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Bullying

Nurse Bullying Is Real

What nurse bullying is and why it matters for nurses, patients, and hospitals.

Key points

  • Nurse bullying contributes to nurse burnout, higher rates of depression and suicide, and diminished patient quality of care and safety.
  • A majority of graduating nursing students have witnessed or been the recipient of nurse-on-nurse bullying in clinical rotations.
  • The vast majority of nurse bullying happens in hospital settings.
 Josephine Ensign
Radical Nurses Group, Edinburgh.
Source: Josephine Ensign

In my almost 40 years of nursing, I have heard about, read about, and taught about nurse bullying, but I had never experienced it directly—until yesterday while working as a COVID-19 vaccinator in a hospital setting.

The American Nurses Association (ANA) defines nurse bullying as “repeated, unwanted harmful actions intended to humiliate, offend, and cause distress in the recipient.” As I write that, I wonder why they include “unwanted” in the definition. Who in their right mind would want to be bullied? And even if that were the case, it would not make bullying OK. The ANA includes bullying in its statement on workplace violence. They point out that nurse bullying threatens patient safety, diminishes quality of care, and contributes to nurse burnout/staff turnover. Nurses who are bullied suffer a host of physical and emotional repercussions, including higher rates of depression and suicide.

“Nurses eating their young” is an oft-repeated phrase when referring to nurse bullying. I imagine that Florence Nightingale was quite the nurse bully. It seems to be ingrained in our profession and treated almost like a necessary rite of passage. Nurse bullying can begin in nursing school, with students being subjected to humiliation and intimidation by professors, clinical instructors, and school administrators. In some studies (see references below), over half of graduating nursing students report having witnessed (bystander) or been the recipient of nurse-on-nurse bullying in clinical rotations. The vast majority of nurse bullying happens in hospital settings, perhaps perpetuated by the high stress, high stakes clinical outcomes, heavy workloads, and low job autonomy of nursing within the rigidly hierarchical hospital setting.

I know that many frontline hospital nurses across our country and in other countries hard hit by the pandemic are burned out and angry after over a year of treating patients with COVID-19 and seeing so many of them die. Many nurses are tired of being portrayed as “angels on earth.” And, of course, the pandemic is far from over despite the rollout of safe and effective vaccines. Perhaps the vaccine clinic nurse manager yesterday is one of those burned-out, pissed-off nurses. It doesn’t excuse the bullying behavior she threw my way (I’ll spare you the details but it went way past incivility) and to a patient who, post-vaccination, asked to use the restroom (located next to the clinic) and she told him curtly that he had to wait the full 15 minutes of post-vaccine observation. Seriously, a patient is a person who has the right to use the restroom. I’d had enough and escorted the patient to the bathroom, waited outside to make sure he was OK, and then excused myself from the presence of that nurse bully. And I reported her behavior in the hopes that she will be removed from that specific role and offered professional coaching of some sort. But I’m not going back to that setting, at least not as a clinician. I’ll find a better place to volunteer as a nurse vaccinator.

I’m attempting to turn this distressing experience into a teachable moment, for myself, and for students I teach. I now know from direct experience that nurse bullying is real.

References

Theresa Brown, “When the Nurse is a Bully,” NYT Well blog, February 11, 2010.

Cole Edmonson and Caroline Zelonka, “Our Own Worst Enemies: The Nurse Bullying Epidemic,” NURS ADMIN Q. 2019, vol 43(3):274-279.

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