Do Nurses Eat Their Young? What’s Wrong With Communication in Health Care?

The Workplace Bullying Institute defines Workplace Bullying as repeated, health-harming mistreatment of one or more persons (the targets) by one or more perpetrators that takes one or more of the following forms:

  • Verbal abuse
  • Offensive conduct/behaviors (including nonverbal) which are threatening, humiliating, or intimidating
  • Work interference — sabotage — which prevents work from getting done

040811_020 retouchedRenee Thompson, MSN, RN, CMSRN, nurse, author, educator and advocate for workplace change, is making it her mission to bring nurse bullying  to light.  In her question “Do nurses eat their young?” she shocks us into awareness of nurse bullying.  “I’ll do whatever it takes,” she asserts. “Enough of us who believe in kindness, support and nurturing each other can do it!  New nurses (and the rest of us) deserve to work in nurturing supportive environments…Bullying has no place in a profession dedicated to caring and compassion.”

So what is wrong with interpersonal and organizational communication in the health care setting? Bullying.  Why is bullying happening?  One theory suggests that since nurses are not valued in the workplace they feel powerlessness.  This results in bullying behavior.  Another points to nursing as a predominantly female profession with a forced hierarchy.  In this model, the cause of bullying lies in female competition for prized males.

Despite these notions, or perhaps because of them, Ms. Thompson speculates that medical and nursing school education may start the process. “Doctors and nurses learn separately, then are forced to work together without training. We wouldn’t do that with an All-Star basketball team,” Thompson says.  “Respectful communication is a skill that can be learned and it is just as important as clinical knowledge.”

Yet it is missing from the beginning.  “Nurse sand doctors don’t learn how to communicate respectfully with each other. Student nurses are not even allowed to speak to doctors when they are learning.”  It makes sense.  “When members of a team learn together, they learn to respect roles and work together.. all working towards the same goal…patient care.”

Research literature describes  nurses “as an occupational group, at considerable risk of violence-related workplace trauma” and recounts experiences of “harassment, bullying, intimidation and assault.”(1)

In her own research for her book, which Ms. Thompson conducted while developing student and new nurse residency programs, she heard horrific stories. In her research she encountered recurring themes. “Students and new nurses are the most vulnerable, but any time you change positions, you are at risk. We are still trying to sabotage, especially when the female is younger, thinner, more beautiful and smarter. While nurses are caring to patients, they can be horrific to each other.”

NursingA study of bullying published in Journal of Professional Nursing in 2009 reveals which departments  in hospitals were most likely to have bullying incidents and who were the perpetrators.  The medical-surgical and critical care units had the highest frequency of incidents at 23 and 18 % respectively.  Bullying incidents occurred within nurses’ first 5 years of employment.  Senior nurses were the highest percentage of perpetrators at 24% followed by charge nurses, nurse managers and physicians (8%).   This research confirms Ms. Thompson’s observations.  “Nurses know we eat our young.  Some nurses think it’s good to “toughen up” the new nurses. In reality it’s not. It decreases confidence and competence. “

In fact it seems to be a vicious cycle.  Those who are bullied lose their confidence and are more likely to be targeted.  Ms. Thompson identifies passive communication styles, like “frequent apologizing, avoiding conflict by keeping quiet, giving others priority” as characteristics of victims.  Other characteristics included being of a different gender, race, or from a different location.

Ms. Thompson has witnessed workplace bullying in the nursing profession.  The behaviors range from“overt-screaming, yelling and openly criticizing in front of others to covert-sabotage, backstabbing and undermining.” Bullying can be as simple as “being nice to your face, but then complaining about you to other nurses all night” or as complicated as “gathering a “posse” against you.”


A 2006 article in Nurse Inquiry suggests that there may be hidden processes at work causing nurse-to-nurse bullying.  The authors propose that health care organizations may actually be maintaining the status quo, recruiting nurses who support a top-down hierarchical structure.  Ms. Thompson uses an Italian saying “the fish rots from the head,” to describe her understanding of what is happening. She believes that many organizations rely too heavily on policy to solve bullying.  Without a robust program, zero tolerance policies don’t work. “Policies don’t solve problems – people do,” she notes.

