Mean Nurses

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