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April 20, 2008

Workplace Violence: Disruptive Behavior, Bullying, Verbal Abuse

Over the last couple of weeks there has been a disturbing video shown within the media involving young teenage girls assaulting another teen. Premeditated violence? Their ages range from 14 to 18 years with charges having been filed as adults for each. This leads me to wonder about a new article that I read about workplace gossip within nursing.

Disruptive behavior such as bullying, lateral violence, and verbal abuse is so common in healthcare settings that the Center for American Nurses  recently released a position statement calling for zero tolerance to lateral violence and bullying in nursing work environments. The Joint Commission also proposed new standards that will require organizations to develop codes of conduct that define and address inappropriate workplace behavior.

Whose responsibility is it to stop disruptive behavior? How do we even stop the bullying and gossip that seems to run rampant? Why not use that time to formulate strategies to solve current issues within nursing? Instead, it is all too easy to ignore the behaviors seen within nursing, rather than to confront them? Gossip, backstabbing, withholding of information, and shunning of our co-workers are all forms of workplace violence. Apparently, this trend appears to be growing.

Have you been a victim of workplace violence? If so, please share your story with us.

(For more information on The Center for American Nurses' position statement, visit www.centerforamericannurses.org/positions/lateralviolence.pdf)

April 20, 2008 in Beka | Permalink

Comments

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Posted by: Emla | Dec 2, 2011 11:28:04 PM

It's unfortunate Adrienne lost her job after publishing her memoirs. However, I think she'll find that every employer has policies all staff MUST follow before publishing ANYTHING with the agency's name on it. This has certainly been my experience: any manuscript had to be reviewed by my employer before being submitted to a potential publisher. This does not mean it cannot be submitted for publication without an employer's approval, but that the employer has advance notice regarding something that may be widely distributed, especially if the content may reflect negatively on the organization. It is, at the very least, a courtesy and, in every place I've been during my 30+ years of nursing, an expectation.

Regarding the topic of "workplace violence", one of the best articles I've ever seen on the topic was "Oppressed Group Behavior: Implications for Nursing" by Susan Jo Roberts, published in "Advances in Nursing Science", 1983 (Vol 5, Issue 4). Excellent presentation of the problem and why it continues to be such a tragic issue for us.

Posted by: Jan Stockton | May 20, 2008 1:49:41 PM

Just thinking as usual- who should be responsible for stopping workplace violence ? Administrators ? Nurses themselves ?

Solutions anyone ??

beka

Posted by: beka | May 19, 2008 8:51:34 PM

Check out Poster Adriennes' Memoir on the following website-
http://adriennezurub.typepad.com/

Something new and altering when it comes to prestgious Healthcare Medical Centers !

beka

Posted by: beka | May 6, 2008 6:31:38 PM

I have been in nursing for over 30 years. It is a crying shame. The gossip, the cliques, the back-biting, the favoritism, bullying, demands, standards or expectations. I resent all the managers I have had who for whatever reason used and abused me, and those around me. I have been reduced to tears at times by the injustice of it all. And then scolded for being too emotional.

I have preached to my daughter since she was in grade school to be anything but a nurse, because I want her to have a profession where she is respected and treated better than nurses are. So why do I continue to work as an RN if I hate it so much? Because I love being a nurse. I love taking care of people, and know this is what I am called to do. I have been around long enough to know that one place is not a whole lot different from another. I don't fit into any of the molds I am familiar with, and being unique is not always valued. I'm a hard worker. I'm dedicated and compassionate. I have very high standards for myself and others. I get so tired of being reminded to be "professional." And I get sick of feeling like no matter what I do, it is never enough, or it is never good enough. What I really hate is feeling powerless. Knowing I need my job, and have to earn a living, but never feeling secure in my job, because some administrator half my age could decide to fire me "with or without cause" in my state. I try so hard to do my best. Some days I'd like someone to tell me my best is good enough, that I have done a good job, that I am appreciated and that someone is glad to have the good fortune of having me on their team. I deserve better pay and better benefits. I think we need to find ways to make nursing less demanding physically for the aging nurse workforce, and to protect the health of our younger nurses.

