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Nurse Bullying Show

There's a saying you hear in hospitals: "Nurses eat their young". Not doctors, paramedics, or physios, just nurses. This week, we explore the utterly common and disturbing phenomenon of nurse bullying, sometimes referred to as horizontal and lateral aggression or violence. I talk to two nurses who say they were bullied by nasty colleagues, and find out how it affected them and their patients. I also chat with Kathleen Bartholomew, a former nurse manager and one of North America's foremost experts on nurse bullying.

We're also looking for your stories about hospital parking, check out this blog post for more details. And you'll hear a column from medical student and blogger Shara Yurkiewicz on mastering the art of connecting with her patients.

Catch our show this Saturday, September 17 at 11:30 am (noon NT) and again on Monday, September 19 at 11:30 am (3:30 pm NT) on CBC Radio One. Or click below to listen right now or download the podcast:

Have you ever been bullied?  I have.  When I was 9 years old, I did Grades 3 and 4 in one year.  That was hard enough, but when I started Grade 5, I was the youngest and the shortest kid in class.  I was also an overachiever.  To this day, I remember being taunted on a daily basis by a bully named Michael - just for trying hard in school.  The experience so impacted on me that I'm quite sure one reason I went into medicine was to surround myself by caring people who never bully others. What was I thinking?

If you haven't yet checked out the TV show 'Nurse Jackie', I recommend it.  You may think of TV's nurse J as a substance abusing RN.  I see her as the quintessential bully - often self-righteous - always preying on vulnerable nurse colleagues to shore up her own wafer thin self-esteem. 

On the surface, the phrase 'nurse bully' sounds like an oxymoron.  Unfortunately, all too often, the words bully and nurse go hand-in-latex-glove.  You may think I'm picking on nurses.  Believe me, it does happen in medicine and other health professions, but nursing is a special case.  Depending on the study, bullying takes place at between 46% and 100% of all nursing workplaces, more than most other health professions.

There's even a saying in the business that neatly sums it up:  nurses eat their young.  I spend a lot of time in hospitals.  You never hear that MDs, physios, or paramedics eat their young.  Only nurses.  It's a meal that's hell on Earth for bullied nurses. 

Kathleen Bartholomew knows a lot about that. A former manager of a 57-bed surgical nursing unit in the US, Bartholomew now researches and advises nurses and other health professionals on the roots of bullying.  She's often invited to Canada.  She's also the author of several books, including 'Ending Nurse-To-Nurse Hostility: Why Nurses Eat Their Young And Each Other'.

"It's deeply entrenched in the culture," Bartholomew told WCBA.  "The entire nursing profession is based on caring, so it's really difficult to admit that we cannot be caring towards each other."

Colleen Collier Breen is a veteran nurse with 31 years under her belt. Currently, she works in an intensive care unit in London, Ontario.  She also teaches nursing students.  She experienced nurse bullying upon returning to work following an illness. 

"For me, it happened at a time when I was feeling extremely vulnerable," said Collier-Breen.  "There were a number of experiences where people would talk about me in an unprofessional way, questioning my integrity and my ability. 

Last Spring, I spoke with Kim, formerly an ER nurse in Halifax  When I caught up with her, she was a student in health administration at Dalhousie University in Halifax.

"I've had people slander me professionally," she told WCBA.  "This one patient died (and was going to die), and this nurse went around telling people that it was my fault this person died.  It was a horrible experience."

Most instances of nurse bullying involve verbal abuse.  However, Kathleen Bartholomew says there are instances of physical abuse as well. "I got an email from a nurse who wouldn't switch shifts with a new nurse and her hair was pulled," she told WCBA. 

"In the United States, there was (recently) an episode in which somebody took a chair and smashed it over another nurse's head.  And she lost her eye."

"Now this is the absolute extreme, and I don't want to give you the impression that this happens frequently," she added.

Bartholomew says the roots of nurse bullying can be traced back to the hierarchical structure of hospitals in which nurses traditionally took orders from physicians.  "When nursing began, it began in a male dominated culture," says Bartholomew.  "When there's an imbalance of power, any group will act out against each other."

Another factor is the need for nurses to feel as if they belong to a group of colleagues.  "I believe the root cause of all these behaviours is that we really don't recognize that human beings want to belong," she said.

Tellingly, Bartholomew, who visits Canada frequently to speak to groups of nurses, believes that the unfailing deference to authority often seen in Canada may make nurses more prone to bullying here than in the United States.

"Studies of workplace instability show that it's worse in Canada than it is in the United States due to the fact that you have a culture of being much more polite than Americans."

Bartholomew believes that nursing administrators are not in touch with the problem of bullying because they're as ashamed of it as the nurses who experience it.

"There's a sense of shame that goes along with it," says Bartholomew.  "What we need to understand is that any human being under these circumstances would act the same way."

Bartholomew says the way to break the cycle of nurse bullying is for nurses to confront their tormentors.  "The greatest tool you could ever give a staff member is assertive communication.  In a healthy culture, you take the person outside and have a conversation with them.  It's our language that will change our culture."

The right language only goes so far.  The only way to stop a bully is to stand up to them.  Bullies prey on vulnerable and insecure people.  Call out a bully and you take away their power.  Nurses who witness bullying should likewise speak up. 

Kim confronted her bully, and more.

"The only way I could deal with it was to respond and address it," says Kim. "And then also just move on with my career.  It's been a big factor - not the whole reason at all but a big factor - in me leaving nursing practice and moving on towards a career in health administration."

That it drove Kim from the profession so early in her career tells me that bullying is a huge problem that - sooner or later - must be addressed.