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When asked the question, “What is one chronic and painful problem in your industry that no one seems able to solve?”, my response was, “That’s easy. It’s nurses bullying nurses.” But the real question is WHY do nurses bully each other? It seems like a ridiculous notion that nurses can be so kind and caring to patients, but so horrific to each other!

Bullying is pervasive, destructive, and exists in every industry. However, there is a high prevalence of bullying in the nursing profession. Although bullying isn’t rampant in every department, every organization has some degree of bullying. In fact, a whopping 93% of all healthcare employees have either experienced or witnessed bullying behavior. Of the new nurses who quit their first job within the first year, 60% quit because of the bad behavior of their co-workers.

Let’s just say that it’s rare to find a nurse who HASN’T been bullied in some way. I wish I could say that nurse bullying is decreasing but unfortunately, it’s not. Recent research shows that nurses are experiencing greater workplace bullying and incivility now more than ever before (El Ghaziri et al., 2021). Bullying is alive and well in healthcare!

And again, I ask, WHY do nurses bully each other?

Nurses bully each other for 3 main reasons.

Reason #1: We are a female dominated profession and women aren’t always that nice to each other. The gender imbalance in nursing taps into female-to-female competition and aggression. It wasn’t all that long ago that we were competing for the prized male, so women are used to trying to make other women look bad.

Reason #2: Nursing exists in a forced hierarchy. Physicians “rule the roost” – after all, it wasn’t that long ago that nurses had to give up their chairs for the physicians and weren’t respected as a profession. Low status creates a sense of powerlessness and helplessness, leading to low self-esteem. This also leads to reason #3.

Reason #3: Nurses work in a high stress environment. When under stress, we’re not always on our best behavior. Think about the life and death situations in healthcare and the unpredictability of patient care. You never know what you’re going to get when you walk into the door. Things can change dramatically hour by hour! And, we are being asked to do more and more with less and less. The result is a group of highly educated, highly stressed individuals who haven’t established good coping mechanisms to deal with the stress. So, what do they do? They lash out at each other.

How does nurse to nurse bullying typically show up in healthcare practices?

Keep in mind that not everything is “bullying”. Sometimes it is teasing, being rude, or inconsiderate. For a behavior to be considered bullying it has to repeat. A common definition of bullying is, “the repeated patterns of destructive behavior with the conscious or unconscious attempt to do harm.”

Bullying is NOT:

The manager holding staff accountable for performance, behavior, etc.

Many nurses complain that their boss is bullying them because they were put on corrective action for not following policy, not coming into work on time, calling off too many times, not giving medications, cursing at a co-worker, etc. This is NOT bullying! This is about being held accountable for your nursing practice.

The instructor holding students accountable for performance, behavior, etc.

Many student nurses reach out to me complaining that their instructor is bullying them because they were given a bad grade or given an “unsafe” during clinical. Again, this is NOT bullying. Perhaps the instructor is just holding his/her students accountable to a higher standard of care. Not everybody should be a nurse!

Conflict and/or expressing a different opinion

Just because you have conflict or disagree with a co-worker or employee, doesn’t mean either of you are bullies. Conflict is different. Conflict is NOT bullying.

Having a bad day and getting “testy” with your co-workers.

As stated before, nurses work in stressful environments FILLED with unpredictability and complexity. And-we are not always on our best behavior. I challenge any one of you to claim that you’ve NEVER done or said anything unprofessional at work when under stress. It’s a human thing. However, we are not all bullies!

Bullying IS:

If…There is a target, harmful, and repeated.

Uneven workloads based on favoritism (charge nurse gives easy assignments to friends-worst assignments to nurses she doesn’t like)
Deliberate exclusion
Negative gossip or rumor spreading
Micromanaging, finding fault, and constant nitpicking
Silent treatment or ignoring
Refusing to help
Yelling or openly criticizing in front of others
Withholding information to make others look bad
Sabotage and setting someone up to fail

Why does nurse to nurse bullying take place?

Nurses bully because they can.

First-we accept the behaviors as the norm and fail to recognize bullying behavior. We say things like, “That’s just the way it is in nursing.” Sometimes we say to others, “Well, that’s just how she is. Don’t take it personal.”

Second-when employees are bullied, they don’t speak up. 40% of all targets don’t tell anyone they are being bullied. This silence occurs because of the fear of retaliation. Targets are afraid that if they speak up, the bully will find out and retaliate against them.

Third-leaders use silence as a strategy too. Nobody teaches leaders how to address the bad behavior of their employees yet 85% of a manager’s time is spent dealing with the behaviors of their employees! So, the cycle of nurse to nurse bullying continues.

Why is nurse to nurse bullying a big deal?

