In my 16 years of nursing practice, I have been a victim of and witness to bullying by physicians, nurses, managers, and patients. It can be an incredibly difficult job when you are in a healthcare setting where the goal is to heal others, yet there is unseen trauma and hurt all around you caused by a toxic and hostile work environment. The more I read about this crisis, the more I realize that it isn’t just about other nurses eating their young, it is happening at all levels of healthcare. But the “system” wants us to move on and behave as though everything is ok, and we are encouraged to have thick skin, “shake it off”, and get on with our life (a direct quote from a prior bully manager).
The definition of bullying is “repeated, offensive, abusive, intimidating, or insulting behaviors; abuse of power, or unfair sanctions that make recipients feel humiliated, vulnerable, or threatened, thus creating stress and undermining their self-confidence.” Typical behaviors by nurses towards other nurses can include undermining, backstabbing, withholding information, gossiping, eye-rolling, breaking confidences, and even ignoring or excluding another nurse. In other words, nurses with bully complexes not only eat their young, but anyone who isn’t stronger or louder and more abusive than they are. Doctors who practice this behavior seem to feel it is a “right” to impose their power, anger, frustration and aggression on staff. I have found in researching this epidemic that I am in a vast majority of nurses who have experienced this problem and have been negatively affected and scarred by it, and it truly is an epidemic.
Bullying in the workplace causes emotional stress, pain to its victims, along with anxiety, isolation, symptoms of physical illness, depression, and has even been linked to post traumatic stress disorder in severe cases. I can’t fathom the number of wonderful, bright new nurses beginning their practice who actually left or considered leaving the nursing field because of this problem. Reporting the bullying isn’t always a viable solution to the problem due to retaliation, managers who side with the bully and believe the lies that have been spread about a nurse, and management that does not want to deal with the poor job satisfaction ratings and negative impacts that it might cause in their “magnet status hospital” and risk dropping their scores.
Physicians are the most difficult to pin down on this behavior, as many have mastered the Jekyll/Hyde behavior to perfection, and the only unfortunate ones to see Mr. Hyde are the victims. I would be willing to place bets and guarantee that unless a whistleblower has talkative and fearless witnesses who are willing to defend them, and detailed documentation of experiences over a period of time that have been verified, a nurse will never stand a chance in prevailing over a physician bully.
What can we do? Ideally in a perfect world, there should be 0 tolerance for this behavior, especially in a healthcare setting. That is what the literature tells us, but I no longer trust facilities to enforce it because I am a realist. I’ve been there, done that, and know what really goes on. You should be able to speak to your manager, or someone in management if your manager is unresponsive to your concerns, and actions should be set in motion for the behavior to be addressed and stopped. Unfortunately, it ends up being a “he said she said” game much of the time, and the nurse who has been there the longest or the physician who is so good at putting on their Dr. Jekyll face will usually not hesitate to verbally destroy the person making the accusation. The hidden and elusive Mr. Hyde usually wins in large hospital settings and medical practices.
What I will share with you is that if YOU are being bullied, begin documenting NOW. Always keep a small notebook on you, and begin documenting the events of your days (excluding any HIPPA sensitive information), any adverse events that happened and the circumstances surrounding it. ALWAYS ALWAYS ALWAYS document what your bully is saying or doing, the date and time it occurred, anyone who may have been preset at that time, any disrespectful or demeaning remarks, any sexual innuendos or remarks, and any events that are disrupting your workflow or patient safety by this person. Document ALL of it, and keep a running log of every event if you ever hope to stop your bully in his/or her tracks and be taken seriously should you decide to report them. And if you bravely make the choice to report them, be prepared to stand strong, determine at the onset not back down, and keep in mind that you may be saving someone else, if not countless others from the sick actions of your Mr. Hyde. Unless we begin standing up to these kinds of behaviors, they will never stop.