Australian researchers report that nurse bullies “are usually themselves past or current victims and most are convinced that their experiences have strengthened them for their nursing role.” Under the guise of teaching younger nurses to be strong, these nurses appear not only to prefer to see new colleagues fail than succeed, but also to help them along in the process of failing. “Why do we tear each other down so much?” a Texas ER nurse wondered. “[They act like] they earned their stripes the hard way, the ‘old fashioned way,’ so they don’t want to make it any easier for the new nurse learning the ropes. It’s like the parent saying, ‘When I was your age, I got beaten with a log, so you should be thankful when I do it to you.’ Right, it was terrible the things you had to go through to get to where you are now. Shouldn’t you then want to make it easier for someone else, so they don’t have to experience that kind of heartache?”
Much like sorority members, the nurses I interviewed were split on whether nurse hazing is ultimately beneficial or detrimental to the profession. At first, Emma, a Mid-Atlantic surgical nurse, was furious when an older nurse hazed her at the Pyxis by “making me feel stupid, when my main goal was to get my patients their medications as efficiently as possible. [I felt] this sort of hazing was totally unnecessary and counterproductive,” Emma said.
Now that she has been on the job for a few years, however, Emma finds herself defending the practice. “Older nurses feel a need to set a high standard and not baby new nurses. Sometimes this comes off as very harsh and unnecessary, but in retrospect, I really appreciate being challenged to be diligent early on, even if it meant being called out on my failings in front of others. This sort of corrective hazing that a few older nurses are known for might not be the most delicate way to help someone see their errors, but it certainly is effective. I was fortunate that the nurses on our unit generally don’t ‘eat their young’ just for the sake of it, but rather to guide and provide the opportunity for new nurses to prove themselves.”
In recent years, as workplace bullying generally has become an increasing part of the national dialogue, some nurses worry that supervisors are abandoning a no-nonsense teaching style because new graduates might consider it bullying. “We’ve coddled these new young nurses. There is way too much hand-holding,” said a Virginia Neonatal Intensive Care Unit (NICU) nurse. “If a new nurse screws up or doesn’t have her stuff together, she needs to know. We have to hold ourselves and each other accountable for our patients’ care. Nurses should eat their young to get rid of the weak. If you can’t deal with an older nurse correcting you and watching out for your practice, how are you going to handle resuscitating a dead patient solo, or dealing with an alcoholic sex offender who is making disgusting comments to you?”
Even some younger nurses are willing to let the practice continue if it prepares new graduates by whipping them into shape, like a nursing boot camp. “Nurses take an immense amount of pride in what they know, what they’ve seen, what they’ve experienced. And unless you know what they know, seen what they’ve seen, or experienced what they have (and you won’t, especially when you’re a new grad and new to a unit), you don’t know jack until you prove yourself otherwise. So suck it up, earn your place,” said a New York pediatric ICU nurse who graduated two years ago.
A nurse in Lebanon argued that bullying among nurses is “good because it is part of the learning process. It helps you sharpen your communication skills. We learn how to face our bully, act with knowledge, and continue doing what we do best for the sake of the patients.” Similarly, the New Zealand study found that a small number of nurse bullying victims viewed the situation positively because it enabled them to stand up for themselves and to “feel stronger.” A Washington, DC, pediatric oncology nurse remembered when older nurses drilled her relentlessly about various patients and diseases. “One nurse was so intimidating that I was crying as I tried to give report to the next nurse. But you do certainly learn things quickly that way.”
Another similarity to sorority hazing: Nurses eating their young continues because nurses often don’t report it. Researchers say that nurses tend to keep quiet because they are afraid of retaliation, they don’t think reporting the behavior will penalize the bully or result in change, or the perpetrator is a manager. Like patient assault, lateral aggression has become so ingrained in the culture of the profession that many nurses don’t report the behavior because they—both victims and perpetrators—don’t realize that it is unacceptable. In one study, when nurses confronted their aggressors, three-quarters were “shocked that the victims felt that way.”
Some older nurses said that they don’t mean to treat new nurses harshly; their language or tone can reflect the tension of an urgent moment. An Arizona pediatric oncology research nurse tries to give students as many appropriate nursing tasks as possible. One day, however, this nurse’s young patient was declining and she needed help from seasoned nurses, residents, and respiratory therapists. As the nurse was attempting to contact the child’s parents, a student approached her to ask, “What should I do?” The nurse recalled, “It seems like an innocent enough question, but I had fifteen people I was listening to and giving information to. The last thing I needed was some clingy, high-strung student asking what she should do. I said, ‘Stand in the corner. Watch, and don’t say a word!’ I knew the minute it came out of my mouth that I had just eaten my young. I simply was not nice. But if a student doesn’t have the wherewithal to know she’s in the midst of a tremendous learning situation just by observing, I certainly don’t have the time to explain it to her at that moment.”
In Washington State, a day surgery nurse explained that although she enjoys precepting on occasion, “It all depends on where my head is on any given day. I’m very Type A and if I’m in a ‘gotta get it done’ mode, then mentoring can drive me nuts, because obviously a new employee (especially new grads) takes lots of time getting stuff done that I know I could be doing so much faster. And sometimes I feel I must jump in and do part of the job. That is not good mentoring,” she said.
Because so many departments are short-staffed and turnover is frequent, some inexperienced nurses are automatically expected to take on massive responsibility and pressured to work on critical patients whether or not they are ready. A nurse in Singapore said that nurses eat their young because they expect new nurses “to be as skillful as if you were already thirty years into the job. And if you are not up to their standards, you may be given a tongue-lashing, taken off the learning curve, or banished indefinitely to the Siberia of nursing chores to clear bedpans and clean backsides,” a repercussion reminiscent of the 1909 New York Times article.
When these new nurses get overwhelmed, complain that they have too many assignments, or don’t have the experience to handle their tasks properly, older nurses can get frustrated; they might have little sympathy because they are or were in the same boat. “We work hard, come to work on time, prepared, focused, and ready to jump into the trenches,” said a twenty-year veteran of a Midwestern NICU. “We have had years of terrible hours, schedules, and holidays—obviously tons of shitty, unfair assignments—and we just did it, trusting that the seasoned nurses had a plan with the assignment choices.”
At the same time, if inexperienced nurses are too casual, older nurses might think they don’t take their work seriously. The generational divide is severe. In the United States, the average nurse is 47, and many nurses are delaying retirement through their late sixties, according to a 2014 Health Affairs study. “The younger nurses have good skills and, with our guidance, demonstrate excellent skills over time. The issue is that they lack respect and can be rude and arrogant. You lose patience with nurses who can’t wait their turn, won’t shut up and listen, can’t stay off their phones, argue with policy, or show their butt-cracks. They whine about their assignments, take chances when asking for help would be safer, take long lunches, interrupt, and bad-mouth other nurses within earshot. They come to work rushed and on the phone, eating, and often not in scrubs; ignore parents of sick children while they are charting; and often surf the Internet,” the Midwestern nurse said. “There is a pecking order and a prejudice against the younger nurses because they are hard to work with. When my generation of nurses started, we were so intimidated as new nurses that we came in early, took notes, and focused on the task at hand. We have years of experience and skills that can’t be matched.”