BananaStock | Thinkstock

I always enjoy hearing other nurses talk about our profession. Everyone has their own opinion, be it positive or negative in nature. One of the greatest opinions on the matter came from a coworker of mine who posted the “true meanings of RN” on her Facebook page which started a tremendous chatter in response. I thought I would comment on each of these meanings and provide my own insight into the truth behind ‘RN.’

“The true meanings behind RN: Reluctantly Nice, Real Nurturer, Registered Nutcase, Rather Nerdy, Rockstar Nanny, Regretfully Naive, Rebelliously Naughty, Rescue Ninja…”

Next, Reluctantly Nice…

*For my friend’s/family member’s/acquaintance’s own discretion, I have left out all identities behind the year events below*

What’s in a year?

A woman re-exploring the joy of nursing after 15 years of devoting her unselfish efforts at raising a family.

A girl considering moving halfway across the world for a guy she met at the bar.

A broken engagement, a new found love, a pregnancy, the death of a child, the life of another.

Over 50 deaths of children in the cardiology department alone.

A new home, a new car, a successful career all combined with the joy of expecting a baby girl.

Successful graduation from law school, landing a job at a prestigious firm, the breakup of a four-year relationship, maid of honor at her best friend’s wedding.

The birth of an unexpected child blessing your life with a lifetime of the joys and woes of parenthood.

Jumping head first into an unexpected relationship while being offered and accepting a job in Asia one month later.

Three full months of dedicated parents visiting their baby in the NICU and on day 100 finally taking her home.

Standing by your brother’s side as he battles cancer for the second time, recovering from abdominal surgery, and falling in love with a new nephew.

Accepting the title of alcoholic while going through a divorce but seeking help for the disease.

Buying a house, selling a house, moving cities, husband passes the BAR, dad gets diagnosed with cancer.

Introduction of a minimally invasive procedure done through a single vein, a procedure that used to keep kids in the hospital for weeks on end after open heart surgery.

A brand new marriage, the startup of a non-profit single-handedly, the loss of a husband’s job, and obtaining a government job herself.

Realizing that the family she has always known is quite possibly not biologically hers.

With two years prior to college entry a troubled teen cleans up her act and sets a college-bound goal.

A surprise birthday party with 50 of her closest friends, maximizing success at the workplace, fending off a fella who’s smitten, four half marathons, a mud race, and an urban race, a two week trek through Europe with a best friend, family financial woes, a dog diagnosed with a chronic disease, and two unbelievably adorable nephews.

A trip to Jordan, Italy, Greece, Austin, Prague, Germany, Vietnam, North Carolina mountains, and Vegas. It doesn’t get much better than that.

Adoption of two small children from an orphanage in Uganda that extends the family from four to six.

A diagnosis of brain cancer with a three month maximum life sentence, a three months filled with more love from friends and family than anyone could ask for.

Bringing your previously healthy 8-year-old to the hospital to find him in heart failure and losing him two months later.

Extending a family of two small children and two grown children with the addition of an unexpected pregnancy, the only boy.

Attending a seminar that details the recent advances in medical technology allowing for pinpoint radiation in cancer treatment.

Happy New Year!

Bananastock | Thinkstock

Ah, yes. Three-day workweeks. So great to have time off during the week to run errands and spend time with the children…until the holidays roll around. Then nurses start believing that the grass is always greener and maybe that office job that closes for holidays doesn’t look so bad after all.

All shift-working nurses have been there. Spending Christmas morning with a work commute half as long as usual because nobody is on the road. Eating a frozen turkey dinner in the break room on Thanksgiving evening while your extended family passes the phone around the dinner table, giving you a chance to talk to everyone. Hoping that Y2K didn’t shut down the country because it would be really unfortunate to lose power to your ventilator-dependent patient for the remaining seven hours of the shift.

How can you best deal with working on holidays? The most important thing to remember, no matter which holiday, is to be thankful that you are not the one IN the hospital. You get to leave after your shift and proceed with your plans while your patient spends the rest of the holiday in a hospital bed.