My first 8 months in my current position, the person who had been in my position before me tried to sabatoge me on a every day. She lied to my boss about me from the first day I was on my job. She spread lies/rumors about me among the staff. She even retained a copy of the key to my office, (which had been her office before she was moved back to her former position), and set up situations to make it look as if I had done stupid, mean and underhanded things. She deliberately gave me incorrect information about things I needed to know in order to do my job. And shredded things! I confronted her when things made their way back to me, and eventually the staff nurses got wise to her antics. Two of them finally reported that she had bragged about having the key, saying "They don't expect her to work out. They let me keep the key." My lock has now been changed. I don't know how long it would have gone on. Thanks to God, the administrator, and the DON who confronted her with the evidence of a number of wrong-doings. She is, as we say, "No longer an employee here." In my position one of the biggest challenges is the number of hours I am required to put in, and when people call-in or can't work, I am expected to help out, in addition to my own job. I am not a young woman any more, and it's not easy. I should at least be able to feel safe and respected by the people I spend 8 to 16 hours a day with.

Posted by: Rebecca | May 3, 2008 2:57:03 AM

It's this simple: Unless a nurse can treat his/her nursing and other colleagues as well as he/she treats her patients it is just another job, not the profession or practice of nursing. It is time for nurses to act like the professionals they are. It can start with just one person - you.

Posted by: Lynn | May 2, 2008 8:28:21 AM

Finally a blog that hits the nail on the head for me! I am an 18 year veteran of nursing as an RN.I have worked in several diffent areas of practice and have found the enviornments in most , reach a point of intolerance for me personally.I have had nurses throw bottles of water at me (* on the desk at change of shift-when SHE arrived)..I have had doctors scream at me or at other nurses when things were not "set-up" on his/their arrival.I have had doctors scream over the phone when called about a change of condition of a patient. This has lead me to anxiety and a dread of facing another day as an RN. I have heard horrendous gossip about colleauges and even about patients right in the middle of a busy corridor. Why do we have a nursing shortage? I believe MOST who choose nursing do so because they have a sincere desire to provide competent and professional health care..many however are lacking in self confidence and find it a perfect enviornment to assert their anger..

Posted by: Dee | Apr 30, 2008 2:25:39 PM

I was recently (January 2008) fired from my job of 26 years on the open heart/heart transplant team at Cleveland Clinic because I authored and published my memoir, 'Notes From the Mmothership The Naked Invisibles.' Although my book is a memoir, part of the holistic collage of who and what I am are my experiences, observations and interactions on the open heart team.

Review:
Adrienne Zurub spent 26 years of her life as a member of the Cleveland Clinic open heart/heart transplant surgery team.
A couple of weeks ago, after almost three decades of professional nursing in the premier heart surgery center, she was fired.
Why?
She wrote a book.
This book.
It’s a book about, well, Adrienne Zurub! A “half-century grrl”, registered nurse, wife, spoken-word poet, mother, stand-up comic, daughter and writer.
Through stories and vignettes, she describes people, places and events that shaped her growth in all these areas.
It’s natural that some of these vignettes would be be about her time on the prestigious heart surgery service.
And the characters that populate the cardiac surgery suites. Doctors, patients and nurses.
I had to know what ticked off Cleveland Clinic so badly that they felt they had to terminate Adrienne’s employment.
After all, this book isn’t about Cleveland Clinic, it’s about Adrienne.
Does Cleveland Clinic have a institutional ego problem or was Adrienne off-the-wall?
I decided to buy the book and judge for myself.
I’m glad I got it when I did - amazon.com sold out of it right after I ordered it!
I read it in one sitting.
Was it because she was brutally honest about the environment she worked in, the team she worked with?
The brilliant and the arrogant? The skilled and the misogynistic? The exhausted and the doormats?
Surgeons yelling at nurses? Surgeons yelling at patients? Patients yelling at surgeons?
What did Cleveland Clinic find objectionable about the fact that the heart team is comprised of unbelievably talented, dedicated doctors and nurses who are inherently human… and, rarely, all too fallible?
Maybe it was the patient stories.
Surely these are composites. Twenty-six years of surgery experience would tend to provide a lot of samples.
Was it the patient who tried to conduct the OR? The one who told a surgeon to go-to-hell by a rather extraordinary feat?
Or the ones that made my throat and eyes burn as I tried not to cry so I could finish the story?
Which ones did Cleveland Clinic disapprove of?
Then again, maybe it’s the fact that despite “magnet” status, Cleveland Clinic does not treat their nurses with the same respect and deference they show to the doctors.
A keychain here, a water bottle there, an occasional T-shirt instead of decent pay and benefits.
Or the fact that a fancy chicken dinner and a watch is considered a big treat after twenty-five years and Adrienne wasn’t buying into it.
Cleveland Clinic couldn’t possibly have been upset with that. They certainly don’t have the copyright on paying lip service to how much they value their nurses and then treating them like so much chattel.
Adrienne herself describes the book as “provocative” and it is!
And yet, it is not an “in-your-face” diatribe, it is more like a “face-to-face” look at an intelligent, funny fifty-something nurse with opinions on pretty much everything, including her time as an RN at the Cleveland Clinic.
They say nursing has no “voice”. Well, Adrienne has one. And she is paying the price for it." K. McAllister, RN

