Bullying and Harassment

“Nurses eat their young” unfortunately is a fact. The reason isn’t known in spite of research. There are contributing factors that start with personality disorder, stressful nature of work, workplace politics, weakly enforced regulations regarding employee behavior etc. When new grad, inexperienced, overwhelmed nurses join the workforce, they make easy targets for unethical professionals.

Harassment and bullying cost organizations thousands of dollars in employee turnover, patient dissatisfaction and care defects. The damage to the victim is much more extensive which involves emotional distress, loss of employment and income, difficulty landing another job, lack of confidence, family grief and much more. Some school curricula include some brief education on harassment but it is not enough. Most often, workplace fails to follow through on subtle signs and obvious complaints of harassment and bullying. It is usually up to the victim to deal the bully.

I walked away from my bully and it cost me up to 5 months of unemployment and very hard time in landing my next employment. I spent many nights re-evaluating the situation and resenting my decision. When I did inform my supervisor about the behavior of my preceptor, she didn’t bother to take appropriate action. So here I am, trying to spread awareness about the monster.

What is workplace bullying? Look here for detailed explanation: http://www.workplacebullying.org/individuals/problem/definition/

Nursing is no exception to workplace bullying in spite of being a profession of caring. First of all, recognize bullying and harassment, verbal and non-verbal cues. Second, don’t feel ashamed if you are the victim. The stigma of being bullied prevents many people to take the next step and stop the bullying. Stop the perpetrator on the spot, use chain of command to follow through and don’t stop when you meet indifference. The anti-bullying laws and regulations are among the least exercised ones in the workplace. There are committees and hotlines if your immediate supervisor turns a cold shoulder to the situation.

Just like any other unethical and violent behavior, we need to prevent bullying and harassment by standing up to it. There is no point in crying over it. Please don’t just “put up” with it. Deal with it by resolving it, not by ignoring it or accepting it. There are many reference sources in dealing with bully, my favorite is Take the Bully by the Horns. It applies to personal and professional life. We all know bullying and harassment aren’t acceptable. We have absorbed the notion but it is useless unless we adopt the value. 

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Shift Report

Shift report is among the topics not covered in nursing school. Not that you can rely on nursing school to teach you all the needed skills anyways. There are some online material and templates on shift report. The best one is your own. Make sure to design a shift report based on body system and additional specifications of your patient populations. Don’t undermine cardiac just because you are on orthopedics units or neurology if on a GI-GU unit. This goes back to treating the whole patient and not just symptoms. Every efficient nurse has a specific method and a well-designed shift report. I like the one based on systems, access, drips, labs and care plan. Shift report should be separate from your hourly task schedule. The important factor is sticking to such efficient habit year after year in this practice. Shift report is your baseline, history and care plan.  Thus it is critical for this report to be comprehensive and precise at the same time. This is one habit to work hard and maintain through thick and thin.

Now on legal issues, your patient is legally your responsibility when assigned to you. You are legally liable for timely and appropriate care of each patient.  Any accidental or intentional lack of care is considered patient abandonment and patient neglect and legal consequences will follow. A precisely comprehensive shift report helps you stay on track with your patient care plan and contributes to saving lives, preventing complications and protecting your license. So invest in developing and following a shift report that works for you. 

Nursing is different

I don’t believe in statements like “nursing is my call”, “I am a nurse because I love to care for people” etc. Don’t go into nursing if those are your reasons. Nursing is different from many other professions in being multifaceted and complicated. In nursing profession like other professions, you have the typical legal regulations (work within your authorized scope of practice), constant learning (keeping up with research and changing organization’s protocols), technical knowledge and skills (can’t be summarized at all), massive technology (from IV pumps to new software), record keeping (documentation), workplace politics (nurses do eat their young), the team work (keeping track of at least 5 separate departments) and managing your compensations. It doesn’t stop here though and that is what makes nursing different. There are the humanized, individualized and lifesaving facets of this caring profession. Ethical boundaries become blurry at times and care or self-care is compromised. Also, the job security factor is no longer accurate for nurses. So choose carefully before going into this profession.

Critical thinking for nursing is like water for life. When you arrive at your unit in scrubs, you are in charge of more than filling up a position and taking care of patients. You are in charge of saving their lives by preventing medication error, checking their labs and their symptoms, managing physicians’ orders, being proactive in infection prevention and much more. And you should do all this in a holistic way, in a dignified and respectful manner. Don’t forget your helpless patient among all the machines and chaos of alarms, orders, lab draws, diagnostic tests, phone calls and etc. The difference between nursing and other professions is the Patient. As a nurse, you have to handle everything else in the background and put your patient in the forefront. Your patient should be the center of your work. You don’t have to cater to personal demands of your patients and families. But all your efforts and nursing care should revolve around beneficence and non-maleficence to the patient. You might be a super nurse, experienced and intelligent, but if you are negligent and disrespectful toward your patient, then you are not a true nurse. Remember that nursing is not like marketing, retail, manufacturing and other professions. At the core of your efforts and services is life in a fragile state, a human being physically and emotionally a mess. No nursing care is complete without respect to the patient.