Second, look at it as a pecking order, paying your dues, working your way up the ladder–especially for the newer nurses, because with more seniority comes fewer holidays spent at work. If you’re a newer nurse without kids, be an extraordinary coworker and offer to work on Christmas so the moms on the floor can be at home with their children. After all, some of you would rather have New Year’s off, anyway.

And finally, embrace it. Scheduled to work on October 31? Dress up in a costume that will make all of your patients laugh. Bring some homemade treats for all to share on Thanksgiving. Donate some hand-me-down baby clothes for the floor over Christmas. Make the best of it, and be thankful for your health.

Blend Images Photography | Veer

My constant hope for the pediatric patients I care for is that they leave after discharge and return for a visit with birthdays past, school years under their belts, and inches taller than when I last saw them. It’s been twelve months in the hospital world for me. In that time, inevitably, some of these patients didn’t ever get to go home, or ever return for a visit, because they have passed away.

To honor all of the patients who have passed away each year, the cardiac service line hosts a remembrance ceremony for the families who have lost their children. I was approached by our chaplain and asked to speak at the upcoming ceremony. Immediately I was overwhelmed with feelings of gratitude, honor, shock and disbelief.

How could I, just a nurse, have anything meaningful enough to say to these parents who have lost their children to a congenital heart defect? It seemed to me like the key speaker should be a surgeon who operated on the child, or the cardiologist who medically managed their care up until the end, or even the floor manager who overseas all functionality on the unit.

But no. They asked me, just the nurse. I have been racking my brain in an effort to figure out exactly what I can say to these parents who have been mourning the death of their child, a pain that I cannot even fathom. But as I looked over the list of children that had passed away in the last twelve months, recognizing many of the names, my feelings about speaking at the ceremony quickly turned from terror to thanks.

I began to reflect on the times I had taken care of these patients, some very near to the end of their life. One name I encountered is the name of a boy whose picture to this day is the background on my phone. A boy whom I still think about every day of my life, although he passed away nine months ago. A boy who has impacted my life perhaps more than anybody has, ever. And then it came to me: People tell me all the time how honorable they think it is that I am a nurse, and how much of an impact I must make on my patient’s life. The reality of it is, these children impact my life more than I could have ever imagined prior to going into nursing.

I’m not going to tell the parents what it’s like to be a nurse or what it’s like to care for a child at the end of their life. I’m going to thank the parents for allowing me to care for their child, and tell them how appreciative I am of everything their child did for me. I’m realizing now that perhaps the surgeon wouldn’t be able to say the same thing, nor would the cardiologist.

I was the one at the bedside playing cards with the child and listening to his plans for after he got his new heart. I was the one at the bedside rocking the baby when mom needed just an hour to sleep because she had been up with him all night. I was the one administering pain medications when the child’s pain was unbearable. I’m no longer “just a nurse” but a thankful individual for the valuable time I got to spend with these children, and I can’t wait to share that.

Hemera | Thinkstock

You’re clinically competent. You know your drugs, diseases and diagnoses. But do you really have what it takes to be a good nurse?

According to Jo, RN, the best nurses know how to stand their ground as well. Take a crack at these questions to see how you rate.


Take the quiz!

Image: Hemera| AbleStock.com| Thinkstock

There’s no fooling a well-versed professional in the hospital. Pediatrics nurses can be picked out of a crowd like a sore thumb. Whether it be the fact that Elmo is strapped to their stethoscope, or that Spongebob characters cover their scrubs, a pediatric nurse is not only specialized, but unique.

It takes a specific personality type to work with small children on a daily basis, and it takes a certain combination of caring and strength to care for sick children. I was intently observing my pediatric nurse coworkers one day at work and gathered a short list in my head of what characteristics pediatric nurses display on a daily basis. Thinking of going into pediatrics? See if this list nags at your interest.

