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Mean Nurses

Thomas Northcut | Digital Vision + Jack Hollingsworth | Photodisc

Since my last blog I have been thinking a lot about “mean” nurses. Sadly, they are out there–and sometimes they make our jobs miserable.

When I previously wrote about nurses not “having time to eat our young,” I was trying to express my belief that nurses SHOULD be too busy to abuse their coworkers. I was not trying to negate the fact that this kind of behavior occurs, and often. Never wanting to negate this HUGE problem, I thought I would address it fully here. And I was reminded by you, my readers, that we have a proper name for actions “mean nurses” inflict on the floor–it’s called lateral violence.

So, what is lateral violence? The International Council of Nurses (ICN) tells us that this behavior is one that “humiliates, degrades or otherwise indicates a lack of respect for an individual.” Now, judging by comments made on my last blog, we are seeing this all the time.

One of my blog readers, Alice, states that nurses who eat their young “believe they are better than you and they don’t remember who taught them how to survive in the field of nursing. ” Another Scrubs reader, Yvette, states that “nursing school also doesn’t prepare u [sic] for the really horrible nurses you meet. (It is) so shocking it leaves me speeches [sic]. I wish someone would explain why would some one become a nurse if you don’t care (a)bout sick ppl [sic] and you don’t like other cultures.” Lisa adds, “In my experience, nurses do eat their young. That was the main reason that after I went to work I regretted ever becoming a nurse. And I vowed that when I gained experience I would never treat anyone the way I was treated.” Finally, Bonny states that it is the norm for nurses to abuse each other, saying, “Yes, nurses are, as a rule, pretty horrible to each other….I have learned to develop a thick skin…” Shocking stuff, huh?

Yes, yes, yes–we are all seeing it–but is anyone doing anything about lateral violence and mean nurses? There are tons of articles out there but is any of the research and consequent solutions even touching our practice? I’d concur with the general consensus out there that we nurses feel, when it comes to lateral violence, we have been left in the trenches to fight for ourselves (Thomas, 104). It seems to me that nurses are having to deal individually with this issue. Our actions need to catch up with our thought processes and zero-tolerance policies must start impacting individual units!

First we have to spot it–what does lateral violence look like? The American Association of Critical-Care nurses say “mean nurses” exhibit any of following behaviors:

  • Backstab and gossip
  • Make belittling gestures (deliberate rolling of eyes, folding arms, staring straight ahead or “through” when communication is attempted)
  • Use constant criticism, scapegoating, fault-finding
  • Have an elitist attitudes regarding work area, education, experience
  • Humiliate others
  • Ignore, isolate, segregate and use the silent treatment
  • Make inequitable assignments
  • Have inflammatory angry outbursts, show impatience
  • Insult, ridicule; patronize, or use condescending language or gestures
  • Intimidate, threat
  • Judge a person’s work unjustly or in an offending manner
  • Make excessive demands
  • Sabotage, undermine others
  • Give unfair evaluations of work
  • Use unwarranted criticism sarcasm
  • Withhold information or support

Shocking stuff–and I can attest to the fact that this is RAMPANT in hospitals. What can we do?? The AACN has a zero-tolerance policy in place and gives us specific guideline for how to deal with these behaviors–in other words, we can not sit back and do nothing! Here are the actions we can take according to Shewchuck (pg. 24):

  1. Address the behavior immediately with the perpetrator (because some people may not be aware of their behavior).
  2. Employ conflict management strategies such as saying “I feel … when you …”
  3. Repeat your replies if the other person makes excuses, denies, or dismisses the incident. If no positive result occurs, keep records of incidents and communicate these to your supervisor.
  4. Break the silence regarding this problem by identifying it clearly when it happens to you or others and by raising the issue at staff meetings.
  5. Inquire about how to deal with this problem at your workplace.
  6. Raise your own self-awareness of the problem by engaging in reflective practice; keep a journal, if incidents occur.
  7. Take care of yourself via, for example, massage, exercise, peer support, good nutrition, adequate sleep, and time out.

Lastly, I want to know what you guys are doing about this problem? We can throw fits online all we want (yes, I’m guilty of it, too), but until we take action, we will never see change!

References

American Association of Critical-Care Nurses. Public Policy Statement: Zero Tolerance for Abuse. Aliso Viejo, CA: American Association of Critical-Care Nurses; 2004. Available at: http://www.aacn.org/AACN/pubpolcy.nsf/Files/ZeroPosStmt/$file/Zero%20Tolerance%20for%20Abuse%204.12.04.pdf. Accessed April 3, 2007.