While on team, I witnessed and at times experienced being screamed at and treated as utterly disposable and dispensable both to my patient's intraoperative well-being as well as being a necessary and critical part of the OR 'team.'
Within my book, (of course adhering to HIPAA and patient privacy concerns, and the instances are compilations of experiences), I remark on an instance whereby a patient was screamed at by a surgeon, for wanting information about their surgery within the operating room! And there are other incredible instances of inappropriate behavior exhibited and expressed by surgeons who rank high within the power hierarchy at my former place of employment.

I have witnessed others (nurses, residents, and other health care workers) being dehumanized and demoralized for sport. Yes, there is bullying. In my book and Blogs I equated some of the occurrences within my former department to a prison environment. In this sense, a nurse (or others) HAVE to align themselves with a powerful and respected surgeon in order to have 'respect' and receive 'props' within that particular OR setting. This is real folks! We are talking about survival.

In doing research for two future manuscripts, I have found that bullying, anger and consequent displays in the workplace, particularly among nurses (and among devalued and disempowered women) is nothing new.
In hospital environments particularly, regardless of the latest technological innovations, cutting-edge surgeries, and innovations, regardless of 'magnet' status, there persists the undercutting agent of sexism. Most, or some hospitals are still bastions of sexism. With nurses being predominantly female, and doctors and hospital administrators remaining predominantly male, I believe that discussions of bullying, workplace aggressive, violence and the like miss the point. We still 'blame the victim,' nurses! In hospitals among nurses and other healthcare workers, it is remarkably demonstrated that the 'abused become the abusers,' sh*t runs downstream. It starts at the top!

These behaviors (aggression, passive-aggressive, bullying, etc) among nurses and health care workers, tend to appear after approximately five years of experience in certain hospital settings specifically and other health care settings in general.
NO nurse that I know of enters nursing as passive-aggressive, angry, or back-stabbing, or a truly conflicted practitioner. Most nurses I know are not disgruntled but frustrated with their treatment, lack of professionalism, yet the constant calls for nurses to 'act professional' and disregarding or actively dismissing the inappropriate behavior of those wtihin the hospital hierarchy.

I propose that nurses specifically women (although men are not excluded as I have personally witnessed them being verbally abused!) are victims of 'Battered Woman Syndrome' with symptomatic displays of Post-Traumatic Stress Disorder both in the workplace and at home. I implore you to look at the 'power wheel' of the 'Battered Woman Syndrome' and note the similiarities. I implore you explore the symptoms that you and your colleagures experience either at work, after work or on your days off from work. I implore you to monitor how you feel when you know you have to go back to work after some time off or a much needed vacation!

The present remedies and recommendations call for NURSES to control themselves, their reactions, and essentially assume the so-called high ground in reacting to perceived threats in the workplace. I say that nurses, men and women, are attempting to survive in these environments perhaps with dysfunctional methods but they are trying to survive..."by any means necessary."

Support my book and my, your voice!
http://amazon.com
http://chasewunderlickpublishers.com.cn

Adrienne Zurub, RN,MA,CNOR

Posted by: Adrienne Zurub | Apr 30, 2008 8:56:10 AM

Two more questions for Readers :

1) Do you think current bullying, gossiping is race-related ? Gender-specific ? Clinical ladder-related ?

2) Do you think workplace violence is likely to occur in specific settings - such as the Critical Care setting vs Endoscopy Units ???

Two hot debatable questions. But , without asking, we can't even begin to address the sources of workplace violence.