You know you are a pediatric nurse when:

• Stains on your scrubs in hues of white, off white, yellow, seedy yellow, and of course, various shades of brown brightly adorn your scrubs. And subsequently, you have mastered the creation of the perfect stain remover substance that works best on partially digested formula-based stains.
• Your locker is also stocked with a spare pink, teal, and Disney Princess scrub top in case of a stain emergency.
• Your friends who are new parents turn to you for advice on diaper changing skills since you get more practice changing diapers on a daily basis than most parents do with their own kids.
• You don’t memorize medicine dosages by mg or mcg but instead by weight-based dosing such as mg/kg or mcg/kg.
• It’s a normal occurrence to see the fairy godmother frolicking through the halls of the hospital.
• You think an eight pound baby is one of the biggest, healthiest looking babies you have ever seen!
• You impress your fellow adult health nurses because you can do weight-based dosing calculations in your head without the use of a calculator.
• People look at you funny when you check the pulse integrity and capillary refill on each new child that you meet, just by habit.
• You have mastered the art of making saline syringes into water guns, blue gloves into inflatable chickens, and tourniquets into the best sling-shots ever seen.
• You look forward to seeing clowns at work.
• Wagons are a hotter commodity to come across than a wheelchair at your hospital.
• You have memorized the channel numbers for Cartoon Network, Disney Channel and PBS kids.

• Lidocaine cream is your very best friend.
• When it snows, your patient population is almost as excited about eating the snow as they are playing in it.
• Until your eyes adjust, you almost need sunglasses when you first get to work to help shade some of the bright colors that bounce off the walls decorating your floor.
• Your patients don’t sleep at night- instead they demand to eat all night long!
• Diapers harbor multiple functions including using them as a boxing glove to wrap up IVs so they don’t get pulled out.
• The art of distraction is the best pre-med you have found.
• You have mastered the art of holding a baby in one arm while changing a bed with the other.
• Your downtime is spent loving on babies whose parents aren’t at the bedside. Sometimes multiple patients can be found nestled in the arms of nurses behind the desk.
• You can swaddle a baby and have them asleep in 2.5 seconds.
• Even your strapping attending physician speaks in higher child-like tones when speaking to his patients.
• Your favorite part of the day is seeing a mother dress her baby in his “home from the hospital outfit,” free of wires, tubes and drains, and take him home for the very first time.
• Your refrigerator looks like a preschool art class exploded on it.
• You know you are a pediatric nurse when you get excited each day that you come to work because you get to experience one of the most endearing, resilient, and beautiful patient populations.

[main image: Hemera Technologies | Ablestock.com | Thinkstock, child nurse image: George Doyle | Stockbyte | Thinkstock]

Image: Keith Brofsky | Photodisc | Thinkstock

Have you ever wondered why certain patients act the way they do around nurses? Why some are pleasant and cooperative and some are disrespectful or difficult to engage? It is easy for a nurse to have expectations of patients because naturally we all want them to be kind, cooperative, and appreciative.

But it is important for nurses to keep in mind circumstances and experiences surrounding the hospital admission, and perhaps even past experiences that could impact how the patient views this admission.

Some people may have had a bad or traumatic experience the last time they were in the hospital, or they may associate the hospital with negative memories. Nurses must remember to be mindful of each person’s unique situation and tweak our treatment based on their reactions.

PEDIATRIC PATIENTS

Interacting with patients takes on a whole new meaning when you delve into the world of pediatrics. Before I walk into a room, I must take into account the age of the patient and how to best interact with them. A good pediatric nurse tries to develop a relationship with all of her patients and performs based on age-appropriateness, instead of just getting through the day giving medications and doing procedures.

We all remember back in nursing school seeing Erikson and Piaget’s stages of development listed in textbooks and cramming the information into our brains for the NCLEX.

In pediatrics, we must put these stages of development to good use and take them into consideration when first approaching a patient and when developing a successful working relationship with them.

Below are some accounts of what a pediatric patient might be experiencing while in the hospital and effective ways for the nurse to deal with that patient.

THROUGH AN INFANT’S EYES…

Bright lights (crying). I’m cold (crying)! Cold hands (crying). I don’t smell my mom (crying). Hungry (crying).

The needs for an infant are defined by Maslow’s basic physiological needs of breathing, food and homeostasis. Nurses can tend to these needs by providing cluster care and a low stimulation environment, especially for neonates, and by swaddling the patient up after interaction.

Warm your hands up prior to touching an infant, shield their eyes when you turn on the lights, swaddle them up tightly with their hands near their faces when you are finished assessing them. Lastly, hand them to mom for there is nothing better for an infant than the mother’s touch.

