Categories: Scrubs

Toxic Nursing: the stories, the solutions

Rankism

Rose, a “mature” nurse, takes great pride in being the most experienced employee on the geriatric unit. Whenever a new nurse appears, Rose goes to great lengths to tell him or her that she has been at Grace Hospital since the unit opened.

One busy day on the unit, Tammy, a float nurse who regularly comes to the geriatric unit, is assigned to work with Rose. As soon as Tammy arrives, Rose gives an exaggerated sigh. “Oh gosh, I guess I’ll have to help you all day—again,” she says to Tammy, who thinks she’s joking and laughs.

Rose spends most of the morning telling Tammy how to do basic procedures that Tammy is competent to perform alone. Eventually, Tammy feels as if Rose is condescending and trying to give her the message she’s just not good enough to work on the geriatric unit. “Just because she’s been here 20 years doesn’t mean she’s better than me,” Tammy tells the supervisor. “Please, don’t send me there again.”

The Expert Weighs In:

Rose, through her tenure, perceives herself as the expert nurse on the geriatric unit. This elite self-designation sets the stage for a work environment in which bullying or insidious intimidation can flourish. Rose may perceive a threat to her position and status and has resorted to classic bullying behaviors to maintain her influence—unwarranted criticism and excessive monitoring of a competent and experienced nurse. It’s also likely that Rose will exhibit the same behavior with other nurses if she continues to feel a threat to her status on the unit. Tammy reacts in a manner that relieves the problem for her by requesting not to work on the unit again. However, this doesn’t eliminate the problem that Rose’s behavior creates for the unit and the ability to ensure the recruitment and retention of qualified staff. Once the nurse manager is made aware of the situation, she can continue to assess the ongoing impact of Rose’s behavior on the unit.

–Mary T. Meadows, MS, MBA, RN, CENP, Director, Professional Practice, AONE, Executive Director, AONE Foundation

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