Posted by: beka | Apr 29, 2008 6:13:09 PM

It often occurs when a person in charge, a manager(in title only) seems to have the backing of administration as well as HR attempts to make others jobs very difficult. I too have had a manager involved in my professional life in the past. I had filed grievences w/ HR etc to no avail. I at that time allowed myself to be harrassed, my every nursing action questioned by her. This occurred over appro 8 months with some staff such as receptionists and nursing asst. being told to document my every move., until I finally was reminded that I am a wonderful RN/NP and have so much to offer and resigned from that hostile placeto save me,&stay in nursing, to still be strong. Unfortunately She,that manager will continue to thrive on finding others to belittle and demean. I am saddened to say that that organization failed to see that they lost many good employees at her hand. I now am in a better place, one that practice mutual respect and true collaboration

Posted by: june | Apr 28, 2008 4:43:48 PM

I have witnessed a regression in behavior of nurses at my place of employment. I don't know if I'm getting old or what but I don't think the nurses' station is an appropriate place for discussing one's sex life and how, where and how often they "do it". This discussion was not quiet either, the nurses were loud enough for patients to here. What is going on? I was raised differently and was taught that this was not appropriate conversion outside of the bedroom. I don't know what to do....

Posted by: Susan | Apr 28, 2008 3:44:45 PM

My story is not as horrendous as the ones I have read but I wanted to share it because it happened when I was a new nurse. I worked on a open heart step-down unit on the night shift. One morning (2am) I had a patient go into atrial flutter. I had just barely gotten off orientation. As I made the call to the physician, my co-workers giggled in the background. Needless to say, the physician asked for information that I had not gathered before calling. Enraged that I had bothered him when I couldn't answer his questions he screamed at me until I was in tears. After the call, my co-workers roared with laughter. They purposefully let me call him unprepared knowing what was in store for me. I will never forget that experience and how much it hurt me to know how mean some people who call themselves health professionals can be. You can bet I was never caught off guard like that again! Also months later I asked how the physician was allowed to talk to nurses the way they did there and I was told "Because they bring the money into the hospital and they are the gods!" No one would touch them.

Posted by: Vicky | Apr 28, 2008 9:44:16 AM

After eight years of exemplary work performance for my employer I developped a physcial limitation which made exessive walking difficult. I worked as an educator in an office type of environment and was easily able to perform the essential requirements of my job with minimal accomodations, but my coordinator, who had a history of bullying, seized this as an opportunity to make my life hell: Even though I had medical documentation to excuse excessive walking and standing, she told everyone in the institution that I was just lazy and did not want to work. She assigned tasks, unrelated to my job, which involved walking and standing and tormented me at every turn.
I turned to my manager who did not want to confront her and did not help me at all. If I had not had the united support of my coworkers, I could have never lasted at my job. All of us had been victims of her bullying and we stood up to her as a group even though our manager did not. Finally, after over 2 years, she was demoted. I learned that even if you have a weak manager, bullying can only continue if your peers look the other way. Thankfully mine didn't. As nurses we also need to take care of each other, not only of our patients!

Posted by: Rosine | Apr 27, 2008 10:27:16 AM

I work in a Health Care Environment, support staff. My health has deteriorated severely over the years I have been in the hostile, bullying, gossipy, distrimination infested place. The very perpetators of the harassment and cruelties proclaim to be model citizen and God fearing. But, they believe God has given them an exemption from common courtesy and decency due to their titles/and or privileges gifted to them by management. People like this will always pick the most vulnerable, the person most in need of human kindness. I fear these people and those like them will never change. As long as their behavior is condoned by Administration and Human Resourses, it will remain a constant: The destruction of co-workers for entertainment and sport.

Posted by: Jane | Apr 25, 2008 1:11:59 PM

As I read these comments , I have to ask the questions of "Why does bullying occur within the workplace ? " and " Are women more prone or ( gosh , what is the word..? ) simply -nurses, who are supposed to represent compassion, healing to the public - more prone to bulling, gossiping, etc. ? "...

Any male nurses who have experienced bullying, discrimination out there ??? Are there differences between a all-female and a-all male workplace environment ?