Thomas, SP. 2003. Anger: the mismanaged emotion. MedSurg Nursing 12(2): 103-110.

Shewchuk M. Interactive work place trauma (IWPT). Can Oper Room Nurs J. 2005;23(2):24–26,29

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Amy Bozeman

Amy is many things: a blogger, a nurse, a wife, a mom, a childbirth educator. She started her journey towards a career in nursing when she got pregnant with her first child. After nursing school and studying "like she has never studied before" she entered the nursing profession eager to get her feet wet. The first years provided her with much exposure to sadness, joy and other complex human emotions. She feels that blogging is a wonderful outlet and a way for nurse bloggers to further build their community. Traditionally, midwives have handed down their skill set from midwife to apprentice midwife. She believes nurses have this same opportunity: to pass from nurse to new nurse the rich traditions of this profession.
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28 Responses to Mean Nurses

  1. HospicenurseLinda

    I was in a job where 2 of the listed bullets were done to me by 1 particular nurse consistently. What made it worse was that we were in a small ICU, and many times it was just her and I. Imagine her stopping conversation with another person when you walk in from a break. Or asking for advice as nurses do and being told, “You’re off orientation. How you do your nursing practice is up to you.” There were no other nurses to go to on the night shift, and they’d convinced me to take the position as a new grad.

    I asked to not be scheduled with this nurse because of the situation. We met with the manager, and I was told what I was doing wrong by the other nurse. She was told that she was “a hot shot ICU nurse” and to keep on doing what she was doing.

    They didn’t schedule us together for about 3 months then started scheduling us together again. I was so relieved when I left that job, and I never looked back. Now I do hospice, and I’ve found my niche.

  2. jackie

    Excellent article, Amy!

  3. Serenity

    I have been a pediatric nurse for 12 years, most of which has been in the same institution. After having surgery, I transferred from my beloved inpatient unit to work in the outpatient clinic for fear that I wouldn’t be able to handle the 12 hour shifts. I was excited about the opportunity to meet new friends, new patients, and learn a new skill set. My first week their I was literally ignored by all but one or two of the staff (including my “preceptor”) who, at one point, when I asked a question about why they weren’t following hospital policy, told me I was a preceptee and I was to “sit down, shut up, and observe”. I had honestly never been treated by anyone so horribly. The harassment continued by multiple staff members, the entire clinic was a toxic place to work. A new manager started shortly after I did, and the behavior was not tolerated, and slowly, over time, most of the nurses actually were asked to leave or were fired due to their continued behavior issues or refusal to follow hospital policy. Although the nursing situation became better to an extent, there continued to be issues within the provider team as well and how they treated the nursing staff….needless to say, I don’t work there anymore. In 16 months, I was treated worse and with more disrespect than in the 10 years that I worked inpatient. It was amazing. I am worth more than that, I have more to offer…whether I am a nurse or not, just as a person I deserve more respect and kindness than that.

  4. Rick

    “humiliates, degrades or otherwise indicates a lack of respect for an individual.”

    Yeah, I would say that many of my friggin TEACHERS treated me like that. One clinical teacher in particular was extremely rude, talked behind your back, made you feel stupid, expected you to act on par with her 30+ years of experience, and on and on…I am not sure how I feel now about my decision to become a nurse; I have regrets–never realized how uncivil other nurses were.

    • Tricia

      Rick, I believe that your instructor is now teaching me, very unprofessional. You described her to a T. Also many of the nursex that I come into contact witj in Clinicals are so demeaning to students, oh especially when we catch something, that is not donr right, or a critical mefication not being given necause the nurse doesnt feel like calling the dr. Some of them hate their jobs so mucj, and you can see it very clearly. I refuse to be one of those nurses, so do the other nurses in my family. We may not make a diffetence in the nursing field, but I walk away from every clinical knowing that I made a diffetence in someones life.

    • Rivka RN

      I graduated from nursing school eager to do some good in the world. What I got instead was lateral violance. I was degraded, humiliated, and one nurse actually grabbed me by the hair one day before I started my shift on the floor on front of witnesses. No one reported it and nothing was ever done about it.
      I later lost my job after I got up the nerve to say something to supervisor. I came very close to quitting nursing. This happened several years ago and It still makes me angry. In my opinion, this problem is so pervasive it needs to be addressed in nursing school, by the state boards of nursing, by JACHO, and any other organizations that have an interest in providing the best patient care and promoting safety. A stressed out nurse looses the ability to think clearly and this can lead to mistakes.
      Lateral violance, should not be tolerated .
      That’s my opinion.

