“It’s a nightmare I can’t seem to overcome,” a young travel nurse said hoarsely as she sat across from me in my office, “but I refuse to give up.”
Tears dropped from her eyes as she looked down at her hands, her last words spoken softly but with a determination that impressed me. I pulled a tissue from the box near the far corner of my desk and gently placed it within her reach. She picked up the tissue and lifted it to her eyes, wiping the tears away in two quick swipes. My heart ached for her as a familiar anger began to slowly twist my gut into a knot.
I’ve seen this before.
A month earlier Ramona* had started her travel nurse contract full of excitement and positive energy. Bright, friendly, and eager to learn, she possessed a confidence and easiness that I knew would be well received by patients and colleagues alike.
I sighed heavily as I got up to close the blinds in my small, cramped office. I turned and reached for my chair, pulling it closer to hers. When I sat down, our knees almost touched. I wanted to protect her from the prying eyes that glanced into my office almost every time someone passed.
“Start from the beginning. Tell me everything. I can’t help you unless you’re completely honest with me. But I want to help. I can help. So take your time and tell me everything.”
Ramona wiped her eyes with the tissue again and then folded it over and blew her nose. When she was done, she placed her hands back on her lap and looked at me. Her eyes glistened with moisture that was still gathering at the corners of her eyes, but it was the way she looked at me that kept me from saying anything more. The mixture of hope and determination in her stare told me my initial hunch about her was right. But it was the vulnerability that was now a part of her stare that punched me in the gut.
She blinked a few times, sat back on her chair, and began to tell me what she had been enduring the last few weeks after being assigned to general surgery.
It was a story that, unfortunately, was familiar in context if not in every detail. But I had no doubt that what Ramona was experiencing was bullying. Direct verbal bullying from a hard-to-please surgeon with a penchant to fly into temper tantrums for minor inconveniences that any 3-year-old would recognize, and nonverbal but no less hurtful bullying from a nurse who seemed to enjoy the surgeon’s abuse of new team members and rather than help, sabotaged Ramona’s efforts to complete what was asked of her.
I knew what I had to do.
The hard knot in my gut transferred its energy to my brain like a lightening bolt. I had to immediately address the issue. Not later in the day, not tomorrow, but NOW. Bullying in healthcare should never be accepted, ignored, or joked about. The burden of being bullied increases professional liability risks due to increased anxiety and an overwhelming sense of vulnerability, and it negatively affects every team member who witnesses it. Bullying affects everyone in the clinical setting, even the sedated, trusting patient. Bullying is the enemy to quality nursing care.
So what did I do? First and foremost Ramona needed to be assured that I trusted her and that it pained me to hear about her experiences, but I was ready to help. If there’s one thing I’ve learned in my nursing career, is that leadership in any role must understand the power behind compassion mixed with clear, assertive leadership. Such a mix has a way of unlocking one’s defenses and when it comes to a victim of bullying, begins to restore the confidence that has been attacked.
And so I got to work.
Within 24 hours, Ramona documented her experiences with varying degrees of detail and filed a complaint on the bullying surgeon. With help from her clinical liaison and human resources representative, she was reassigned to another specialty. Finally, the nonverbal bullying from the nurse who sabotaged Ramona’s efforts was called into her manager’s office and given a written reprimand. This was her second offense that was reported, but everyone knew she should have been reported many times prior.
If you’re being bullied in your department, follow these general steps TODAY:
- Document all incidents as objectively as possible and call your agency’s clinical liaison. Discuss protocol and your need to meet with your assigned clinical manager. Safeguard all your original documentation on the subject.
- Don’t trust the manager, or the manager is the culprit? Your agency’s clinical liaison should guide you on how to best follow protocol. A common path is to make an appointment with the appropriate human resources representative. Take your documentation with you for reference only – again, safeguarding it.
- If you feel safe to do so, confront the bully as calmly as possible while colleagues are present in the room. “The way you’re talking to me is making me uncomfortable and I’m losing focus on the patient. Please stop.” This option works well nurse-to-nurse, but follow your gut.
- Ask to NOT be assigned to work with the bully. Document any meetings you’ve had on the subject and the agreed upon resolution(s).
Above all else, be confident that how you’re being treated has serious legal consequences. The nursing process is negatively affected when personal safety is an issue. How you’re treated matters.
If you’re not the one being bullied but witness the bullying of a colleague, don’t ignore it. Document the incident objectively, encourage the colleague to do the same and report it, and offer support. Knowing someone is not afraid to help can do wonders for the colleague’s morale. Lastly, be a nursing role model. As a traveler, you’ll come across different healthcare cultures – do what you can to increase morale and confidence in your assigned workplace.
Bullying in healthcare is real. It takes a culture that does not tolerate bullying in any form to stop the behavior. Every member of the healthcare team has to join in, stand up, and speak up. But it can be done. It must be done. Our patients, and we as nursing professionals, deserve no less.
*Names and some details have been changed to protect privacy.