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Tough love for “incivility” in nursing

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There’s been a recent surge and great interest in the “incivility in nursing.” I dare ya to do a quick search–go ahead and Google it. I’ll be here when you get back…

Incivility = violence = lateral violence = disrespect = offensive= etc, etc. In fact, I read an article that spoke of incivility as simply being mean. Mean? Really?

Better yet, I read another article that talked about actions that can be interpreted as ‘”uncivil” (incivil?), such as tardiness or sending an email without a greeting (be still my heart!).

I’m poking a little bit of fun at a real and serious problem. For some strange reason, the world of nursing thinks the problem is unique to its profession. Or that the lateral violence we experience is new or, dare I say, different.

I spent a good amount of time reading some of the leaders’ opinions, blogs, articles and presentations online. I have to admit, I’m still trying to understand the uproar here.

Incivility in the workplace is as old at time. The only difference is how it gets handled and whether or not it’s tolerated. The truth of the matter is that lateral violence or incivility will never go away. It’s everywhere–not just in the workplace, but also in our social circles, in our classrooms and in our homes. It can be less prominent or more severe no matter where you go.

I think therein lies the problem. Lately it’s become more severe in the nursing world. There are a lot of theories as to why, and they are all equally entertaining (at least to me).

1. Men vs. women (nursing is a female-dominated career)
Women are more sensitive and thus are “hurt” easily.

  • How is it that women all around the world have survived in the medical community, then? Are you saying physicians are insensitive?

2. Women by their very nature can be catty
I have a hard time refuting this theory, since you don’t hear construction workers complaining about incivility. Men may resort to physical violence, but they aren’t diabolically vengeful (mostly!).

3. It’s the generation (Generation Y vs. Generation X vs. Baby Boomers)
Newer nurses feel “entitled”–they are “above” the basic bedside skills.

  • I would have picked the word “spoiled.” And it’s not just the younger nurses who are guilty.

4. BSN graduates are entitled and have an ego
So you think because they advanced their degree, they forgot what it was like at the bedside? Or that they would treat a bedside nurse poorly because they have more letters after their name?

5. Newer nurses preoccupied with leapfrogging
Apparently, it’s viewed as an offense if a young nurse wants to advance his or her education? While neglect is rampant (no argument there), how is pursuing a higher education a bad thing?

6. Newer nurses have no respect
Have you heard the saying “nurses eat their young”? Since when is a bad thing if the young fight back? Respect is a two way street.

  •  I think it has everything to do with you as a person (and professional) and how you deal with challenges. Period. It’s that simple. If you don’t want lateral violence to snowball, figure out a way to challenge it and deal with the root of the problem.

REALITY CHECK

We all need to grow some thicker skin
If someone offended you, don’t go tattling on them to your supervisor. Have the self-indignation to confront the assailant as a professional with your views, interpretations and explanations as well as suggestions to alleviate the occurrence from repeating. Do not turn into a high school teenager.

There should be zero tolerance from anyone holding a supervisory or leadership role
This includes every nurse who has more experience than the nurse next to them. I’ll say that again: You assume a leadership role the minute you are no longer the rookie. Period.

Newer nurses: Quit being so spoiled rotten
Just because you were coddled doesn’t give you the right to whine every time something didn’t go according to plan. Learn to roll with the punches. There is definitely a difference between self-assertiveness and immaturity.

Seasoned nurses: Quit being so vindictive and insecure
Leaving the bedside is neither good or bad, it’s just a decision to further one career. If you find it so offensive or appalling, keep it to yourself. Better yet, I dare you to try to take the same leap.

And lastly, this is for all the nurse leaders out there. If you really want to effect change, then quit with the academia-babble
Get out there in the trenches. Get your hands dirty (figuratively and literally). Quit creating new employer-based committees and developing action plans with continuum manifestos and evidenced-based theories. Walk the walk, folks.