  5. Nico

    Yes, NURSES EAT THEIR YOUNG!! It is the most horrifying thing about nursing. So much so, that I have finally decided to lLEAVE nursing. Tired of all the JUDGEMENT instead of ENCOURAGEMENT, the BACKSTABBING instead of HELPING, and the UNGRATEFUL and JEALOUS TECH’s that RESENT YOU for being an RN. GET AN EDUCATION ALREADY!!! AND..if you are a Tech in nursing school, QUIT being so damn judgemental about the RN’s you work with. School is school, REALITY is WORKING the job.

  6. Christine

    I think that mean nurses are actually insecure nurses. They are not secure in their own abilities so they have to make someone else look or feel inferior to make themselves feel better. Unfortunately, this is counterproductive in our ultimate mission of being a patient advocate. Sad. If only nurses realized that building each other up is not only in the best interest of the patient, but in their own best interest as well.

  7. t-rex

    forget “i feel … when you …” like “i want to bust your teeth out”. unfortunately after seeing mean behavior (my 7 yr old daughter was taught about bossy bullies in kindergarten, by the way) i have learned to treat people the way they treat me. confront the issue, thereafter act like they are invisible.

  8. John

    I’ve seen and had the displeasure of working with nurses that need to re-evaluate their career choices. If you’re happy in your work, you tend to treat your co-workers with respect and kindness. Some nurses may be short-tempered r/t a problem at home, an issue with management, or maybe they’re just having a bad day. I treat ALL of my co-workers with respect and dignity, as I do my patients. The sooner others do the same, the sooner “Lateral Violence” (isn’t it amazing that we have a name for everything now-a-days?) can be a thing of the past.
    Also, for those nurses that are so imprressed with initials behind their name, remember, there was a time BEFORE you were an RN, or even LPN, and YOU wanted respect for the job you did. I’ve also seen, in my experience, that the higher the education level, the more prevalent this behavior is. Remember people, this is a job, other people depend on us, somewtimes with their lives, let’s keep the “playground politics” OUT of such a dignified profession!

  9. Vicki Whitworth

    Yes, nurses eat their young. And sometimes for a good reason. You have to toughen up. I have had doctors yell at me because dietary served a breakfast tray to a patient before my shift. I’ve had family members yell at me because I ordered a medication ordered by the MD that the family couldn’t afford (how I am I supposed to know?). I have had good mentors and bad in my 27 yrs of nursing and I have been a good mentor and a bad one. The “mean nurses” taught me to do my job and take the abuse dished at me by other nurses, doctors, patients and family members.

    • Dawn

      “You have to toughen up.”??? Give me a break. . Would you tell a child who was abused by a parent, teacher or sibling that they just needed to toughen up? I have been know to yell myself at times but I always try to go back after the heat of the moment is over and say I’m sorry and explain why I reacted the way I did. As a nurse it is our job to care for others not tear them down or apart.

  10. Amy Bozeman Scrubs Blogger

    @Jackie thanks for setting me straight! 😀

  11. DSB

    The article is interesting. I work with nurses who talk the talk but when it actually comes to doing their job they suck!!!

  12. maribeth

    We had a group of 4 nurses that fall into this category. For the first 2 years I was here they made me regret my 3000 Mile relocation. They had our direct manager in their pocket. Cost me raises both years. Because of a 3 year contract I tuffed it out. They left 8 months ago, the manager was demoted and we have a kinder gentler ED. I am a valued member of the department. They are causing the same problems at a different hospital. A sunny attitude and a smile wins the day. That and a boatload of self-confidence. They hate it when you smile.

  13. Fay

    I am actually not a nurse, but I stumbled across this article by accident. I’d like to give the patient’s point of view.
    I recently had my first baby, an experience that can be absolutely beautiful or absolutely traumatic.
    During my entire stay I loved the hospital, and the nursing was great. On my third day, I had already packed up and gotten dressed to leave. My husband was out loading the car. A nurse I had never seen before was on duty, and I asked if I could speak to my doctor before I left because I felt short of breath.
    She was incredibly nasty; I’d never in my life been spoken to this way. My doctor ordered more tests, and I had to get undressed and reregister. I was devastated and scared. Before my husband came back, nasty nurse came back and gave me a serious yelling because the doctor was mad at her.
    I was in tears, and a scary experience became even more traumatic. Then she couldn’t get the iv in, and pricked me painfully about ten times on both arms, to the point that I couldn’t hold my baby for the first few days because my arms hurt so.
    Thank god, everything was okay and I was discharged that night. My husband was outraged, and called the hospital numerous times until he got through to the top of the management to file a report. I am proud to say that she is now on probation.