Bullying can impact patient care.  “Organizations with a high rate of bullying have worse patient outcomes.** Many studies demonstrate bullying prevents nurses from asking for help and calling docs at nursing_02.sized3am,”  Thompson observes.   “I  know some nurses who feel they can’t rely on co-workers if they need help for patient.” Nurses who are bullied suffer physical, emotional and mental distress which is disabling, impacting their ability to effectively care for patients.  “Bullying is pervasive, destructive and nurses are suffering all over the world. I know because they call me!”

Patients are becoming aware of nurse bullying. They are asking questions about it. “They’re on to us! “ she says.  And Ms. Thompson is glad. “Awareness is vital to change. The first step for organizations is awareness. You have to know how bad it is first before you can take action.  We get numb to bad behavior, accepting it as normal. Too often we believe what the bully tells us.”

The most powerful intervention to stop bullying, she notes, is for witnesses of bullying to speak up. “We need to teach people how to establish peer-to-peer accountability.  A simple way is to just starting naming behavior. ‘You are screaming and yelling at me in front of others.’” Thompson proposes “skill development for managers and strong human resources partnerships.”.

StopBullying It sounds a lot like personal courage is key.  “What you ignore – you condone. It doesn’t matter if the aggression is aimed at you or someone else… Set behavioral expectations. You can’t assume everyone knows what respectful behavior looks like. So spell it out….[It’s true] confronting might not work. But not confronting NEVER works. We have to try.”  In speaking up, Renee Thompson has decided to do just that!

For a detailed discussion of this topic, see the transcript of the #hchlitss twitter chat that this summary is based on.

Several chat participants requested seminar information from Renee.  Please visit Renee’s seminar information page at http://rtconnections.com/events-2/bullyproofing-communication/ to learn more about her upcoming seminars in:

  • Irvine, CA: February 7th and 8th
  • Orlando, Fl: March 14th and 15th
  • Raleigh, NC: April 24th and 25th
  • Atlantic City, NJ: May 22nd and 23rd

If you are interested in reading Renee’s book, Do No Harm both the hard copy and the Amazon kindle version can be accessed at http://rtconnections.com/products/book/

1) Vessey, J., DeMarco, R., Gaffney, D., Budin, W. (2009) Bullying of Staff Registered Nurses in the Workplace: A Preliminary Study for Developing Personal and Organizational Strategies for the Transformation of Hostile to Healthy Workplace Environments Journal of Professional Nursing, 25, (5) , 299-306.

2)Hutchinson, M. Vickers, M. Jackson, D. Wilkes, L. (2006).Workplace bullying in nursing: towards a more critical organisational perspective.  Nursing Inquiry 13,( 2),  118–126.

**Aleccia, J. (2008).  Hospital bullies take a toll on patient safety.  http://www.msnbc.msn.com/id/25594124/ns/health-health_care/t/hospital-bullies-take-toll-patient-safety/#

http://www.workplacebullying.org/individuals/problem/definition/

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19 thoughts on “Do Nurses Eat Their Young? What’s Wrong With Communication in Health Care?

  1. Absolutely bullying is not exclusive to young or new nurses. I recently have been subjected to outrageous bullying the only difference for me was i fought back much to my dismay I was fired as the end result. I’m angry but I will never allow anyone to bully me professionally or personally.

    • 1/31/13. Dear Sandy.I too was a victim of bullying leading to termination.I am 64.I have worked in Cardiac nursing x 40 yrs.I had been employed at same Catholic hosp.x 32 yrs.I believe many multi-discplinary and RN co-workers felt threatened by my knowledge and expertise.I never bragged or came across as superior or know-it-all.I was well liked and respected by physicians and a lot of long term co-workers.It was a devastating blow to me-painful,hurtful and just wrong.It was a non-nursing manager who trumped up charges against me.I am angry.Struggling to find another job after getting a bad rapp.Upper management moved from Sisters control to secular big business/money minded people.Non-magnet status but i was caught under a Supposed “whistle blower”type accusation in which I was given no option to discuss/explain my position.It was malicious manipulation of the system-I was black-balled.Very painful and sad.My integrity defamed,my devotion to nursing nearly destroyed.Keep the Faith.
      Respectfully, Marti

    • I’ve experienced exactly what you went through Sandy; I left when I saw the boss was a professional idiot. I have made the decision to leave this awful profession. Never again.

