Almost every nurse has heard the expression ‘nurses eat their young.’ It’s almost like a right of passage for new grads and senior nurses alike. The American Nurses Association defines nurse bullying as the persistent actions meant to degrade, upset, and distress the recipient, carried out deliberately and undesirably. For me, this phenomenon made me terrified to start my first job as a nurse. I spent the night before my first shift tossing and turning, wondering what horrors awaited me. Unfortunately, nurse bullying is REAL. It is one of the main reasons new grad nurses leave so early in their careers. Why is the nursing profession like this? What can be done?

The Evolution Of Nurse Bullying

Nursing was far more rigid than now when it first became a profession. Nursing was–and still is–governed by strict hierarchies and fixed structures. The ‘eat their young’ culture in nursing, a metaphor for how experienced nurses sometimes treat their less experienced colleagues, can be traced back to these early times. This hierarchy and attitudes towards inexperienced nurses were not just about seniority; they also reflected societal attitudes towards gender and class. To dive even deeper, historical events, racism, and socioeconomic factors have contributed to the culture of nurse on nurse bullying and have persisted over the years. 

The Impact Of Wars On Nursing Culture:

Both the World Wars as well as the American Civil War were heavy hitters in shaping nursing as a profession and inadvertently contributing to a culture of bullying. During these times, nursing expanded rapidly to meet the demands of war, leading to a sudden influx of new, inexperienced nurses into a high-stress, high-stakes environment. This situation worsened the existing hierarchies within the nursing profession, where more experienced nurses held significant power over the newbies. The intense pressure and chaos of wartime nursing created a situation where brutal treatment of inexperienced nurses was not only standard but seen as necessary for rapid, on-the-job learning. 

In addition to conflicts between inexperienced and inexperienced nurses, there was friction between paid and unpaid nurses. Unpaid, religiously motivated nurses, as well as volunteers, saw themselves as superior to paid nurses. The paid nurses were typically from wealthier families and glorified themselves as doing ‘God’s Work.’ They tended to look down on the paid middle-class nurses, leading to resentment. 

Racial Dynamics and Nurse Bullying

Race has been an ongoing factor in the culture of nurse bullying. Historically, nursing in many countries was predominantly a white profession. Nurses of color, especially in times of segregation and during the civil rights movement, faced significant barriers to entering and advancing in the field. When they did enter the profession, they often encountered hostile work environments, where bullying was both a reflection of societal racism and a means of enforcing existing racial hierarchies within the profession. This racialized bullying had extreme effects on individual nurses and the overall inclusivity and diversity of the profession.

Socioeconomic Class and Its Influence 

In the early days of the profession, nursing was seen as a role for women from lower socioeconomic backgrounds, contributing to a perception of nursing as a lower-status job. This perception created an environment where the mistreatment and devaluation of nurses were normal. Bullying became a mechanism through which nurses, who felt powerless in a system that undervalued their role, exerted control over each other. This terrible dynamic was particularly evident in the treatment of new grad nurses from different socioeconomic backgrounds entering the field.

The Lingering Effects Of Bullying On Nursing 

Bullying has had far-reaching consequences in nursing, influencing the overall healthcare environment and patient care. Studies have shown that environments with high levels of bullying are associated with increased stress, lower job satisfaction, and higher turnover rates. The impact is incredibly profound on new grad nurses, the most vulnerable to this issue.  

Impact on the Nursing Profession as a Whole

– Workplace Culture: Nurse bullying contributes to a toxic work culture characterized by fear, mistrust, and low morale. This culture can lead to decreased collaboration and teamwork, essential for effective patient care.

– Staff Turnover and Shortages: The hostile environment created by nurse bullying often leads to higher staff turnover rates. A study conducted by AMN Nursing showed that up to 60% of new nurses leave their first position within six months due to bullying and related issues. This turnover exacerbates the nursing shortage crisis, putting additional pressure on the remaining staff.

– Patient Care: Nurse bullying negatively impacts patient care. Nurses who are bullied are more likely to experience burnout, fatigue, and disengagement, which can lead to errors, decreased patient satisfaction, and potentially compromised patient safety.

Impact on New Graduate Nurses

– Emotional and Psychological Toll: For new graduates, the transition from the academic environment to the clinical setting is hard enough. New nurse bullying makes this even worse, leading to anxiety, depression, and a decline in mental health. A survey conducted by ConnectRN and OnePoll indicated that over 50% of new nurses experienced verbal abuse, significantly impacting their mental well-being.

– Professional Growth and Development: Bullying hinders the professional growth of new nurses. It creates an environment where they cannot learn effectively, ask questions, or seek professional development.