    • christymel

      Excellent work. Patients tend to have a larger say as far as reporting mean nurses because you are the bread and butter. Glad you stuck up for yourself. You are a human being first and no one deserves that sort of treatment especially after having a baby.

  14. NenaMataHari CNA

    There is a local hospital where nurses’ bad behavior, cliques, and catty behaviors resulted in the death of a patient. The management actually hired a conflict resolution therapist to deal with that floor.

  15. chocolakat Student

    One thing you left off your list was the Prejudice nurse. During nursing school I worked briefly as a CNA through a registry at a local hospital in Torrance. One of my many assignments there was working the night shift in the Peds department. Most of the nurses were pleasant but there were two nurses who were the nastiest, meanest, most despicable and horrible people I’ve ever met and I’m sure they won’t be the last. One of the nurses in particular told me not to take any of her vitals because we (CNA’s) only charted what the last person charted and this was before I started my shift. She even told a husband of one of the patients not to let me touch their child because I was incompetent, stupid and didn’t know what I was doing. I was shocked when the father and mother of this sick child told me this. She would always put in the video ‘Song of South’ that depicted blacks as slow thinking, stupid you get the point. Not once did either of these nurses ask me anything including what my name was. It was really funny one Sunday I just happen to sit down and in the pew in front of me was one of the mean nurses. When she turned around to shake hands the color drained from her face when she saw me. Will I let these two and I’m sure more to follow, including clinical instructors, nurses deter me from my path? Of course not. Will I grow a thick skin? Of course not. I like the skin I’m in and I like helping people who are sick and injured. I’ve taken the moto “Don’t Tread on Me” which doesn’t mean I will match those unhappy nurses behavior. It just mean I won’t tolerate anyone who tries to walk on or stomp on me. Nurses don’t have to be mean and nasty to each other; they choose to be.

    • christymel

      I would love to work with you. You sound awesome and maybe you should look into coming out to Hawaii. I recently was in a gaggle with a RN, a retired nurse who worked in HR hiring, and an LPN and the one thing everyone agreed on was that CNA’s know their stuff. They have to since they and this is horrible to say but are basically everyone’s “b*tch”. You get so many orders from so many different specialties that you end up learning the most out of anyone. The retired RN even suggested that when I start nursing school that at my clinical sites I find the CNAs and make friends since they’d be able to answer all of my questions.

  16. aimeemendel

    It took me a lot of years to discover that there are work places where mean nursing is not the norm…..I had to leave Atlanta and experience nursing in another part of the country to have my faith restored in our profession….now I am working at a small hospital in the Atlanta area where my experience and dedication are appreciated.

  17. angienurse35 Caption Contest

    In my experience, dealing with “mean nurses” is much like dealing with “mean doctors” …. Until you take a stand, they will continue to do it. If we all stand up for ourselves and address it directly, or if it keeps happening, to our superiors, we will make the field of nursing so much better, for everyone.

  18. RNinDallas

    I came upon this article obviously because I am recently experiencing this first hand. I’m coming from a bit of a different place though. I am 44 years old and a 12 year nurse. I did home health for 10 of that but have also done home health software training, work comp case management, home health management and a few other things. I tell you this to show I am by far not a “new” nurse. I have recently gone to the floor, Why? Because without recent acute care experience, my options were closing fast. I also just graduated with my BSN. I needed this “foot in the door” to open other doors. That being said, I am experiencing the “mean nurses” you speak of. I work at night at a small surgical orthopedic hospital. A few of the day nurses that apparently “run the show” have apparently made me the topic of conversation so I’m hearing. One of them gives me a hard time every time I give her report. She asks irrelevant questions and when I don’t have the answer, I get the eye roll etc. Yesterday morning I had had my fill and asked her if she had a problem with me. She said no but when I give her report, she wants the basics before I start telling her about the meds. I told her about the meds to paint the picture of the patient being that he is on enough narcotics to kill a horse! She finally got up, said if she had a problem with me she’d come to me then stomped off. I told her to please do. I have a 22 year old daughter and this nurse can’t be much older than that. The situation may become worse because of my confrontation but I will not be bullied by a young nurse with less experience than me who is going around trying to make me look bad. This is ridiculous!! Home health has it’s issues but the nurses are typically kind to each other. This nurse and a couple of others have been sticky sweet to my face yet bad mouthing me to others during the day. What is the answer. Can’t we all just play nice?

  19. This is an excellent article that touches on lateral violence. Too many nurses (myself included) experience this phenomena and we have got to stop this!

