When Nurses Hurt Nurses

By Linda Friedel , The Kansas City Nursing News

Cheryl Dellasega, PhD, CRNP, examines work force behavior in her latest book, “When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Bullying.”

Dellasega, author of “Mean Girls Grown Up,” “Girl Wars” and “Surviving Ophelia,” said bullying is not unique to nurses. She sees similar behavior in other fields.

“I’m fascinated by women and how we are these caregivers, but then it can turn bad as well,” Dellasega said. “When they’re girls and how wrong they can be to each other, and that can last into the adolescent years. It’s all been connected.”

A study Dellasega conducted revealed that 73 percent of adult women found workplace bullying to be common or very common. The same women reported that weekly, they are, on average, a bully 1.5 times, a victim of bullying 1.8 times and a bystander to bullying nearly seven times. Dellasega said bullying is often unintentional.

“I don’t think it’s entirely an intentional vicious kind of thing that’s just inside of nurses, as compared to say, female executives who I work with that do the same kind of behavior,” she said.

Dellasega said 10-hour and 12-hour days in a confined space contribute to rudeness at the day’s end.

“A lot of what I see is due to these long hours,” she said. “That’s just exhausting. By the end of the day, you’re irritable, you’re frustrated, you’re trying to keep your energy up.”

Dellasega said the whole context of the work environment can be part of a dynamic where somebody starts giving you a hard time or doesn’t have the best communication skills or management skills.

“You’re at the end of your energy and tolerance and the situation just sort of explodes,” she said.

Still, much of the bullying, she said, is aimed at new graduates.

“The group of new nurses may get harassed or picked on or aggressed against, but it’s not like that old dynamic of ‘this is part of the hazing initiative that goes on,’” she said.

Dellasega said employees would do well to understand that what comes off as bullying sometimes is symptomatic of a greater problem.

“It’s rarely you. It isn’t that you are a bad nurse or bad person or stupid. It’s usually the context or something else in that person’s life,” Dellasega said.

She recommends taking a deep breath and saying to yourself, ‘This isn’t about me.’ Ask yourself what is going on with him or her. Find out the whole situation. Sometimes we invite aggression, she said. Beware how we pass information. Monitor our own behavior.

“We repeat something we shouldn’t,” she said. “It gets blown out of proportion – ‘why did you start this rumor about me?’”

Dellasega said the work setting is getting more tense and registered nurses are spending less time at the bedside. They are caught in the computer, paperwork and dealing with different players in the health system. That leads to frustration, then bullying.

“They’re not really getting to do the things they thought they would be doing when they came into nursing,” she said. “That’s the biggest source of frustration I hear.”

Curtis Weber, RN, BSN, CPN, recently blogged about bullying. As a male, Weber said he is less likely to be bullied by a woman, nurse or physician, but it still happens. He became aware of bullying during his clinicals in nursing school

“I saw it more then than when I became a nurse,” he said. “Bullying goes on at every institution at some level. I think sometimes bullies usually know what they’re doing.”

Weber said bullying should never be excused, that the victim should confront the bully and let her/him know the effect of what they said.

“Tell the person, ‘Maybe you don’t intend it this way. You’re making me uncomfortable.’ It may end it right there,” he said.

Kathy Bosaw, MS, RN, CRRN, assistant professor of nursing at Graceland University, said bullying has decreased since she started nursing in 1975. Bosaw did not like the way young graduates were treated and made it a point to mentor others new to the field.

“I ended up being a preceptor for a lot of them because when I worked as a staff nurse I always thought that I had the patience to work with them,” she said. “That’s what drove me to teach.”

Most institutions today have policies in place on how to handle harassment or bullying. Bosaw said each employee at her institution must participate in a class addressing the issue.

“I think it’s absolutely necessary,” she said. “It makes everybody realize that they’re all equal and they’re all there for the same purpose – taking care of patients.”