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How to Lose Good Nurses

Alexandra Wilson Pecci, for HealthLeaders Media, June 25, 2013

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 a managing editor for HealthLeaders Media.

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4 comments on "How to Lose Good Nurses"


Veda Andrus, EdD, MSN, RN, HN-BC (7/3/2013 at 8:02 AM)
This is such a tough topic to truly address! The theory of oppression (consider Freire's Pedagogy of the Oppressed http://www.pedagogyoftheoppressed.com/) captures the deeper issue here as Betty Jo has indicated but how to get to the proverbial bottom of this issue has eluded nursing for decades. I teach my students to send lovingkindness (see Sharon Salzberg's book Lovingkindess: The Revolutionary Art of Happiness) to challenging colleagues with the intention of "rising above" the negativity, competition, and fear-based thinking. I also encourage them to choose to not get involved with gossip, which is a form of bullying that separates nurses from one another. I would appreciate hearing other strategies to end the cycle of bullying in nursing ... and in our world.

moda year (7/2/2013 at 1:00 PM)
As a veteran RN of more than 30 years, I have witnessed the bullying throughout my entire career. It is, as you stated, insidious. Often, it is also thinly veiled as teasing. "Do some cloak themselves as abusers in order to avoid becoming the abused?" I've wondered this many times over the years. Keeping your head down, minding your own business, tending to task, and avoiding the cliques unfortunately doesn't keep you from becoming a target sooner or later. It is not just the young or the new nurses who are vulnerable. Bullying can and does occur at any interval along the path of the nursing career. It doesn' matter if you are thin or fat, attractive or not, highly intelligent or average, high on the career ladder or entry level. As much as new nurses, those nurses who are nearing the end of their career are especially vulnerable. I'd like to see an article dedicated to the entirety of bullying in nursing.

Pat Akinyombo, RN (6/28/2013 at 11:45 AM)
It has been said that nurses eat their young. I think the biggest problem is that new nurses are being sent in to be trained by overworked, overstressed and often disrespected nurses and the end result is bullying. Perhaps we should look at why nurses behave the way we do towards new nurses. People who are happy and fulfilled don't usually take on bullying behvaiors.