Bullying: The Culture of Nursing

The healthcare world is, ironically, one of the most aggressive workplaces. It tends to take people to the limit as there are patients about to lose their lives and they have to be treated urgently. These moments create a lot of pressure between co-workers, one of the biggest reasons is because in a matter of seconds someone could lose their life.

Intolerable stress, constant pressure and hierarchy are relevant aspects that may cause clashes between professionals from the same area. But among these three aspects that may play an important role in an argument between professionals, hierarchy is probably the one with worst consequences. 

The aspect to be highlighted in this article is the problem nurses are facing with their co-workers. Not only is harassment very frequent against nurses, patients all the time are abusing nurses verbally and physically as it has been exposed by many different researches. Sadly, the problem does not affect Americans only, according to a research held by the Spanish newspaper called “El Mundo”, 31% of healthcare professionals admits having suffered from different kinds of abuse, being one the most common, hierarchical clashes. NHS, a British magazine stated that actually more than 50% of harassment cases against nurses come from a superior.

Breaking down the types of abuse

Data provided by the Institute of Safe Medical Practices demonstrate bullying comes in different ways. Approximately an 87% of male nurses have been ignored once or many times by a doctor, a 74% assures having received patronizing comments or direct insults and offenses. A 42% of all nurses assured they have been humiliated by their superiors and a 26% even proclaims they have been targets of objects doctors have thrown.

It is not a secret how abuses can negatively affect nurses in their daily tasks. Seeing their emotional status affected by abuses lead to a poor performance, and this is a very important aspect of how services provided by hospital and other healthcare settings may drop their quality.  The worst part of these issues is that most nurses are afraid of reporting the problems they are facing because they think they may lose their jobs.

Another palpable problem is that laws enforcing co-workers to treat each other better may not be taken into account in most cases. Another curious fact regarding the way doctors treat nurses, is that there is an important percentage of nurses stating surgeons may have incorrect behaviour at a sexual level against nurses.

Bullying in a daily basis

It is known by anyone with any kind of relation with the professional environment of a clinic, hospital or any kind of healthcare facility that bullying is a day to day matter between physicians, nurses, supervisors and everyone else. Becoming an ironic idea how an industry which main purpose is to offer services related to compassion and patience can turn into an aggressive reality that professionals have to face.

As it was mentioned at the beginning of this article, there are many different causes that may trigger chaos and emotional strain among healthcare professionals; some of the most extremes are:

• People working in healthcare usually have to spend a large amount of hours at the facility, usually more than a normal shift. Some professionals end up sleeping over the counter when there are no emergencies and they are too tired and need some rest. Lack of sleep and general discomfort at the workplace can represent a heavy emotional charge for professionals.
• Few things in the world can cause as much stress as having the life of someone else depending on one’s actions. Having to face this scenario on a daily basis while giving or receiving instructions can be very difficult.
• General underestimation of the work done by some of the co-workers. It is important to understand each position complements the other one. Doctors would be unable to work without timely assistance from nurses and nurses would not be able to solve every issue without the knowledge of a doctor.

Hierarchy cannot disappear in medical practices because emergencies would turn into chaotic situations if there were not a leading voice telling what to do. But it is also important for professionals to recognize how valuable their co-workers are and how they make work possible.

Tips and recommendations to avoid bullying at medical workplaces

There are some tips and recommendations that may be useful for bullying cases, the most important thing however is to encourage professionalism and appropriate manners, and the best way to do this is by setting the example. Probably making an environment totally free from bullying can be a hard and time-consuming task; nevertheless, there are some measures that can help to make it faster and easier:

• Remaining calm: cooling off before deciding what they want to say may save nurses from a lot trouble. In the moment, emotions may get in the way, making it impossible to think clearly and decide what would be the best decision in that case and even destroying any possibility of selecting words accurately.
• Chatting is always a great way to start: when it is requested carefully, most people agree to have a conversation in order to solve problems. Big part of these cases can be solved with proper communication. This should better be done in a calm moment when each part has a period of time, not in the middle of an important situation or emergency.
• It is important to encourage respect at the time of talking. Being respectful and promoting respect is the best way to assure the conversation will have a positive effect.
• Always begin with something good: This is the reason why it is so important to remain calm at the time of taking action in one of these problems. Starting a conversation telling someone how they admire his or her abilities or that both are related to the same kind of work because both look forward to giving an excellent services that alleviates even saves patients in emergencies.
• Flag the improper behaviour: once something good has been mentioned and conversation has begun in a proper way, it is important to proceed with the matter causing discomfort. Clearly saying how it happened, feelings triggered, etc; is very helpful.

Even though the task of confronting someone that abuses is not easy or enjoyable, however, in some cases it is needed. If it does not work then further actions need to be taken such as speaking to a supervisor or another person in charge.