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Nurse Bullying: Where do the mean girls work?

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About a year ago, I was trying to market my 2-day bullying/conflict seminar and sought advice from someone who had been successful in filling seats at her events. We had a conversation about “target audience” and although I had focused my previous seminars on teaching individual nurses how to bully-proof themselves, this time I wanted to focus on teaching nurse managers how to address the bullying behavior of their staff. “Oh.” She said, “That’s easy. Send your brochures to your hospital list but send one addressed to “Critical Care Nurse Manager” and one to “OR Nurse Manager.” When I asked why, she replied, “Because that’s where the mean girls work.”
Hmmm. I thought. Was she right?

Nurses can be so caring to their patients but horrific to each other! But is there is more bullying among critical care and OR nurses and if so, why?
The answer has to do with perceived power
One reason bullying occurs is because the bully perceives she has more power than someone else. It’s called having “a perceived power gradient.” We often see this when an experienced nurse perceives she has more power than a new nurse; a physician perceives he has more power than a nurse; or a nurse perceives she has more power than a nursing assistant.
Or when a critical care or OR nurse perceives she has more power than a medsurg nurse.
I read an article about nurse bullying and the author shared an experience she had as a new medsurg nurse who got pulled to the ICU (it was a long time ago). When she arrived on the unit, the critical care nurse looked at her with disgust and said, “I can’t believe they sent us THIS!” There she was in a white uniform while everyone else was in seal blue. They all stopped what they were doing and glared at her with evil eyes!
Okay. I certainly don’t want to pick on critical care and OR nurses (because I’ve seen horrific behavior among hospice nurses too!!) but I do want to talk about this perception that some nurses have that they are better than other nurses just because of where they work or what they do.
We joke about how ED nurses are mean to ICU nurses; ICU nurses are mean to OR nurses; OR nurses are mean to medsurg nurses: and medsurg nurses are mean to outpatient nurses, etc. 
What makes them believe they are better than the other?
I’m a true step-down-unit nurse. I take care of 3 patients. Everyone is monitored and I do everything for them every 2 hours. It’s my comfort zone. But if you put me in critical care with vents, I panic. Likewise, put me on a medsurg unit with 6 patients and I feel like a brand new nurse again – overwhelmed and confused (at least that’s how I felt). I’ve also worked as a homecare nurse; as the quality manager for a managed care company (yep); as a unit manager, educator, nurse executive and now as a business owner. And although some of these positions may be perceived as powerful, I’m the very same person – same intellect; same values system; same personality. The positions themselves DO NOT give me the right to THINK of myself as better than any other nurse. Each role just required learning a different skill set. 
I am a nurse. Just like the other 3.1 million nurses in this country. I just happen to do (fill in the blank).
The problem is that when nurses don’t value the different roles we have and perceive one role to be more powerful than the other, we then begin to categorize each other into hierarchies – with some being higher than others. 
What we have to realize is that there are no hierarchies!! Just different roles.
From now on, I want you to think of yourself and other nurses in this way:
We are professionals first (and need to behave that way)
We are RNs (same initials – same family)
We each have a functional role (ICU, homecare, medsurg, etc).
If we all respected each other with the above perspective, we would never be mean to each other but rather; we would celebrate and support each other!
I’d love to read your comments about “where the mean girls work” and your opinion on this topic.
Thanks so much for reading! Take care, be kind to each other, and stay connected.
Renee
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5 thoughts on “Nurse Bullying: Where do the mean girls work?”

  1. Rene, Thank you for this great article. I recently taught a class on bullying and I think you are on absolutely onto something by targeting nurse managers. Ineffective management allows bullying to thrive. Additionally, bullying from nursing supervisors and managers is a real issue. They often have a false sense of power as most of the time, administration has unrealistic expectations from nurse managers.

    Wouldn't it be great if we could all walk in the shoes of a shift and see how the challenges of each specialty? It would enlighten all of us. I have found it helpful to have nurses identify the bully, the victim and the bystander within themselves. Over the past 25 years as a nurse in ICU, oncology and obstetrics, they all have lived inside of me. This can be humbling but necessary. When we see that we are all human and not perfect, we can start the healing process of this dysfunction in nursing.

  2. Thanks so much Eileen. You are so right!!! I spend the majority of my time as an author, speaker and consultant helping individuals and organizations address and eliminate this problem. What I've found is that bullying continues for 3 reasons – 1) we accept the behavior as normal (well, that's just the way it is in nursing), 2) we fear retaliation, and 3) managers use silence as a strategy.
    For bullying behavior to stop (and it must), it requires commitment from leadership (sometimes they are the biggest bullies as you mentioned) and individuals to not only stand up to the bullies but to also turn the mirror back on themselves. In my book, "Do No Harm" Applies to Nurses Too!, I include a self assessment titled, "What if the bully is you?" It's an eye opener for sure!

    Thanks so much for taking the time to comment Eileen. We need more nurses who recognize the challenges nurses face but who are also committed to doing their part to end bullying behavior!

    Blessings
    Renee

  3. Renee, this is a great article. I looked back and my first post on my blog (circa 2012) was on this dirty little secret – nurses eating their young. I remember it happening to me as a new grad (1984) and I left hospital nursing because of it. I agree with you leadership has to be on board, we need to support one another, and be honest with ourselves – are we a bully? Hopefully the bullies will get the help they need and change their behavior – and I bet they will evolve to a better, more compassionate leader. Here's the link to my post: http://blog.life-verses.com/hello-world/
    Take care! ~Kathy

  4. I just read your blog post Kathy and tweeted it! Very well written and so true. I really liked your advice about banding together. I recommend finding other nurses who feel the same way you do and make a pact to protect each other, support and to help each other stand up to the bully. Some of the best examples of eliminating bullying within a department really start with grass roots efforts – a small handful of nurses who refuse to accept disruptive behavior as the norm!
    Thank you sooooo much for commenting and for sharing your blog post!!!

    Nurses should be kind – not cruel!
    Renee

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