• Nurse bullying is common, but that doesn’t make it okay.
  • Whether it’s criticism or gossip, insults or disrespect, nurse bullying can stem from competition, organizational culture, and from feeling overwhelmed or stressed.
  • At the end of the day, we’re in this shift together, and we can reduce and prevent nurse bullying by lifting each other up rather than putting each other down.

Nursing is an inherently collaborative job. Caring for patients requires a ton of teamwork and shared responsibility — so why do we often feel so lonely?

The work itself is demanding — long hours, challenging caseloads and, of course, the skill and talent required to treat and care for patients. But that isn’t the full explanation for why so many of us are struggling.

There’s another aspect of the job that creates the feelings of isolation that is harder to talk about — and that’s the fact that we don’t always treat each other very well.

Now, we don’t want to paint anyone with too broad of a brush here. We know so many kind, compassionate, caring nurses who embody the spirit of the job. Yet, every single one of us has experienced communication and relationship challenges with other nurses in our workplaces — in the best cases it’s a few snippy or passive-aggressive comments, but in the worst cases it’s full-on animosity and overt bullying. They don’t say “nurses eat their young” for nothing.

Nearly half of nurses report experiencing bullying in the workplace, and it’s driving good nurses out of the profession at a time when we need support more than ever.If solving this feels easier said than done to you, you’re not alone. If talking about this feels intimidating, it’s OK. SHIFT is a safe space to have a conversation about why bullying is happening. And understanding the behavior is an important first step on the path to putting a stop to it.

What does nurse bullying look like?

Micromanaging. Criticism. Rumors and gossip. It can be passive aggressive, such as withholding information, sabotage or retribution. It can also be blatantly aggressive, like name-calling, public insults and even explicit threats to our jobs.

In addition to the immediate emotional impact on the nurse who experiences the bullying, there are physiological consequences to this dynamic. Nurses who are bullied report feeling humiliated, vulnerable, threatened and stressed, which undermines their self-confidence. And it starts early ­— more than three-quarters of nursing school students report experiencing bullying in nursing school.

When it comes to who does the bullying, research shows bullying transcends age, gender and experience level, but in the American Journal of Nursing, Cheryl Dellasega identified useful nurse bully archetypes, including — but not limited to — “supernurses,” characterized by elitism and condescension; “resentful nurses,” who tend to hold grudges and create drama; and “cliquish nurses,” who use exclusivity to create hierarchy.

This clarifies a bit of the what and the who — but not the why. Surely, none of us wakes up in the morning and makes a conscious decision to bully our coworkers. Nevertheless, it’s happening. So what’s driving this behavior?

There are a few common theories behind nurse bullying.

Feeling disrespected

Nurses often experience mistreatment or bullying at the hands of administrators and physicians, including feeling undermined, criticized or belittled.

Many nurses are expected to defer to physicians, no matter the situation. Many also report feeling as though their intelligence, experience and ability to care for patients are in question. In an uneven power dynamic, and without a productive outlet to express these frustrations, we can sometimes lash out at other nurses with whom we feel more comfortable, out of irritability, insecurity, embarrassment or just plain old getting our feelings hurt.

Overwhelmed and overburdened

Understaffing, patient crises, going hours without eating or drinking — these aren’t exactly the healthiest working environments, and can be triggers for big outbursts against our colleagues. Emotions like anxiety, stress and grief can result in a nurse unintentionally acting like a bully. Recognizing and owning these patterns in ourselves or our coworkers isn’t easy, but doing so identifies what’s driving bullying behavior, and getting to that root cause is the first step in stopping it.

Organizational culture

Nurses are nearly as likely to be bullied by a manager or physician as by a fellow nurse. Because these roles have more authority in the unit or floor, this can lead to a “sanctioning” effect, where bullying is normalized or even expected. When leaders manage by way of threats, intimidation or high levels of criticism, this trickles down to how nurses interact with one another and creates a toxic environment.

This is also one of the harder aspects of nurse bullying to address. When bullies are authority figures, there is often little nurses themselves can do. Documenting behaviors and familiarizing yourself with your organization’s harassment policies are good first steps.

Competition

Nurses are high performers, eager to advance and demonstrate skill. When there’s a sense that there are not enough opportunities for all of us to succeed, it can create an environment ripe with competition and put-downs. This isn’t unique to nursing — workplace bullying transcends professions, but it does tend to thrive in competitive environments. And it can be particularly prevalent in professions dominated by women; it isn’t that men don’t bully, but it appears their aggression is more equilateral, whereas women tend to bully other women.

Ultimately, nurse bullying is often a result of all of these factors, best summarized by nurses feeling disrespected and stretched thin, without good outlets to express their frustrations.

The role of the bystander

There is one other important aspect of nurse bullying to discuss, and it’s that there are actually three primary roles in bullying — the bully and the victim, of course, but also the bystander or witness.

While we may feel confident that we ourselves are not bullies, can we really say with total confidence that we’ve never been the bystander? That’s a hard question, but certainly one worth asking. We can’t control administrators or our colleagues. But we can control our own behavior. And without the explicit or tacit approval of an audience, bullying doesn’t have the same impact. It can still be hurtful, absolutely. But when bystanders see it and don’t speak up, that’s actually what turns it into an organizational and systemic issue. Standing up for one another and raising “bystander awareness” isn’t going to eradicate bullying in full, but it can decrease its prevalence, which is something we can all commit to.

We don’t have to get too “after school special” with it, either; a quick comment in support of a colleague can diffuse a situation before it turns into something more damaging. Also, this may seem counterintuitive, but sometimes it’s the bully who needs our support the most. If one of our colleagues is stressed, burned out or facing criticism from supervisors, a helping hand or kind word can stop a negative behavior spiral before it even starts.

That said, there are often broader dynamics at play, and urging everyone to “just get along” may not always be the most useful approach for combatting nurse bullying. We need to consider what drives the behavior in our particular organizations. Sometimes, how we relate to our fellow nurses, and how they relate to us, is actually informed by experiences we have with others in the unit, including administrators and physicians, and whether we feel supported or undermined, collaborative or siloed.

Improving workplace relationships won’t happen overnight. But if we have teammates who are difficult to work with — or, okay, if we’ve been a teammate who is difficult to work with — we can work on repairing those relationships little by little.

Because at the end of the day, we’re in this shift together.