What's the solution ???

beka

Posted by: beka | Apr 24, 2008 4:45:28 PM

As a nurse of 40+ years, I have witnessed all forms of abuse and harassment in clinical nursing, hospitals, managed care, home health, etc. by both nurses, physicians, management, patients, families and visitors. I have personally been threatened with death, physically knocked around and injured, threatened with reprimand and termination, been victim of gossip, verbally abused, placed in hostile work environments, placed in sexual compromise, embarrassed and belittled, pushed to perform tasks that would compromise my license and reputation, etc. I have noted many nurses are dependent upon the job for financial survival and fear loss of employment and do not come forward thus remaining victims. Female nurses also sometimes encourage and respond positively to physician abuse/harrassment because they perceive that attention to be somewhat positive (particularly sexual harrassment) sort of a reprieve from the negatives in their work environment. The culture of the medical profession has historically been a power based system with physicians (male)at the top along with management just below. Nurses (who have traditionally been female) have been expected to be at the bottom (a culture held over from when women were without rights). I also have noted that nurses perpetuate bullying and repeat it with their underlings when they move up the "ladder" - sort of an expected right of passage. Unfortunately I am still witnessing this bullying, hostile behavior in managed care where I now work. I applaud the ability of a professional to uphold the values of respect and dignity in a medical career under such adverse conditions and traditions. I certainly hope the culture is beginning to change for the better. No wonder there is a "nursing shortage".

Posted by: Cindy | Apr 24, 2008 4:19:04 PM

Bullying in the workplace place is not just a preserve of women - although it's generally more subtle and damaging than male harrassment as female nurses are thought to be more supportive and caring of their colleagues. It's a dreadful indictment of the system that the victims either leave or lose their job; the perpetrator then carries on with no sanctions brought against them. Why are we all so reluctant to speak out against this appalling behaviour? And why are senior management so dilatory in acting?
I work in the UK and the rates of bullying are on the increase. In my worplace it's 17%. In my experience, some of this is power imbalance but also unchecked and unchallenged harrassment.In it's most subtle forms, the victim doesn't always recognise that overly sweet and helpful behaviour then escalates into damaging psychological manipulation until it's too late and their confidence destroyed.

Posted by: Diane | Apr 24, 2008 7:30:25 AM

I have noticed that gossip, backstabbing etc is always a problem when a large group of women are not only the employees, they are management too.
Those cliques in high school never disappear especially in nursing.
It is immature behaviour that is encouraged by a role that is in itself immature. Nurses are nothing more than worker bees that have all their tasks set for them by someone else. We can all talk about our role or "profession" but let's be serious , a nurse cannot initiate any action without having the permission of someone else, be it a doctor, a hospital protocol or the rules that govern their license.
Because of that lack of power women look for another kind of power and the easiest one available is using seniority to bully.
Nursing attracts a certain kind of personality we can all agree and with all personality types there are extremes in the spectrum. Those extremes are either the aggressor or the victim.
What is worse is this behaviour is not only tolerated it is encouraged.
Most male nurses wont tolerate the behaviour of a bunch of catty high schoolers but they can still be damaged by the idiots.
A large group of women forced to work together will always devolve into immaturity if there is a lack of management and leadership.
A leader that has strict expectations and no tolerance for juvenile behaviour will weed out the bullies. A unit that feels empowered will also weed out it's own bullies.
Empowerment cannot come from the nursing role itself as it is a subservient role. Empowerment has to come from the environment in which the role is displayed.
If nurses have control over assignments, education, schedule, supplies, assistance etc and a responsive strong leader bullying disappears.
It is a sad but true fact that women cannot be trusted to remain professional unless there is a threat of significant punishment.
Here is a simple question for every nurse working today; how did you describe the nursing care of the nurse you took report from and how many people did you share that opinion with during your shift? Now justify why you thought it was okay to do this.....oh wait I already know...it's all about the patient right?
This is the story I have to hear every day, one nurse bad mouthing another nurse and justifying it by saying they are just protecting the patient..of course they would never confront the nurse in question nor would they document their opinion with management.