THROUGH A TODDLER’S EYES…

Ahhh, who is that? I don’t know her. Where’s my mom? I remember getting an ouchy last time they came near me. What is that thing around her neck? Don’t touch me!

Toddlers are fearful, parent-oriented, and oftentimes weary of strangers entering their rooms. Also, if somebody with a white lab coat came in and gave them a shot, then everybody with a white lab coat is surely out to get them.

Approach a toddler slowly, talking to them and letting them observe you before you get close. Once you are by their crib, play with them for a couple of minute prior to assessing them- grab a favorite stuffed animal, let them play with your badge or your stethoscope.

Prior to listening to them or taking their temperature, listen to yourself first so they can see that what you are about to do is not painful. Of course, there will be instances when shots and IV sticks are unavoidable, but utilize rooms outside the patient room, such as a treatment room, to keep their own room a safe place.

This age is all about play, so interact with them, they will learn to trust you. Also, what they can’t see won’t hurt them so if the patient loses his mind when you take his blood pressure and stand over the bed, place the cuff on him and leave it, then push the button as you are walking out the door so he can’t see you. You are probably a lot scarier than the cuff squeezing his leg.

THROUGH A SCHOOL AGE CHILDN’S EYES…

I want to play outside. I miss all of my friends. This food is gross. I’m bored. Why do I have to get another shot? I don’t feel good.

These are some of my favorite years because the children are way more intuitive than most people give them credit for. You can reason with school age children, so keep them informed of the plan for the day. They are typically still very obedient because they want to make their nurse happy.

They do well on a reward system and thrive off of positive reinforcement. Distraction is an effective technique when performing procedures. They can be imaginative so expect questions such as “if you poke me with that needle won’t all of my insides ooze out of the hole?”

Take them out to the nurse’s station with you and introduce them to all of your coworkers as your bravest patient. Let them perform heart surgery on their stuffed animal. Most importantly, be honest with them about what is to come.

THROUGH A TEENAGER’S EYES

This place sucks. I’m not taking my medications anymore. I would rather die than be here. I miss my friends and my boyfriend. Why does this have to happen to me? Why won’t she give me privacy? Why do I have to pee in that stupid cup anyway? Why won’t my mom and everybody just leave me alone…

Granted, not all teenagers are like this, but it is not uncommon to see some of these manifesting behaviors in that age group. I have found that for teenagers that are over being in the hospital, sitting on the bed with them and letting them vent is the best answer. Some will talk to you, and others won’t. But if you find something that you can relate to them about, they are more likely to open up.

As with the school age child, be honest, and don’t be afraid to be frank. Tell them that if they don’t take their coumadin, they may clot their valve and possibly end up in an emergency situation.

Give the teenagers some sense of control over their care. Let them make a schedule for their day and agree that while you have to add certain things like times for medications and time for physical therapy, they can control the rest, even if it means giving them an hour of peace and quiet in the afternoon where you won’t let anyone in to bother them.

Arrange with their parents a visit from friends as long as the policy on the unit allows it. Take them out to the garden or the library. Teenage years are already some of the most tumultuous years in a person’s life, combining that with the stress of a hospitalization can be very trying.

Talk to them about their future and what they want to be when they go off to college, encouraging goals is a good way to keep the teenager focused.

THROUGH AN ADULT’S EYES…

Last time I was in a hospital, it was to see someone die. Plus, I have no privacy here…can’t get a decent night’s rest. This place is depressing and different people are just coming in and bugging me every time I finally am about to catch some shuteye.

If your 30-year old patient is emotional because the last time she was in the hospital it was to watch her mother pass away, do your best to establish a rapport of trust and encouragement, and keep her informed of all decisions that are being made.

If a 55-year old man is modest and wants some privacy, try your best to respect his wishes as long as it is safe for the patient.

If your patient is elderly and grumpy and demanding, just appease him, kill him with kindness, and ask to hear stories about his life, because realistically, nobody wants to end up in the hospital.

Throughout nursing we encounter different personalities, different ages, and different backgrounds on a daily basis. As a nurse, I pride myself on being able to deal with all of these patients and care for them effectively. Although it can be hard, try to put yourself in your patient’s shoes. There is nothing more gratifying than hearing one of your more difficult patients expressing how thankful they are for the care you provided.