      • I’m convinced this is one of the big reasons so many nurses go into other nursing fields that take them away from the pack – like insurance case management, nurse coder, nurse auditor, etc – the more autonomous areas of nursing.

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    • Thank you for mentioning my post in your blog! Gender differences are supposed to be a factor in nurse-to-nurse bullying. Renee Thompson’s book and seminars, I hope, will make a real difference in the culture. We all need to stand up and say STOP BULLYING!

  3. I was bullyed also recently by a nurse manager and lost my job because of it. I will never work in that kind of environment either.

  4. This is an outstanding article, and more needs to be said about this problem. So many nurses say that they have come to “hate nursing”, when what they might really hate is the way they are left to drown by their own coworkers. In this time of healthcare crisis, should willing, able nurses be run off?

    • Thank you so much for the compliment. You are so right. Peter Buerhaus of Vanderbilt University said that there will be a large shortage of nurses in the next 10 years–about 300,000–in an article in the Washington Post,

  5. Excellent article. First time I’ve seen this common issue with nurses written about!

    We need to learn to treat each other with respect, dignity, integrity. We’re working to enhance relationships and healing in healthcare, and created the International Charter for Human Values in Healthcare, starting with the capacity for compassion. The mission of the International Charter for Human Values in Healthcare is to restore the universal core values that should be present in every healthcare interaction to healthcare around the world. Enhancing these values will decrease bullying and improve how we treat each other! Important reading for all ->
    charterforhealthcarevalues.org

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  7. Excellent article. I am puzzled how a profession that involves address the needs of our patients spitual and physical needs find the need to eat their own. Bulling another is counter-productive and can lead to various poor outcomes. Hopefully at some point nurses will start to view fellow nurses including new nurses as equal teammate and treat each other with respect.

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  9. They most certainly do, I am a clinical instructor for senior nursing students. I am currently at a facility that has done nothing but mistreat my students, I can literally say they are a hand full; maybe not a hand full lets say three, that have been supoortive, informative and nurturing to my students. In a proffession that requires nurturing, support and patients we are such a disappointment to our future nurses. I take this personnaly because I truly love being a nurse, the good, bad and ugly of nursing. I really believe the reason we have such a shortage of nurses is because we don’t know how to treat the new generation.

  10. I feel so blessed to have had amazing nursing experiences through my RN, BSN and CSN education. I was mentored by amazing woman who nurtured, responded and encouraged my personal and professional growth. From those experiences, I developed a place in my heart for students and new nurses. Therefore, much like bullying, the experience and example have been passed to the next generation. All this being said, I have seen bullying and interestingly have been a victim of it professionally in terms of my diabetes and what that represents for accommodations. I have learned that many nurses do not extend compassion when it comes to team mates with illness. I have always found it interesting that those who choose a profession which demands compassion, are often the least compassionate people of all. This lack of compassion is what turned me away from nursing. I find it repulsive to be treated so poorly and even more repulsive to listen to the constant, heartless chatter revolving around patients’ illnesses, family circumstances and personality traits. I often pray that each heartless nurse gets a wake-up call and ends up in the same bed and circumstance he/she regards with such absent empathy.

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  12. I remember an old-school nurse instructor who was just mean. A good friend of mine had the same issue. I found the younger instructors much more helpful and supportive. Great article. My sister (also a RN) experienced a more recent event but luckily someone else stood up for themselves and they FINALLY looked into why so many were leaving a particular floor. It was one person who was bullying– and this one person had cozied up to the supervisor. When it all came out the bully had to mind and the workplace changed. It does take someone to stand up, sadly some lose their jobs over it.

  13. Ian Miller writes about how nurses should stop all the pettiness and be “Hardcore Nurses.” “The Hardcore Nurse” is worth a read. It will definitely make you to think a little harder about what you do when you are at work an the efforts you make to be a good nurses while showing care for patients without letting any bullying or nonsense get in the way.

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