“I cannot put into words what it feels like to have nurses laugh in your face and belittle you when you ask a clinical question. I cried every shift I worked for the first 6 months.
Amanda, RN, new nurse
“Houston, we have a problem…” This famous understatement from the crew of Apollo 13 which encountered devastating complications shortly after liftoff, unfortunately fits the nursing profession today. Bullying or incivility is all too prevalent in nursing education and in practice. It is a cancer that wounds and destroys the spirit and passion of those who encounter it. Whether you are an educator, student, or practicing nurse, as health care professionals, we must ACT like it, and do all that we can to eliminate this plague on our profession.
Bullying is NOT an isolated event, but a consistent PATTERN of inappropriate abusive/aggressive behavior toward another colleague that is done solely to diminish, devalue, or disrespect them (1). 

What does this look like so you can recognize it more clearly?

  • Having your views and opinions ignored                                  Hospital problems
  • Being personally ignored or excluded
  • Excessive monitoring of work…micromanaging
  • Persistent criticism of work and effort
  • Insulting/offensive remarks (2)

Consequences to the Victim
Bullying is emotional abuse and NOT without consequences.
It wounds the victim DEEPLY in the following ways:

  • Inadequacy/feeling like a failure/self-doubt
  • Anger
  • Depression/decreased morale
  • Post traumatic stree disorder (PTSD)
  • Leaving unit or even nursing profession
  • Patient safety impacted because it is not “safe” to ask questions (3)

Do NOT Take It!
Twisted Sister, a hair band of the 1980’s, had a song that became an anthem “We’re Not Gonna Take It!” (this video will inspire you!). Seriously though, you do have options, and the key is recognizing bullying, being PREPARED with an appropriate response, and respectfully CONFRONTING it. The article Teaching Cognitive Rehearsal as a Shield for Lateral Violence: An Intervention for Newly Licensed Nurses is a MUST READ on this topic.

Faculty to Faculty Bullying
friends are watching TVDo you see an elephant?
Unfortunately, there is an elephant in the room, and until it is acknowledged, called out, and confronted, it will continue to poison the academic environment for both students and faculty. Would it surprise you that in a recent survey of nursing faculty, 68 percent reported moderate to severe levels of FACULTY to FACULTY bullying and when mild levels are included, 96 percent of faculty have experienced it first hand (4)!

Patricia Benner has made it clear that nursing education is in need of a RADICAL TRANSFORMATION, but in order to see this vision realized, it must begin FIRST by seeing our nursing departments transformed through eliminating all vestiges of incivility!

Bullying in Nursing Education: I have summarized the current literature of incivility in nursing academia and its many forms. Student to faculty/faculty to student and faculty to faculty.
Learn more…

My Personal Story: As a new nurse educator pursuing my passion, I had no idea how joy stealing my journey in nursing education would soon become…
Learn more…

Useful Links:
Students/Nurses
Fact Sheet: American Nurses Association: Lateral Violence & Bullying in Nursing
Book: Appendix from THINK like a Nurse! Skeletons in the Closet: Nurse-to-Nurse Bullying and Incivility by Keith Rischer
Article: What students can do to promote civility by Cynthia Clark
Book: Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other by Kathleen Bartholomew
Book: When Nurses Hurt Nurses: Overcoming the Cycle of Nurse Bullying by Cheryl Dellaseega

Nursing Faculty
Book: Appendix from THINK like a Nurse! Skeletons in the Closet: Nurse-to-Nurse Bullying and Incivility by Keith Rischer
Website: Civility Matters: Creating and sustaining communities of civility
Article: Why civility matters by Cynthia Clark
Book: Creating & sustaining civility in nursing education by Cynthia Clark
Article: From incivility to civility: Transforming the culture by Cynthia Clark
Article: What educators can do to promote civility by Cynthia Clark

 References

  1. Bartholomew, K., (2006), Ending nurse to nurse hostility: Why nurses eat their young and each other. Marblehead, MA: HCPro Incorporated.
  2. Johnson, S.J. & Rea, R.E. (2009). Workplace bullying: Concerns for nurse leaders, The Journal of Nursing Administration, 39(2), 84-90.
  3. Murray, J.S. (2008). No more nurse abuse, American Nurse Today, 17-19.
  4. Clark, C.M., Olender, L., Kenski, D., & Cardoni, C. (2013). Exploring and addressing faculty-to-faculty incivility: A national perspective and literature review, Journal of Nursing Education, 52(4), 211-218.
11 Comments
  1. keithrn

    Do you have a personal story about your experience of incivility and bullying in nursing or in academia? Feel free to share it here.

    • Georgia

      DS
      I have personally become a victim to lateral violence and bullying from faculty. Eye rolling during meetings, private meetings, and obvious alienation techniques are amongst the hostile environment I go to every day. Unfortunately, this behavior has caused me to want to leave one job to find another. Nursing education needs to change and become more professional with communication directly to colleagues. Benner has it right. Transformation is needed. My spirit and desire to work in academia is crushed.

      • Keith Rischer

        I feel your pain and having experienced similar dynamics where I have taught. I know how “joy stealing” and devastating this lived reality can be. I hope that you can persevere and find needed allies and remember to give no one person the power to steal your joy as you pursue your God given talent and passion in nursing education. My thoughts and prayers are with you…

    • KJ

      My chair recently lied in my performance evaluation out of retaliation and does not want me re-appointed. I was devastated to read her lies and it broke my heart.