Posted by: mo | Apr 23, 2008 11:57:49 PM

After 23 years of nursing I quit my job and persued another careeras a licensed massage therapist. I own my own business and there are 10 other LMT's that work at my facility. Wile working as a nurse I witnessed abuse from patient family to nursing staff, patient abuse to nursing staff, nursing to nursing both physical and emotional abuse and last but not least and concidered the most common and appauling DOCTOR TO NURSE verbal, emotional and PHYSICAL abuse. I once saw a doctor throw a chart in anger at a nurse because there was not a new progress sheet available in the chart. I took a stand at that moment, as the nurse was bending over to pick that chart off the floor, Istepped on the chart and asked the doctor if he would like to pick up the chart,and appologise to that nurse for his violent behavior not to mention a FELONY. He asked me if I would like to keep my job and called the supervisor. I told him I would not move from my position and picked up the phone and asked one more time and told him I was calling the police to report a crime. The supervisor asked me to back down. The doctor asked that I be fired immediately. I said THIS IS MORE POWERFUL THAN DSOMESTIC VIOLENCE right in our own professional environment. This was a threat to do bodily harm to another individual and I would not back down. I called the police and the police came and told the doctor that this was in fact a felony. Assault with a deadly missle with intent to do bodily harm and asked the doctor if he would like to appologise or that the party had the right to press charges against him. He appologised and picked up the chart. I said I wanted to make it clear that I would no longer tolerate any such behavior in any job I was ever at. I should tell you that because of fear of loss of job many nurses have put up with abuse for years. My supervisor told me to wait until I start my own business that i would have to put up with some things like this. I have had a business for 15 years and I can tell you negativity from clients toward a therapist or therapist to therapist, or therapist to client is not allowed. I have asked a client once or twice to remove themselves from our property if they didn't immediately get control of their energy as we did not allow that kind of behavior at anytime on our property. We have zero tolerance for abuse and always will. Abuse is never acceptable. I will continue to take a very strong stand on this. Also when taking my domestic violence classes for CEU's I read that doctor/nurse rrlatiopnships were at the top for some form of violent behavior.
Thank You for listening.
Sandra
hartwisperer@aol.com

Posted by: Sandra | Apr 23, 2008 4:08:15 PM

Don't take this the wrong way - but every comment posted thus far is from a female nurse. Might this issue have something to do with gender? Are women more threatened about where they fit in the hierarchy of power in the work place? I'm just asking a question - I'm not saying it's true. I would like to hear from some male nurses to learn if they experience the same issue.

Posted by: Belleboo | Apr 23, 2008 12:41:25 PM

I took a position as an experienced Case Manager at an insurance company. Shortly after I was hired, one of the supervisors chose me as her 'special friend'. This entailed significant micromanagement, belittling and humiliation at staff meetings. Any suggestions for improving processes or work flow were turned down, but later presented as her ideas. Coworkers were not supportive and shunned me at every opportunity.

I dreaded going to work each day, wondering what new tortures I'd face. After 11 months, I resigned. I spoke of this during my exit interview and was told by the HR person they were aware of her behavior but weren't taking action because she was so effective in her position.

Posted by: Lynnda Simpson | Apr 23, 2008 11:53:21 AM

Bullying in the workplace is nothing new across job categories. I have experienced it, as has my husband (he is not a nurse), and I have witnessed it time and again in every kind of setting from inpatient to community, and even in academia. Everyone I know who has been employed for a long enough period of time seems to have a story. Some of the worse bullies I have encountered have been working in ICUs, and all justify their behavior on the grounds that they care about the patients (as opposed to everyone they bully, I guess). When I have worked in an environment where bullying took place, it was sometimes possible to keep one's head down and manage with some modicum of peace. But I recall one unit I worked in at a major medical center where my guts clenched every time I put my hand on the door to enter the unit. That feeling prevailed for some time after the bully left. It was a conditioned response, apparently
What I have noticed over a long career is that bullying covers up the bully’s sense of powerlessness. I have seen bullying as a reaction to powerlessness in staff nurses, directors of nursing, and in physicians. In trying to figure out why every ICU I ever worked in had at least one bully I could see that bullies were often people with seniority and a great deal of experience, whose perspectives on patient care were all too often disregarded by young house staff who didn’t have the experience or insight to manage the patients optimally in the unit, or people less involved with the pateint and family than the nurses at the bedside. Often times the bully was someone who had been bullied by more senior nurses at some time in her career, so there was a certain payback, or perhaps a socialization to the bully role.
I have also worked in settings that actively took on the problem to eliminate the bully and the environmental conditions that nurtured the behavior. No system wants to encourage a behavior that adversely affects worker productivity, just as no one wants to work in such an environment or be vulnerable as the next possible target. In times where increasing and often unreasonable demands have been placed on the healthcare system as a whole, we can expect that maladaptive behavior might appear in response. Problems in the workplace seem to be getting increasing attention. I am glad that nursing is shining a light on our own situation so that the system can work on solutions that improve the conditions that currently are contributing to nurses leaving the profession.