Image: Shane White | © Veer Incorporated

Warm weather. Most of us love it. Some of us are plagued with allergies, bug bites, bee stings, sunburns, and all the other joys that being outside in lovely weather bring with it.

Just the other day at work I was involved in a conversation with fellow coworkers about holistic remedies for everyday warm weather woes. Sure, I took note of some of them and will be sure to invest future efforts towards making Mollie’s deceased grandmother’s sworn natural deodorant, but I also snickered at most recommendations. I tend to favor non-medicinal treatment of ailments in some cases, and I actually find alternative medicine quite intriguing.

Thus, spawned by the discussion held at work combined with my already investigative nature, I did a little research on what people have actually claimed as home remedies for common ailments. Perhaps you will find some of these as useful, or perhaps you will read this post and get a good abdominal workout from laughter. Either way, enjoy. (Disclaimer: I am not a holistic medicine doctor, nor do I have MD behind my name at all. I have read reports of people trying these techniques, have not tried them myself, and probably do not recommend most of them due to safety/stupidity reasons. So please, read them, laugh at them, and take them with a grain of salt.)

Got a nagging ailment? Who needs a doctor when you can treat it from home…

Headache 1)  Cut a potato (uncooked) in half and rub it on your forehead.  2) Pound your head with a hammer.  3) Have someone come up behind you, grab your hair in a fist, and pull up as hard as they can- used most effectively for migraines.

Bleeding cuts Gather up a collection of spider webs and vigorously pack the wound with them. It will surely stop the bleeding. Another use of spider webs? If you find yourself coming home from Africa with malaria, chew them up and swallow them.

Joint/knee pain We have all heard of magnet therapy for joint pain which has some physiologic truth behind it because the magnets supposedly attract the iron-ridden red blood cells to the area for increased healing. However, people have gone to the extreme of drinking metal compounds (silver) for severe pain. NOT RECOMMENDED. This can lead to seizures, kidney damage and many other ailments worse than the original. Another suggestion to treat knee pain? Sleep with a bar of soap under your knee- one guy even said it had to be a specific brand or he wouldn’t bother.

Toenail fungus Soak your toes in Listerine. The next time you go to swish your mouth with Listerine, I know you’ll be encouraged…

Too much ear wax The latest trend to extract ear wax has been those ear candles where you light one end of a hollow stick and seal the unlit end to your ear, in hopes of sucking out the ear wax. This is actually dangerous to your ear because the creation of the vacuum in the tube can rupture your eardrum. Alternative? Put olive oil in your ear instead. It breaks up the wax and allows it to run out. Yum.

Bad case of the runs Drink a packet of powder jello and chase it down with a cup of hot water. This concoction will “stick” to your intestines and slow the process down.

Bug bites Sit in a tub full of vinegar. You will probably ward off bugs and people for a while after that endeavor.

Jellyfish sting I have heard many reports claiming that if you get stung, get out of the water immediately, track down a person (preferably somebody that you know, so it doesn’t get awkward) and have them pee on you where the sting was. Have yet to try this one out, hope to never have to.

Halitosis Case of the bad breath? Try chewing up coffee beans. I’m guessing this only works if the people who are smelling your breath enjoy the smell of coffee.

Severe sunburn Mix together a combination of yellow mustard and, wait for it, vagisil. Could possibly be the most hilarious remedy that I found. Next sunburn, you know what I’m doing…

Warts Cover them with duct tape. Change out the duct tape every couple of days. I’ve actually heard of this working because you are depriving the wart of oxygen, thereby killing the virus.

Hiccups We have all heard our grandmothers telling us to eat a spoonful of sugar to get rid of the hiccups. But there is some truth behind such a tale. To rid yourself of hiccups, you have to distract the vagus nerve. Downing a spoonful of sugar overloads the nerve endings in the hopes of distracting and ending that reflex.

Nausea/motion sickness Suck a lemon. Although you may make a terrible face, lemon juice actually helps to evaporate excessive saliva that is associated with feeling nauseous, and may help to settle your stomach.

