One bad egg can spoil the bunch. And it’s not just eggs, is it?!

One colleague on a rampage, one employee stuck in a rut, one subordinate contaminating the minds of others – sadly, it happens all too frequently. And it matters – a lot!

To create quality practice environments, everyone needs to play full on so that we can have our best foot forward for our:

• Teams to function effectively.

• Facilities to run efficiently.

• Patients to be treated with dignity.

• Selves to be able to function with excellence.

We needn’t look further than the last, and possibly most important question, on the hallowed HCAPHPS* scores, to give us our cue. The patient is asked what is their ‘Likelihood to Recommend’. Patients can choose from the following answers: never, sometimes, usually, and always. Of course, always is the answer we are ‘always’ looking for. It is no exaggeration that our jobs may depend on it.

Think about your own experience in a hospital when you were not a caregiver but a patient or family member. You expected expertly delivered and safe care. You expected accurate diagnosis and timely treatment. But beyond that, what you notice is the manners in which the staff carry themselves, conduct themselves and treat you, your family and each other.

With that in mind, here are a few ideas for you to consider:

The truly toxic people must go. Period. Keep them and you will risk losing the great people instead. If this is your situation and you are not a manager, bring this to your manager. Read more…

I am a male nurse in a woman’s world. When we think about it who took care of us when we were kids, it most likely was mom. But as times change, with it the whole job market. Women can work construction and men can be nurses. But, sometimes it’s hard—and not only because I am going against cultural stereotypes about gender. When I was in school I remember some of the instructors saying nurses eat their own. I didn’t really know what that meant until I started working.

I don’t think it’s any worse for men than for new female nurses. But being a man can add another opportunity for discrimination, and gives me a different perspective about nurse culture. I believe men and women are equal. Well, women may be a little bit better than us guys at some things. Guys definitely do things differently. Guys, if we have a problem, we’re like, “Hey bud, I’ll wait for you out in the parking lot and we’ll talk.” Some women seem to be willing to spend the next twenty years messing with each other. Sometimes, I wonder what I have done to myself.

I love nursing and have met great people. Nurses that are both old school and new that have been very nice and fun to work with. I have worked really hard, I’m never late, never call in sick, and am always a team player. I’m willing to work with anybody, I just hope others will work with me too, and not treat me badly because I don’t look like the nurse they think I should—whether because I am a man, or because I am less experienced than they. Read more…

A nurse rolls her eyes at a co-worker as she picks up the assignment sheet that was created by a younger charge nurse. An ICU nurse pretends not to see her co-worker is drowning and ignores her request for help saying she is ‘too busy’. A newly hired RN who was previously a scrub tech finds she is now shunned by both groups. Is this just life as a nurse – or a nurse’s right of passage? Or is it something more insidious?

These behaviors go by several names: lateral or horizontal violence, incivility, nurse-to-nurse bullying, sabotage – “nurses eating their young.” In general, bullying in the United States is a term used to describe uncivil behavior from someone who has power over you – vertical aggression. Rude behaviors from peers are referred to as horizontal or lateral hostility and are defined as: “A consistent pattern of behavior designed to control, diminish or devalue a peer (or group) which creates a risk to health or safety” (Farrell, 2005). Some specific examples are:

Overt: name calling, bickering, fault finding, criticism, intimidation, gossip, shouting, blaming, put-downs, raised eye brows

Covert: unfair assignments, refusing to help someone, ignoring, making faces behind someone’s back, refusing to only work with certain people – or not work with others, whining, sabotage, exclusion, fabrication

Estimates of lateral violence in the nursing workplace ranges from 46–100% (Stanley et al. 2007). Nursing literature abounds with examples of prevalence. In one study, one-third of nurses perceived emotional abuse during their last five shifts worked (Roche). Read more…

If the freedom of speech is taken away then dumb and silent we may be led, like sheep to the slaughter.
-George Washington

At a recent legislative meeting, as I was physically encouraged to stop speaking and leave the premises.  I have been an outspoken and passionate patient advocate for many years and I make no apologies.

I have been a victim many times over of covert bullying. However, this was the first time someone literally attempted to physically terminate my freedom of expression! I ask the readers, what would you have done if your left shoulder was grabbed by a nurse saying, “That’s enough, Helen…It’s time for you to leave”?

During my 33 years of working in the operating room arena, I had to pick my battles of when to stand up for myself and when not to. Although retreating was never in my makeup, the loss of dignity in the face of fire was not pleasant! The loss of sleep at times was not conducive to my spirit. The loss of my hard earned monies being siphoned off to my attorney to ensure my continued employment at a time when my children were in college was hard to bear. The intentional cajoling whispers behind my back as I passed certain staffers were hurtful.

The saddest realization as a nurse was when it finally dawned on me that some of my nursing managers were part of the lateral violence, as it is called today! Bullying for the most part is the easiest and most simple method to get a nurse to quit her or his job, i.e. Read more…