Posted by: Nancy | Apr 23, 2008 11:03:51 AM

After trying for five years, I was finally hired at a well known insurance company doing case management. I had heard it was a great place to work, and I had dealt with this company at another insurance management company I worked for. Little did I know how badly I was going to be treated, and how hard it was going to be to meet this company's "standards". Daily meetings and inservices, sometimes more than one a day, made it very difficult to get caught up. Numerous reports and grafts had to be done also, not for Medicare or URAC guidelines, but for the whim of the Director. Just about every one of my coworkers stayed behind, and the ones who didn't, well, I wouldn't want them as my case manager. We were told that management had an open door policy, so when I went to explain that trying to learn all the company demands and computer operating systems, going to meetings and inservices constantly, and trying to carry a full patient load after only 3 months was, in my opinion, impossible,I expected some assistance. What I got was being kept on "orientation status", weekly badgering sessions, and told if my performance did not improve within so many weeks, well perhaps I just wasn't their insurance company material. I also found out that personal confidences were being "shared" with management. My coworkers stated that they did their best not to say or do anything that might bring the focus onto them, and one coworker confided that the assistant manager always found one new employee to humiliate and deride and they had a hard time keeping people. As this situation became more and more stressful, my physical and mental health began to suffer. My husband said I became someone he didn't know, and it was then I knew I had to leave. The "straw that broke the camel's back" came when I was told to continue calling a member, who had already told 3 previous case managers that she did not want to be in the opt out option program, simply because she had not said this to me. I understand that payment is made by Medicare for every member in the case management program, but why try to push it on someone who probably would not be compliant with the care plan in the first place. To me, this is harrassment, and I know I would not want to be continually called to participate in a program I did not want to be part of. When I pointed this out to management, stating they would not want to be harrassed in this manner either, I was deemed disrespectful and insubordinate. Needless to say, I evidently was not their insurance company material, so I gathered my things and left. Because of physical conditions that have developed after years of nursing and patient care, it is impossible for me to perform hands on nursing any longer, so my career opportunities are limited. Because of many such instances of on the job bullying and harrassment, I am even considering leaving nursing altogether.

Posted by: Chris | Apr 23, 2008 9:12:40 AM

Emotional bullying is an ongoing problem in our society. We all remember our teen years and unfortunately there are alot of our peers who never outgrew the behavior. I see the cliques in every unit I work on. The whispering behaviors, rumors, gossip and just rude comments are ever present. We recently had a employee who was fired due to gossip and rumors that were unfortunately taken for truths by management. Thankfully he is fighting for wrongful termination. It amazes me how kind we can be to our patients but how hurtful we can be to our own co-workers. I worked a unit for over 10years and then we had a new nurse manager who had the divide and conquer attitude. She would have staff meetings where she encouraged people to complain about one another if they were present or not. I walked out of the meeting. When she confronted me about leaving the meeting, I informed her that I would not attend any further staff meetings unless they concerned improving pt care or development of staff education. Also, I told her that encouraging bad mouthing of one another only would lead to further damage to our floors morale and lead to further conflict between staff nurses. Her only answer was to start crying. I never did attend another staff meeting and transfered to another unit. I truly feel that being a professional is not only how much education we have, but demonstrated in how we treat our patients and our peers. As I always tell my pre-teen daughter who is struggling through her own torture of emotional bullying, If you can't say someting nice don't say anything. Be civil to everyone and treat them like you want to be treated. We can't be best friends with everyone but we can all get along.

Posted by: Wendy | Apr 23, 2008 12:53:32 AM

This behavior is not limited to the clinical environment. As nurses expand their roles in the business world the problem goes with them. I am a nurse and at the time of my experience I worked for a large, nationwide company as the Director of Clinical Business Analysis. The Vice President that I reported to was also a Registered Nurse. She systematically cycled through the department picking out people to bully and others to use as spys and pets. Her verbal and psychological abuse was beyond expanation. The people not singled out were just happy to slip by and senior management did nothing to stop the behavior. It was a horrible and long 15 months before I escaped her venom. There truly is no protection from people like this in the workplace and even the law doesn't protect us. Attorney's I spoke to after my horrible experience told me that it is almost impossible to take any legal action in these cases because it is not sexual or race based harrassment.

Posted by: Gloria | Apr 22, 2008 8:14:02 PM

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