Stuttering child (prepare yourself, this is bad)  A technique used in ancient Chinese practice to stop a child from stuttering was to smack him/her in the face multiple times on a cloudy day.

Body odor Try Milk of Magnesia as a natural body deodorant.

Yeast infection Yes, we have heard that we should increase our oral intake of plain yogurt to add some healthy normal flora to our bodies. But I read reports claiming that just as effective as Monistat is actually inserting a tablespoon of plain yogurt, um, down there. I will never look at yogurt the same.

Any other home remedies to share? Share the wealth.

Stockbyte | Thinktsock

By nature of the profession and the work that we do as nurses, doctors, or other medical staff, we are routinely exposed to the sick, the dying, the tragic accident, the miracles of medicine, the joy of cures.

Also by nature of our profession, I see on a daily basis the organic reasons for life, the physiology behind somebody healing from an illness, how medicine works on a human body to fix their ailments.

On the other hand, I also see what goes wrong and I see when a body’s organs fail to function properly and what the end result is. When we have a death at the hospital, a common question that floats around the nursing staff is “what happened” or “why did they die?” Although there is oftentimes a medical “reason” for such travesty, do we ever really know why?

I was raised in a Christian household and taught that God has the ultimate control over our lives. I pray every night before I go to sleep for the health and happiness of my family and friends. Fortunately, in my own life, aside from aging grandparents, my family and friends have led relatively healthy lives- and I thank God for that. But I’m certain that families of children at the hospital have also prayed every night for God’s healing hands to help their dying child. As a nurse (and as a believer in God) one of the greatest struggles to overcome is that three letter word, why.

Why would God take the life of an innocent child? Why would He heal this child but allow the one next door to suffer? Why would He put such a wonderful family through so much turmoil?

One of my very first posts on this blog was about a boy whom I referred to as Frog Boy. He was a patient at our hospital that I met the previous year at a summer camp, and we grew extremely close to one another during his months spent in the hospital awaiting a heart transplant. Five days after his ninth birthday he died suddenly one evening from a “silent” coronary event.

His current heart was a transplanted heart back from when he was just over a year old and because during transplantation you lack innervation to the new heart, these children oftentimes do not have warning signs of a heart attack like the average person would have. Along with being completely devastated by his death and angry that I was not there to be with him, for months as other kids were getting their transplants my prior-to-bed prayers were spent questioning why that beloved child was not given more of a chance.

I hit a low at work after his death. I felt burnt out, angry, sad and most dramatically directed this frustration at God. I would watch the news at home and see criminals surviving police chases, murderers getting acquitted of their crimes, people on a daily basis breaking into homes and robbing people at gunpoint. Why did these people live and such a vibrant child with so much life ahead of him have to die? How could God do that to his family, his siblings, and selfishly, me?

Then one day it hit me. Everyone’s time spent here on earth has a meaning and a role that they play in life. For some, it takes a lifetime well into adulthood to figure out that meaning or to fulfill it. For others, they are so wise beyond their years and have such an impact on those surrounding them that they only need a short time.

That young boy, even at the ripe young age of 9, touched so many lives in his short lifetime because of his huge heart, even though it was sick. He brought smiles to those that needed some sunshine, and he brought optimism to those that didn’t think they could go on. He was a child basically locked up in the hospital attached to an IV pole, and he had a better spirit than most people I know.

Perhaps he knew his time was limited, that’s one thing that I will be sure to ask him when I see him in heaven. All I know is that I am a better person today because of him, and his life and subsequent death has taught me that even amidst tragedy we must remember life and not dwell on the why. I know he is happily acting as my guardian angel and looking over the child that got the heart that he was waiting for. God knew he was special and thought he could continue doing all of his good from heaven.

Since then, when deaths have occurred, no matter what age or circumstance, I have not turned away from God, but instead turned to him, and thanked him for the time he allowed me spend with that person here on earth. I used to once be afraid that I would never care for another patient again for fear of losing them unfairly. But like I said in my past post to that fine young boy, I’d rather love a patient like you and lose you than never love at all.

