By Nancy Deutsch, RN, contributor
A new nurse had a busy night shift on a med-surg unit. At 3 a.m., one of her patients started to crash, so she spent the night working with the patient, skipping her break, not having time to chart or do much with any of the other patients. When it was time to report to the day shift, one of the nurses who had just come on immediately demanded to know why another patient’s pre-op checklist was not complete, without listening to what the night nurse had experienced.“Where’s our compassion for each other?” asked Seattle nurse Kathleen Bartholomew, RN, MSN.Bartholomew said this is not an isolated example of how nurses can be unkind to each other. “I observed these behaviors,” she said. “They were hurtful, but they didn’t mean to hurt each other; it’s frustration.”Troubled by this issue, Bartholomew wrote the book Ending Nurse to Nurse Hostility: Why Nurses Eat Their Young and Each Other, interviewing hundreds of nurses who were upset by the behavior of their peers.Bartholomew, who has a master’s degree in nursing from the University of Washington and still works as a nurse a few days a month at the Swedish Medical Center, said that “at the very core” of the problem is “the fact that we’re not united.“We’re the only profession that can’t seem to get it together on what the entry level should be.”She believes the behavior stems from nurses’ belief that they lack influence. While nurses no longer rush to give up their seats or bring coffee to physicians, “We still show deference in little ways,” she said, adding that when people feel powerless, they often lash out at others—even unconsciously.Bartholomew pointed out that much hostility between nurses is passive-aggressive, and many new nurses witness this when more experienced nurses answer questions abruptly or not at all.An example is during the preceptor relationship when new nurses sometimes feel they are a burden to veteran nurses. Preceptors don’t get a lighter load in order to take time to train a new nurse, and that can cause some conflict, according to Bartholomew.Bartholomew is quick to point out that these issues can be overcome—and that new nurses can take a leadership role in changing the cultural dynamic.“Talking it out is the answer,” she said. “Always respond to the non-verbal, to the feelings. Respond to that nurse. Say, ‘I know you say nothing’s wrong but the tone of your voice says differently. Please tell me what’s wrong.’“If you don’t speak to the truth,” Bartholomew explained, “you can’t fix it.”You Can Fix ItStephanie Thibeault, RN, has been a nurse for three years and currently works at Western Missouri Hospital. She made the transition into nursing in her 30s after working in the corporate world. She agreed with Bartholomew that she took awhile to get used to the “nursing culture.”
“I found some nurses weren’t very helpful, but I realized much of the perceived problems were related to miscommunication, not animosity,” Thibeault said. “I always try to talk to a nurse privately if I am feeling hostility—and often find is has nothing to do with me at all.”Thibeault has three suggestions for new nurses to help ease into a new job.
- Don’t take criticism personally: Listen with an open mind and use suggestions to become a better nurse.
- Be honest. Don’t try to cover up mistakes or say you know how to do something when you don’t—learning is a lifelong process.
- Step up to the plate: Don’t’ be afraid to take on responsibility and try new things. Thibeault added that what helped her the most was being gracious. “Your preceptor has his or her own caseload and responsibilities to attend to, in addition to mentoring and helping you. Respect their time and be appreciative.”
Bartholomew said that pointing out this issue is the first step in changing it, and that, indeed, the culture is beginning to change. And, both Bartholomew and Thibeault agreed that the current generation of new nurses can have a dramatic impact on creating a positive work environment now and in the future.© 2007. AMN Healthcare, Inc. All Rights Reserved.