71% of physicians and nurses have linked incivility to medical errors
27% of them said it led to a patient’s death
99% of physicians and nurses believe bad behavior leads to poor patient outcomes
81% of nurses who leave an organization cite peer and nurse/manager relations as a cause for leaving

When organizations ignore workplace bullying, they have high turnover, added costs, and ultimately, patients have worse outcomes. According to those statistics, one of those outcomes is death! I’d say that’s a pretty big deal.

What can healthcare leaders do to address nurse to nurse bullying?

One of the reasons why bullying can continue for decades without leadership even knowing about it is because of those 40% that don’t even speak up about it! As a leader, the first strategy to addressing nurse to nurse bullying is to start paying attention to your employees by standing back and observing. You’ll be amazed what you see and hear.

Here are some statements to look out for:

You’ve got to pay your dues.
It’s always been this way.
I’m making her a stronger nurse.
It’s sink or swim here so if you want to survive, you’d better learn how to swim.
Just ignore him like everyone else does.

Another strategy is for leaders to heighten awareness of behaviors by infusing content related to nurse bullying everywhere. Include content related to conduct in everything ongoing, i.e. staff meetings, leadership meetings, performance reviews, annual competencies, etc. Not just when employees are hired. Every employee should know that they matter AND the way they treat each other matters too.

After all, you can’t expect people to adapt their behavior if they’re not aware their behavior needs to be adapted.

Tackling a problem that’s been swept under the carpet for decades can feel like an overwhelming burden, but it doesn’t have to be that way. If you really want to create and sustain a professional work environment by eliminating nurse to nurse bullying, you need to adopt a top-down, bottom-up, and everything in between approach. Equip yourself with the skills and tools you need to end nurse bullying in your organization once and for all!

Like Like Celebrate Support Love Insightful Funny Comment Share 34 Comments MinKao Lee, graphic

MinKao Lee 1y

One contributing factor could be the stress and insecurity faced by per diem nurses, particularly regarding their lack of health insurance. Addressing this could help reduce workplace tension. For more information on health insurance options for per diem nurses, check out this resource: https://educationforinsurance.com/health-insurance-for-per-diem-nurses/

Like Reply 1 Reaction

Kelly O’Brien-Jones MSN, MBA, RN, graphic

Kelly O’Brien-Jones MSN, MBA, RN 2y

Thank you for this. I’m still ruminating over an interaction yesterday. Unfortunately there are too many nurses that bully and I just don’t see enough staff speaking up about it. It accomplishes nothing but negative outcomes for all.

Like Reply 1 Reaction Lorie Giordano-Hane, MSN, RN, graphic

Lorie Giordano-Hane, MSN, RN 2y

I am currently in the DEMSN program but have been in healthcare for 30 years. It has not always been this way. The nurses I worked with (that generation since retired) were very compassionate. Somehow there has been a shift in just who is getting into this field. They seem to be a more aggressively competitive group lacking compassion for their patients, but in it for the "hero" title. Especially after Covid. I have also noticed many of these "bully" nurses are the main financial providers for their families, and many state their husbands are "stay-at-home dad." I am one of the oldest in my cohort, but see that these new nurses are being trained to be defensive and competitive. There are so many patients in need of compassionate care as our substance abuse and mental health issues are climbing. I believe it begins in the colleges and is up to the educators to teach strategies to work together for the good of the patient. This aggressive/competitive behavior weakens the structure of the healthcare system and causes nurse burnout. Also, I see these schools are accepting almost anyone due to financial reasons. I do not think I will ever work in another hospital on the floor again. I hope things change.

Like Reply 1 Reaction 2 Reactions Dolores Gurule de Duran, graphic

Dolores Gurule de Duran 4y

How about the nurses that do very little in their job because they are having all the patient care techs doing their work. That is a form of bullying. Which occurs in a lot of professions not just nursing.

Like Reply 2 Reactions 3 Reactions

Michaela Lindahl, MSN, MPH, RN 4y

Renee Thompson DNP, RN-Nurse, Workplace Bullying Expert Thank you for the work you are doing to address bullying in the nursing field and providing support for those trying to change the culture around bullying in the workplace. I was, however, disappointed to see in your article that the #1 reason bullying happens in nursing is because it's a female dominated field. This reinforces gendered stereotypes and is akin to saying "boys will be boys". To have a leader in the field state -"It wasn’t all that long ago that we were competing for the prized male, so women are used to trying to make other women look bad" is harmful to women and the workforce overall. It denies the experience of many who are being bullied, and in my opinion truly misses the mark. It was difficult to keep reading, and is out of touch from much of the workforce today. I agree with a lot that you had to say in that article, but really feel you are missing the human nature aspect, and that systems have been created and allowed for generations to provide space for bullying to happen.

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Nurses bully each other for 3 main reasons.

How does nurse to nurse bullying typically show up in healthcare practices?

Bullying is NOT:

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Bullying IS:

Why does nurse to nurse bullying take place?

Why is nurse to nurse bullying a big deal?

What can healthcare leaders do to address nurse to nurse bullying?

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