  20. candiceh

    I had to leave a job as a result of this issue. I worked with an LPN who was constantly writing “concerns of care” on practically everyone on the floor. She would disobey orders given directly down from the RN. For example….I would often ask her to give pain medication. When I would check about a half hour later on the patient’s pain, the patient would say “I was never issued any medicine”. I would then find in the nurse’s notes that she was incorrectly assessing patient’s as lethargic. One patient in particular was walking around the unit when she had made such a note. We would later find out that she was disciplined by another facility for overdosing a patient. She would constantly email our boss or would visit her personally. She would degrade the CNA’s. She refused to do anything but pass meds on the unit. It got so bad that about 90% of the unit requested not to work with her. This is just a few examples of the things I experienced there. I’ve also had other bad experiences in school and at another facility. However, it is just to long to discuss here.

  21. valh RN

    Wow, this is shocking to me! I graduated from nursing school 3 years ago, went right to work at a large teaching hospital, and have not to this day experienced this kind of behavior. When I had an issue with another nurse on the floor, we took it to the patient care director and it was worked out; we now work together without a problem.
    I want to make note of the fact that the characteristics of “mean nurses” can be applied to any profession. I have friends who are teachers who complain of these same things. I think we let people treat us badly for many reasons, and even as new nurses, we have to learn to speak up for ourselves and confront bad behavior aimed at us.

  22. shebeckom

    I have been a nurse for over 15 years and I have came across a very few “mean nurses”. I was so blessed that straight out of nursing school I was trained by one of the best nurses I know to this day. She was understanding and patient with me. She also made sure that I got the hands on that I needed. I hold so much respect for you LeAnne. How could a seasoned nurse be so cold to new nurses. I think we all remember the first day on the job. Why would we want to intensify that feeling for someone? I have a hard time with nurses that back bite each other and are always keeping up workplace drama. Let me tell you one thing, I don’t care if you like me or not but for the 8 or 12 hours that we spend together at work should be common grounds for us to all do our jobs. There is no way you can care for patients like they should be cared for if everyone is not on the same page. As nurses we should support one another and listen to one another.because in our field you never stop learning. I don’t care if you have been a nurse since the stone age or if you just stepped out of nursing school, we can all learn from one another. I have been blessed to work with some of the best nurses, so many amazing women and men. One last thing, if you have time to go behind another nurse and always know what she/he is or isn’t doing…well there is no way you are doing your job and/or you don’t have enough to do. In nursing that is something you don’t find…a job that doesn’t have enough to do.

  23. Mugsy

    I started in the O.R. at 18 , right out of H.S. as a nurse’s aide–we would wash, sterilize and put the trays together, and stock the rooms. I knew immediately, that was where I wanted to work. I went to school, and got my first job in the O.R. Everything went fine.
    I left for a few years to have my kids, and went back when the kids statrted full time in school. It was a rude awakening! I was treated horribly. Every day was a struggle–being bullied, back stabbing, gossiped about, the list goes on. I worked there for 20 years–it got better until the hospital was sold and they brought in their own management. It was intolerable. We had “runners” to pick up patients. One afternoon, I went to get some supplies, and one of the runners and or new Nurse Manager was watching a pronographic video (BEASTALITY!) and laughing.
    I was nauseated and shocked. I left the OR and got the one of the new “Big Shots” and she came with me and walked in on them looking at this guys lap top, and he immediately closed it. She told me that there was nothing she could do, that she didn’t see it. After that I was on the sh– list. They absolutely didn’t do anything to support me.
    I left there after 20plus years and started at a new place.
    I was an extremely experienced O.R. Nurse. There I was tortured by bully’s! The first 4 days on the job, I just observed, on the 5th day, I was asked to scrub on a CBD Exploration. This was a case I had done many times–I had actually scrubbed with this surgeon at my old place!
    During the entire surgery, I had 3 nurses standing behind my table making unkind comments–one of the nurses actually said,”I can’t watch, she is doing EVERYTHING wrong!” the doctor wasn’t complaining–I knew what I was doing! I didn’t handle the situation properly, I should have asked my circulating nurse to get the nurse in charge, and she would have made them leave the room, but I was only 5 days on the job! There were atleast 5 huge bully’s that I had to endure everyday.
    Shortly after that I was diagnosed with Rheumatoid Arthritis, and my husband was battling cancer, so I retired.
    I loved what I did, but I felt as though I had no place to go with my problem’s.
    I still miss working, and it makes me feel very sad and angry when I think of these experiences. I always tried to be supportive to the new girls on the job–it’s difficult to acclimate in a new hospital. I sympathize with all the girls that are writing in…I left my life long career feeling defeated.

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