– Career Trajectory: New graduates who experience bullying often question their career choice. A study found that 25% of bullied new nurses considered leaving the profession entirely, a significant concern for the future of nursing. A 2020 survey reported that nearly 35% of nurses experienced bullying from senior staff, impacting their confidence and job satisfaction.

Recognizing And Avoiding A Toxic Nursing Unit

Most nurses, especially new grads, wonder how to avoid working on a toxic unit. Knowing the signs of a toxic unit and understanding how to research a unit’s culture before joining can be super helpful in making an informed career decision.

Identifying Red Flags During The Job Interview

1. Lack of Open Communication: Pay attention to how staff members communicate with each other during your interview or tour of the unit. A lack of open and respectful communication, or visible tension among staff, can be a red flag
2. Negative Attitudes: What is the general mood and attitude of the staff on the unit? Are they welcoming, or do they seem disengaged and unhappy? Staff demeanor can be a strong indicator of the unit’s culture.
3. High Turnover Rates: Inquire about staff turnover rates. High turnover may be a sign of a stressful or unsupportive work environment.
4. Inadequate Responses to Your Questions: Be wary if there is an undue emphasis on enduring tough conditions or dealing with difficult personalities without the mention of support systems. 

Signs That Indicate A Nursing Unit Is Toxic

1. Persistent Staff Conflicts: This is not normal. Frequent conflict among staff members, especially if unresolved, indicates a toxic work environment.
2. Bullying or Harassment: Any signs or reports of bullying, harassment, or intimidating behavior are major red flags
3. Lack of Support For Professional Development: A toxic unit may not support continuing education or professional growth opportunities for its staff.
4. Poor Work-Life Balance: Excessive overtime requirements or lack of flexibility in scheduling can be signs of an unhealthy work culture.
5. Neglect of Mental Health and Well-being: If a unit does not prioritize its staff’s mental health and well-being, it can be a sign of a toxic environment.

Tips on Researching A Unit’s Culture Before Joining

1. Connect With Current or Former Employees: If you can, contact nurses who currently work or have worked on the unit. They can provide valuable insight into the actual working conditions and culture.
2. Use Social Media and Online Forums: Platforms like LinkedIn, nursing forums like All Nurses, and social media groups like Facebook and Reddit can be useful for gathering information about a specific unit or hospital.
3. Review Employee Satisfaction Surveys: If available, look at employee satisfaction surveys or reports, which can give an idea of the overall morale and workplace environment.
4. Ask Specific Questions During The Interview: Prepare a list of questions about workplace culture, conflict resolution, staff support, and professional development opportunities.

Asking these questions during job interviews and researching your potential workplace thoroughly can help you avoid potential nurse bullying and toxic work environments. Being proactive is one of the most important steps to protect your personal and professional well-being. 

How To Handle Nurse Bullying

Dealing with nurse bullying in the workplace is hard, especially if you’re new to the unit. Navigating this is easier said than done, and standing up for yourself is scary when you feel your job is on the line. Here are some professional strategies to handle bullying.

Immediate Response To Nurse Bullying

• Stay Professional: It’s hard to manage your emotions when someone disrespects you. However, the last thing you want to do is blow up and have your reaction escalate matters. Saying phrases like “I feel uncomfortable with how you are speaking to me.” or “This is unprofessional” can illuminate the situation.
• Document Incidents: Sometimes, telling the person you’re uncomfortable doesn’t always help. Be sure to record every incident, including dates, times, witnesses, and details of the events. This is incredibly important if formal action is needed.  
• Ask For Help: Talk to someone you trust, so you’re not alone. Make a supervisor aware of what’s happening so that they can take action. 

Long-Term Defense Strategies

• Understand Your Rights: Be aware of your unit’s policies on nurse bullying and harassment. They are required to abide by these regulations.
•  Develop Strong Communication Skills: This can help you to assert yourself effectively and manage difficult conversations without falling apart.
• Build A Support Network: Having someone in your corner makes all the difference. Having a colleague that you can trust will help you with emotional and professional support. 
• Report Bullying: If the situation does not improve, consider reporting the bullying to human resources.

Moving Towards a Healthier Professional Environment

Acknowledging the context of nurse bullying is the first step towards change. It’s important to understand that this issue is not just about individual actions but about changing a culture that has been accepted for too long. Efforts to address nurse bullying must involve systemic changes, including policy reforms, education, and a shift in how we perceive and practice nursing leadership. 

As healthcare professionals, recognizing the historical roots of nurse bullying allows us to be more empathetic towards those affected and more committed to creating a positive and supportive work environment. When nurses support each other, it can improve the entire culture of a work environment.