Am I being blasé? A little too laissez-faire? Insensitive? Is it because I’m a man??!! (Ohh let the hate mail begin!) Or maybe, it’s because I don’t tolerate or accept the incivility when it shows its face.

I take a professional, head-on approach instead of whining, crying wolf and pleading with a “woe is me” attitude. There is a profound difference between being a victim and acting like one.

Let’s all put on our big-girl and big-boy pants and learn to play nice in the sand box.

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Sean Dent

Sean Dent is a second-degree nurse who has worked in telemetry, orthopedics, surgical services, oncology and at times as a travel nurse. He is a CCRN certified critical care nurse where he's worked in cardiac, surgical as well as trauma intensive care nursing. After five years practicing as an RN, Sean pursued and attained his Masters of Science in Nursing. Sean currently practices as a Board Certified Acute Care Nurse Practitioner (ACNP-BC) in a Shock Trauma urban teaching hospital. He has been in healthcare for almost 20 years. He originally received a bachelor's degree in Exercise and Sport Science where he worked as a Certified Athletic Trainer (ATC).
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8 Responses to Tough love for “incivility” in nursing

  1. Nurse Rene RN

    Sean: Thank you for responding to this topic. I requested that the editor get as many of the other writers as possible to give their comments when I was asked to write on the subject.
    And, yes, originally I DID use the word ‘spoiled’ but figured that it would look as OLD as I do and changed it to ‘entitled’ (the ‘now’ term).
    Again, Thank you for your comments!

  2. fnightingale512

    I think the main reason that nurses are perceived as being unkind to new nurses is simply that they are greatly overworked and stressed. There is no time to deal with a coworker who doesn’t know exactly what they are doing and not ready to pull their weight. If the patient loads were lessened, I don’t think this phenomena would be so prevalent.

  3. nursemary7 RN

    As a newer nurse I see the eat the young all the time. As students you get a lot of nurses who hate students and put every thing on them. If they didn’t (for example) tie the restraints right, but the person in the room with the patient when they pull out their tube is the student then it’s the student is incompentant ex ex. I also saw it as a nursing assistant. But one thing I’ve learned is to not be mean back and for things to change you have to be that change.

    • Abby Student

      Is that why nursing students are now required to purchase liability insurance. If I am correct, they used to practice under their instructor’s license.

  4. lmh391 Caption Contest

    I was just thinking about this the other night while watching the SAG awards and I listened to after actor after actor acknowledge fellow nominees with such respect and admiration. Why are we as nurses not treating each other with respect? Why are we not approaching each other vs. going to management or writing an e-mail that could destroy or directly impact the future of another nurse? When did it become ok to watch a nurse new or seasoned “drown” with a high acuity assignme…nt? It ultimately affects the patient, even if you think you are doing it to “that nurse”. This article was so well written, and I have noticed a sort of lack of civility. Even among CNA’s towards nurses and I would like to say “If you want to be the nurse with responsibilities then you need to go to nursing school”. I mean that in the sincerest way because RN carries alot of responsibility. We need to look out for each other and help each other and with the same admiration I saw at the SAG awards we need to display to one another~

  5. jeannevacca Caption Contest

    I think that some people are just mean,no matter how you look at it. Nursing is a profession which requires a TEAM to work together and for everyone to be as mature as possible in the attempt. I had a young nurse tell me that I didn’t really know what it felt like to code someone or work with a dead body.It made no difference to her that I’d been doing this line of work since she was 18 months old. By the same token, one of my seasoned senior colleagues was so intimidated by another senior coworker that she signed for that person’s med error! It was corrected,but still. So it goes both ways, and it can make a tough job that much harder.

  6. AaronLPN LPN

    People need to get a grip, leave the go at home and focus on being an advocate for the people in their care! They also need to accept that they may not always be 100% correct, their actions DO affect their co-workers and if they can’t deal with it, work somewhere else. I am so sick of nursing being all about “ME ME ME!!!”
    PS to the oldnurse who chewed me anew one for calling somebody by their name: I know how to work with the people in my care. Do you?