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June 5, 2019

By: Victoria Rondez Squier, MSN, RN, CNL

Role of young nurse leaders in ending bullying

Food for thought: Rather than dining on our young, how might we—the next generation of nurse leaders—model positive professional behaviors and help to end the hazing, the bullying, the eye rolling, and all the other covert and overt intimidation that has plagued our profession for decades. A mentor once said to me, “Physicians groom their young and teach them early that they are the leaders of the healthcare team.” I do not for the life of me remember ever being conveyed the message that I was to lead anything but a code blue in the event that I would be asked to do so. However, I do remember being told, “You are the coordinator of care…you are in charge of your patients…and if anything goes wrong, you will be blamed, so cover your behind!” I suppose that was one way of saying to me that I am the captain of my ship.

I made it through nursing school with just a hint of PTSD, unscathed, and ready for action. The bit of confidence I gained from having passed the grueling boards was enough to last me my first week of orientation as a new grad. But was training and validation of skills enough to make a rookie nurse not jump out of her seat in the middle of charting when shot with the, you’re-in-my-chair look from senior nurse Grumpy or doctor McCrabby? Back then my safe zone was at the bedside, developing a therapeutic relationship with my patients away from the drama at the nurses’ station. This was where I felt empowered—caring for another human being and helping an individual get through a vulnerable moment in time. Whether or not my patients were receptive or resistant, I was sure to do my best to advocate for them.

I fondly remember my preceptor, the only seasoned peer who offered any encouragement those first 8 weeks of sucking it up and holding back the tears. She said to me, “You learn quick. You’re a smart one. You really care about your patients.” Her kind words still resonate with me, as she was my lifeline that first year out of the gate. I paid close attention to her attitude and behaviors, as she modeled professionalism. Despite the prevalent culture of incivility among our colleagues, her work ethic and integrity were of the highest standard. The rest of my bittersweet memories as a novice nurse, now healed from the past bullying and hostile environment, is fuel for my passion to lead and mentor all nurses and future nurse leaders.

My goal is to create an environment of psychological safety in my setting, which fosters accountable, caring, compassionate, professional behaviors. In my recent poll for thoughts from a convenience sample of nurse leaders, I found the sentiment is that we are starting to move in the right direction in curbing nurse incivility but there is opportunity for growth among leaders. Here are some soundbites to chew on:

  • “We should anticipate the answering of questions, that which a nurse who is new to a role, might not know to ask.”
  • “Withholding pertinent information that hinders another nurse from being successful in completing a task is another form of incivility to be addressed.”
  • “An ongoing mentor/mentee program ought to be in place, a custom pairing of nurses who mutually share knowledge and coach one another.”
  • “Share stories, get to know one another, re-inspire each other.”
  • “Incivility among leaders sends a subtle message that there is a double standard and that behaving badly is not a barrier to upward mobility.”

Fellow nurse leaders, my call to action is to reflect. Remember when you were the novice RN or the novice nurse leader and be mindful that your words and behaviors can tear down or build up the individual on the receiving end.

 

Victoria Rondez Squier is nurse leader in adult patient care services at Kaiser Permanente South San Francisco in California. The postings on this site are her own and don’t represent Kaiser Permanente’s positions, strategies, or opinions.

5 thoughts on “Role of young nurse leaders in ending bullying”

  1. Ivette G says:

    I totally agree with Joan Jones on her comment. Any form of bullying or negative attitude should and will not be tolerated at any hospital and healthcare facility and should be grounds for termination if the perpetrator continues to behave negatively towards any new nurse. This type of behavior should NEVER be acceptable, whatsoever! I have never treated any new nurse bad or with an attitude. There is absolutely no need for it. Clearly, if there is a new nurse on board they are going to ask questions. My thing is to always ask questions just so that you are well educated and sure of your decision making while taking care of patients. Safety is always a priority and I would much rather have a new nurse ask me all the questions than to assume their judgment costing injury to a patient. We were all novice nurses at one point in our lives. We need to be more understanding and patient with one another.

  2. Rick says:

    I am a seasoned nurse, and recently dual boarded NP… There is sadly still a culture of bullying g where i work that is from the RN’s directed at the NP’s. I have documented, gone to my supervisors, dept heads, and still have received no assistance. I feel for you. All we can do is be better than them and stronger… management only gives lip service… and this is at a major teaching hospital…

  3. Annette Kasselman says:

    Very nice article. Sorry you had to deal with that unprofessional atmosphere.
    I would suggest that peers would have more lasting change on the culture of a unit that doesn’t allow incivility to exist. If that were the case management would not have to flex its muscle at all. This would be an example of “we the people” or in today’s vernacular self-governance.
    We all need to be professionals, kind and compassionate to each other as well as our fellow healthcare providers. I have noticed throughout my 36 years of nursing that bullies beget bullies. Let’s all stop the incivility toward each other. It begins with me and you.

  4. Joan Jones says:

    During nursing orientation, it should be noted that bullying in any and all forms is against institutional policy and must be reported to management and/or Human Resources. For seasoned employees, mandatory trainings on what bullying looks like in all its forms should take place quarterly or twice a year at a minimum. In my opinion, management and administration has allowed bullying to get out of hand. Employee assistance programs should address the need for confidential counseling and support for victims of bullying and for the perpetrator of bullying as well as both have issues. Should a perpetrator of bullying continue to exhibit the same damaging behavior after counseling, employment termination should follow.
    Another victim of bullying that is seldom (if ever) considered is the patient. Patient care is impacted when the nurse is burned out, victimized, traumatized, etc. I haven’t seen the research but it would be interesting to know how bullying affects employment retention and how many nurses have left the profession due to abuse. Also, staffing is impacted as bullied caregivers will have seemingly unrelated health issues. If we are putting our patients first, as we give lip service to, nursing leaders need to stop tolerating the culture of staff on staff psychological violence.

  5. Jean says:

    Agreed…I remember being told I could ask “3 questions a day” when I was a novice. Thankfully another seasoned nurse told me, “You’ll have lots of questions, pay no attention to her.”

    Positivity can be learned…but only if required by management or desired by individuals.

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