 2014 from Kaplan Test Prep revealed that this issue is breeding fear. A staggering 48% of participants admitted they are concerned about being the victims of workplace bullying or working in a hostile environment, according to the press release. This finding should come as no surprise considering 39% of those who answered the survey knew nurses who had experienced these conditions. As nurse leaders – this is our issue to own. Bullying will not stop unless nurse leaders establish cultures of zero tolerance to stamp it out in their areas.

Horizontal Violence and Bullying – What is the Difference?

Horizontal violence (also called lateral violence) between nurses is an act of aggression that’s perpetrated by one colleague toward another colleague. Although horizontal violence is usually verbal or emotional abuse, it can also include physical abuse and may be subtle or overt. Repeated acts of horizontal violence against another are often referred to as bullying. You may also hear this referred to as “nurses eating their young” because the victims are often new graduates although bullying happens in all areas of nursing

Signs to Watch For

As a nurse leader, the challenge is to identify behaviors that should be characterized as bullying in order to stop the cycle. Nurse leaders have a responsibility to analyze the culture of units and then watch closely for verbal and nonverbal cues in the behavior of staff. Some common ones include:

Talking behind one’s back instead of directly resolving conflicts
Making belittling comments or criticizing colleagues in front of others
Not sharing important information with a colleague
Isolating or freezing out a colleague from group activities
Snide or abrupt remarks
Refusing to be available when a colleague needs assistance
Acts of sabotage that deliberately set victims up for a negative situation
Raising eyebrows or making faces in response to the comments of colleagues
Failing to respect the privacy of colleagues
Broken confidences

Breaking the Cycle

A culture of zero-tolerance for bullying is the most effective leadership strategy to prevent its occurrence. Staff need to be educated about the behaviors that constitute bullying to help break the silence. Raising the issue at a staff meeting and letting staff tell their stories is a key step to helping rebuild a culture. Staff need to know that you will quickly be responsive when you observe the behavior or when it is brought to your attention. Leaders need to engage in self-awareness activities to ensure that their own leadership style does not support horizontal violence and bullying. The selection of preceptors who will support a zero-tolerance policy is critical to orienting new staff about behavioral expectations.

When a unit culture has a history of bullying as described above, there will need to be a culture change. Part of that change is promoting a new set of shared values and goals with staff that promotes staff empowerment. communication, collaboration and life-long learning. A good start could be to visit the StopBullyingNurses websites and order an armband for each staff member asking for a commitment to change. If your unit hires new graduates, provide opportunities for staff to talk about their own first year in practice and use these stories as powerful reminders to nurture our young. Breaking the cycle of bullying on a unit promotes better patient safety and can help to both re-energize the staff with enthusiasm for their profession and create a healthier work environment

Read to Lead

Brown, T. (February 11th, 2010). When the Nurse is a Bully. New York Times Blog.

Longo, J.,& Sherman, R.O. (2007). Leveling horizontal violence. Nursing Management, 38(3), 34-37; 50-51.

Stanley, K. (April 24, 2010). The high cost of lateral violence in nursing. Sigma Theta Tau Leadership Conference.

Strong, R. (September 3rd, 2014) Bullying a Rising Concern for New Nurses.