Nurse-on-Nurse Hostility Remains an Issue

To those outside the nursing profession, it may be a bit frightening to hear the phrase, "nurses eat their young," but to any nurse, this is just a standard expression meaning the bullying or harassment of a fellow colleague.

"Nurses eating their young has been around since I started in nursing 25 years ago as a nurse's aide," says Frances Hodgkins, RN, PMHN-BC, from Michael E. Debakey Department of Veterans Affairs in Houston. Hodgkins acknowledges this issue continues today.

"I have decided that I will not eat my young and I will be a role model for the future. On my unit, we do not allow 'nurses to eat their young.' We welcome students and want to teach them the skills necessary to be good, solid nurses. I am interested in helping the younger nurses understand the dynamics of professional nursing. Not the childish behaviors that I was exposed to as a young nurse," says Hodgkins.

In a recent post on the Well Blog on The New York Times, Theresa Brown, RN, delves deeper into the issue of why nurses bully one another, reminiscing about when she first started out as a nurse and experienced senior nurses lying about whether Brown had completed her work.

"It's the dirty little secret of nursing, and it needs to be publicly acknowledged, and just as publicly discussed, because it's keeping us down," she wrote.

Other nurses in the field are aware of the situation.

"This lateral hostility is still alive and festering," says Tonya J. Barrere. "It seems more prevalent in the critical care areas [maybe because these nurses are many times aggressive by nature]. Many critical care nurses feel their knowledge level is above 'floor' nurses and they look down on them and consider them inferior. These same nurses are often rude and unprofessional when a bed in their unit is requested."

Brown references Kathleen Bartholomew, RN, MN, a nurse and consultant who literally wrote the book on the topic. In Ending Nurse-to-Nurse Hostility, Bartholomew addresses how and why back-stabbing, intimidation, and sabotage are all too common on some nursing floors, and provides strategies for how to stop these behaviors.

In her book, Bartholomew argues that "research shows verbal abuse significantly affects the work environment by decreasing morale, increasing job dissatisfaction, and creating hostility. Bullied staff report a decreased sense of relaxation and well-being at work, increased mistrust, low self-esteem, and lack of support from both staff and superiors."

To help prevent against the common issue, Bartholomew suggests the way to break out of the cycle of oppression is "to illuminate the behaviors and raise our self-esteem." Bartholomew continues saying "when self-esteem is low, individuals are powerless to change their situation, thus the very act of taking back our power raises our self-esteem."

Debra Savage, RN, MSN, BSN, CNO, at Sacred Heart Hospital in Chicago, IL suggests some ways of her own to help address the issue of nurse-to-nurse hostility, and "nurses eating their young."

"Selecting preceptors with the best attitudes and training them to understand generational differences as well as how to be an effective preceptor are crucial to preventing this problem," says Savage. "Nurse managers and educators need to keep an eye on new staff and meet with them regularly to make sure they are experiencing support and teamwork throughout their first year,"

All the women agree this is a common issue in today's healthcare settings, and that nurses need to do something to change this.

"We, as nurses, must be there for one another whether we are just starting or nearing retirement not only for the best interest of our patients, but also for increasing our own satisfaction and effectiveness in the workplace. We cannot afford to turn new nurses off to our profession or cause them excess stress from lack of camaraderie to want to leave the bedside early," says Savage.

"I am an advocate for my patients when I promote good collegiality and teach good nursing practice," says Hodgkins. "It is the responsibility of the older nurses to stop eating the young and change the culture of nursing today."