      • Keith Rischer

        I am so sorry KJ. My thoughts and prayers are with you.

  2. JJ

    Would you believe that I find it difficult to type my experiences here for fear that faculty colleagues will know I consider their behavior bullying? Yet is bullying not what gathering the whole teaching team together for lunch, except for me of course, discounting input about the course, asking others to obtain course materials from me rather than coming to me directly is? Or perhaps it is just incivility. I have been teaching for several years, and I find that my experience is more of a negative than a positive. It is depressing to feel so devalued, and I wonder how nursing ever came to be known as a caring profession. The behavior I see is anything but professional. I need a personal cheerleader like Patricia Benner. Thank you for your blog and its encouragement.

    • Keith Rischer

      Thank you JJ for sharing your story. Yes, this is bullying behavior and important to put a clear name to the vague feelings that one experiences when this behavior is directed towards you. When one feels devalued or disrespected these are the classic fingerprints of uncivil behaviors. It is imperative to find at least one other colleague that you can go to for needed support and encouragement. I hope that you can find the support and validation that you so desperately need. My thoughts and prayers are with you.

  3. BC

    I have 30+ years of clinical experience and have been teaching for 5 years. I came into nursing education with the passion of teaching my experience to the new generation of nurses. Unfortunately, what I found was a faculty member who has run off multiple clinical experienced faculty and several directors in our program. She literary cries to the students telling them that “other faculty are bullying her” (untrue) and tells them that “nobody cares about them ,but her” (once again untrue). Unfortunately by playing on the student’s sympathy, she has convinced upper administration that she is the student advocate. She is a master manipulator and has taught for years with minimal clinical experience ,is tenured, and does not like change. Her incivility is now being seen in the students. I am at my wits end and very dishearted with nursing education. I have the ability to retire, but feel that someone that acts this way toward students and faculy should not prevail!

    • Keith Rischer

      I share your frustrations and you too are in a hard place. Have you taken your concerns to the dean or department chair? I have observed that incivility flourishes in both the clinical and academic settings when leadership is passive or part of the problem. I hope nursing leadership in your department is holding each faculty responsible and accountable for inappropriate and unprofessional behavior.

  4. Coralene Medved

    I am enrolled in a LPN to RN program at my local community college. I have been a LPN for 9 years. I am a preceptor and mentor at my current place of employment, and receive the highest ratings for my performance, teamwork, and collaboration. Prior to that, I was in retail management for 10 years where I was responsible for training new employees and performing store audits. I have a 3.56 GPA. My college uses ATI for computer-based assessments, where I have a predicted 99% chance of passing the NCLEX.

    I had problems with one clinical instructor who kept telling me no-one liked me because I acted like a know-it all, and talked to much. So I stopped speaking unless it was absolutely necessary. I passed, and thought it was over.
    Then in my last class prior to graduation, I got a classroom instructor who treated everyone like dirt. And she happened to be my clinical instructor as well. During post-conference, if we didn’t give her the answers she wanted to hear, we got rolled eyes, the bowed head shake, the hand to the forehead. The verbal comments were “Really? Is that all you got?” or “Wow, you guys are supposed to be able to be on the floor by now.” I turned in my clinical paperwork on time with my other classmates, but mine was not returned to me when theirs was. Then I got 3 weeks worth handed back to me, and was told I was failing, I met with the instructor twice to discuss what I needed to do to pass the concept maps, and was given vague answers like “there’s more” or “that’s not right”. I sought tutoring from our retention coordinator, and she felt the work was adequate. I sought tutoring from another faculty member who only had a few minor suggestions for improvement. My papers were 11 or 12 pages long, compared to my classmates 4-5 pages who passed. When I reached the point of no chance to pass, the 1st clinical teacher I had a problem with publicly pulled me out of class so she and the current clinical instructor could gang up on me for an hour until I was in tears, telling me how horrible of a nurse I am, how I am dumber than my classmates, how I could never hope to make it as a floor nurse, and how I need to change my whole attitude. Then the current instructor wrote me up on a clinical variance for an event that did not happen.

    My college’s Nursing program has no policy allowing students to appeal a grade. I have spoken with other faculty about my performance and demeanor. None of them found flaws with my attitude or performance. Every one of them stated they had heard gossip and rumors from those 2 instructors, and they feel there is no way I will be able to pass at this school since the only 2 instructors who teach this last class have decided I am not worthy. I spoke to our Nursing Director, and she is well aware of the bullying behaviors, but is sticking to the policy that the clinical instructor is the only one who can decide a pass/fail for clinical.

    Have you had any experience with how schools can adopt a code of conduct for the instructors, and implement a policy that will allow students like myself to contest a failure so we can be judged on our merit and ability instead of a personal opinion? I don’t have any options at this point, but I can possibly help others in the future to be more empowered.

    Thanks in advance for any insight you may have.

    • Keith Rischer

      You bring up an interesting point Coralene. Nursing incivility can not only be student to faculty but faculty to student. When it occurs as you describe, there needs to be a clear mutual code of conduct that not only applied to how students need to act, but at times faculty need to be held to this same standard. If nursing leadership is not able to remedy this for you, your options are limited. I know that there are two sides to every student concern, but the nursing literature is clear that faculty can be uncivil to students and needs to be addressed. Nursing education leadership in the department is responsible for ensuring that academic cultures remain respectful and healthy places for both students and educators and ought not to tolerate incivility in any form from students or faculty.

Leave Comment

Your email address will not be published. Required fields are marked *

clear formSubmit