Jupiterimages | liquidlibrary | Getty Images

Think back to your middle school and high school days. There were the stereotypical bullies that everyone tried to steer clear of. They picked on the weakest, they picked on the youngest, they picked on the ones they were most threatened by. The media even hits on this rampant problem that is still around in schools today with the production of movies such as Mean Girls.

Although as professionals we all have grown up in age since then, do you ever wonder if people that surround you at work have grown up in maturity?

We have a journal club at work that meets each month to discuss articles of interest related to nursing or healthcare. This month’s article was about bullying in the workplace, most specifically in the nursing field.

Some interesting findings? Although there has been minimal research into the issue surrounding workplace bullying, all studies that have been done nationally and internationally report that over 50% of interviewed nurses have experienced some form of bullying at work. Now, one can argue that women tend to be sensitive creatures and even constructive criticism can be perceived as bullying, but by definition bullying involves multiple efforts to cause another person physical or emotional harm or injury. Obviously in the hospital setting, there is (hopefully) no physical abuse between co-workers. But a specific type of bullying that deals strictly with the emotional aspect involved, called relational aggression, is the equivalent in the adult world to the bully that walks down the hallways in school with her elbows out taking down all the weaklings.

Some examples of bullying in the workplace? Nurses that voiced their personal experiences with bullying included instances of gossiping about a certain co-worker, the formation of cliques among groups of nurses and ostracizing others, purposeful withholding of information from another nurse, bossy nurses, pushy nurses, or nurses that always criticize another nurse in front of others, and failing to help out a fellow nurse.

Who are these bullies? I thoroughly enjoyed the portion of the article where nurse bullies were given identities based on certain characteristics they displayed. The Supernurse is always right, has always been a better nurse than you, and will always be a better nurse than you. Just accept it. The Resentful Nurse is still holding a grudge against you from when you had to give her a 4th patient when you were in charge three months back. You obviously aren’t a team player. The PGR Nurse Puts downs her co-workers, Gossips about others constantly, and spreads vicious Rumors. She is always great for lunch conversations, as long as you aren’t the one being conversed about. The Backstabbing Nurse cultivates friendships then betrays them for her own good. She is the epitome of Jekyll and Hyde in nursing. The Green-with-Envy Nurse does everything in her power to obtain a certain status that she is envious of, no matter what or who stands in her way. Although some of her patients might be green from nausea, she is green from greed. The Cliquish Nurse reveals her bullying by playing favorites or by excluding others. If you’re not “in”, you can see your way “out.”

What makes you a target? As unfair as it seems, bulling trends tend to correlate with the old nursing adage that scares many away from the profession that “nurses eat their young.” New graduates or new hires are often targeted because they haven’t quite found their niche either socially or professionally.

Those that are recognized or honored for a job well done are often the target of jealous nurses displaying covert means of bullying as they try to even the playing field and increase their own recognition. And unfortunately, much like the movie Mean Girls, those nurses with close relationships with physicians may be the target of gossiping and wide open flood gates of the rumor mill. Times of stress, understaffing, and low floor morale can also increase the likelihood of bullying. As ridiculous as these examples seem, similar circumstances exist in the workplace that should be acknowledged and addressed.

What to do? To combat this problem that has recently peaked as an interest in the field, the Joint Commission, as of January 1st, is requiring that institutions have a process in place to address and handle “intimidating and disruptive” behavior in the workplace. What that means? I’m not so sure…

Some institutions are adopting a more democratic model to their management and eradicating the hierarchy found in many floors. Awareness in our own practices does wonders for a problem as preventable as this.

• If you see bullying first hand on your unit, without causing extra conflict, do you best to intervene.
• Actively UNparticipate in gossiping by redirecting conversation to something more neutral or walking away from the offender.
• If a new grad is having a difficult time, take her under your wing…we’ve all been there.

We have a council on our unit, the Recruitment and Retention Council, that I think by nature unintentionally does a nice job of eliminating some bullying tendencies by creating a sense of community among the unit. They plan team building exercises and tackle problems that are the root of low morale phases on the unit. This is an issue that can and should be resolved in the hospital setting. Nurses are nurturing and deemed the ultimate caregivers by nature of the job, so we need to start acting like it.

Has anyone experienced bullying themselves at work? How is your unit tackling the issue?