Hospitals that fail to stamp out verbal abuse among RNs and those that demand 12-hour shifts risk losing valuable employees to other organizations where working conditions are more favorable.
New nurses, especially if they are young, are classic victims of nurse-on-nurse bullying. But while the practice may have been viewed as a rite of passage in the past, hospital leaders can no longer afford to let it go unchecked.
One reason is financial. Cheryl Dellasega, PhD, RN, CRNP, an expert on bullying among nurses told me that left unchecked, it can result in good employees leaving an organization.
New research adds more evidence to Dellasega's point. A study of newly licensed registered nurses finds that nurses who are verbally abused by nursing colleagues report lower job satisfaction, unfavorable perceptions of their work environment, and greater intent to leave their current jobs.
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The study, "Verbal Abuse From Nurse Colleagues and Work Environment of Early Career Registered Nurses," was conducted by the RN Work Project and published online in the Journal of Nursing Scholarship.
Researchers surveyed 1,407 newly licensed registered nurses about how often they were verbally abused by nurse colleagues:
- Never (low level);
- One to five times in the past three months (moderate); or
- More than five times in the past three months (high)
Almost half (49%) experienced moderate verbal abuse and 5% said they had experienced high levels of verbal abuse. The most commonly reported experiences involved being spoken to in a condescending manner and being ignored.
The authors of the study say that it's this kind of passive/aggressive abuse that's the most "insidious."
"Rather than yelling, swearing, insulting or humiliating behavior, most early career RNs reported that the abuse they experienced involved condescension or lack of acknowledgement," Wendy Budin, RN-BC, PhD, FAAN, adjunct professor at the College of Nursing, New York University, one of the study authors, said in a statement.
"This kind of subtle abuse is less likely to be reported and more likely to be overlooked as a problem, which makes it all the more insidious and it is all the more important that hospital administrators work to confront and prevent it."
Indeed, Dellasega told me a few weeks ago that such behavior is common when nurses form cliques and gang up on or exclude other nurses. For example, nurses who are part of a clique often make rude or sarcastic comments to or about newcomers, and even go so far as not sharing supplies.
Part-time, agency, or floater nurses are another group of nurses that Dellasega says often experience bullying. The RN Work Project study appears to support this claim: It found that staffing shortfalls were also correlated with higher levels of abuse.
Another finding had to do with shift length, with RNs working day shifts saying that they experienced higher levels of verbal abuse than those working evening and weekend shifts. RNs working eight-hour shifts were less likely to experience abuse than RNs working 12-hour shifts. Unmarried nurses reported higher levels of verbal abuse, too.
The consequences of bullying and verbal abuse are wide ranging, from spurring nurses to call in sick more often, to causing post-traumatic stress disorder, anxiety, depression, or insomnia in victims. Patient safety might also be in jeopardy when nurses are working in a toxic, abusive environment.
But a striking finding of the new RN Work Project study is that nurses who are verbally abused are more likely to jump ship.
The study shows that intent to leave a job is highly correlated with the levels of abuse new RNs experienced.
RNs who reported no verbal abuse were least likely to plan to leave in the next three years. But those who experienced moderate to high levels of abuse were most likely to say they intended to leave in the next 12 months.
It's also important to note the finding that these new RNs didn't want to leave the field of nursing, just their current, poisonous environments. This means that hospitals that allow verbal abuse to occur are likely losing valuable employees to other organizations.
The authors of this study recommended a course of action similar to the one Dellasega calls for in her book, Toxic Nursing: Managing Bullying, Bad Attitudes, and Total Turmoil. They say hospitals should implement mandatory organization-wide programs for all employees about the impact of verbal abuse and other disruptive behaviors, as well as zero-tolerance policies.
And if your organization hasn't taken the time to train its nurse leaders in conflict resolution, now's the time to do it.
Alexandra Wilson Pecci is an editor for HealthLeaders.
