Saturday, April 24, 2010

When What's For Lunch Is You: Dealing With Workplace Bullies.

Nurses eat their young.


Nurses don't eat their young any more than electricians do, or bookstore clerks do, or lifeguards do. There are bullies in every profession; the thing about nursing is that we're expected to be all warm and cuddly and friendly and healing angels of peace yadda yadda. So when "horizontal violence", or bullying, happens, everyone clutches their pearls and has a little crinoline-lifting moment.

Still, if you have to deal with a bully at work, things can suck hard. I deal with three on a regular basis. Two I've dealt with fairly successfully up to now and the other I've ignored. Here, therefore, are the three types of bullies you'll encounter most frequently and the ways I've come up with to handle these people. More suggestions in the comments would be welcome.

(Nota Bene to new nurses: If your manager is the one who's determined to clean your bones, get a new job. There is no winning with a bullying boss, unless you're willing to spend a whole lot of time and effort to get them reprimanded repeatedly and then fired. If you're new, quite frankly, you have better ways to spend your time. Get the hell out and leave the crusade to older nurses who don't have to worry about ruining their future careers through one bad apple. Seriously.)

Bully Number One: The Know-It-All.

This person just wants to help you. Yeah, right. They know more than you do (debatable) and are better at their job than you are (extremely debatable), and are determined to let you know it every single time you two work together. It's wearing and exhausting to have to listen to unsolicited advice when you're trying to get something done, and a lot of what the Know-It-All does involves criticizing (ever so subtly!) the people who taught you how to do those things in the first place.

How To Deal With Bully Number One: Speak Up.

This is the hardest sort of bully to work with, though he's often the least damaging to you personally and professionally. Bullies in general are easily recognized by other people that you work with; it's likely that this guy has a reputation that preceeds him. Still, he can make you (meaning me) freeze up and screw little things up when he's got you under the microscope, no matter how much experience you've got.

Therefore, the only way to handle such a person is to be frank. You have to tell them--sometimes repeatedly, in a variety of situations--that you're doing fine, thanks, that yes, you understand that X, Y, and Z lead to Q, and that the way you're running that line is just fine with your preceptor, manager, and the attending.

Doing it respectfully is the key. Doing it without losing your temper is critical.

Oh, and by the way: Never, ever, ever ask this type of person for help. They'll likely defer to the patient care aid, the charge nurse, or Santa Claus before actually being useful.

Bully Number Two: It's a bird! It's a plane! No, it's Off-The-Handle Man (or Woman)!!

This sort of person can be nurse, doctor, or aid. Or respiratory therapist or X-ray person or whatever. The thing that distinguishes this sort of bully is that everything will be fine for some time.....when suddenly, they'll blow up at you over a situation or problem over which you either have no control or weren't involved in in the first place.

There's usually shouting involved. There's also usually hand-flapping, eye-rolling, and perhaps some loose spittle here and there. It's scary and can be enraging, but like the Know-It-All, the actions of OTHM, while disturbing, really don't make much of a lasting difference to anybody.

How To Deal With Bully Number Two: Employ Heavy Weaponry.

This is another sort of situation you gotta deal with immediately. It's fresh in my mind because I just had a mild, drama-free showdown with our local OTHW the other day, and here's what I did:

I waited as calmly as possible until she finished screeching, and then I said, "There's obviously a problem here. Let's take it to Boss Lady as soon as she gets in."

OTHW backed down immediately, saying that oh, no, that's not necessary, but--and here's where the heavy weaponry part kicks in--I would not let her off the hook. She'd yelled at me for something completely beyond my control, made some remarks about my parentage and my personality into the bargain, and scared hell out of a student I was precepting.

So in the morning, off we went to see Boss Lady. As we walked into her office, I said, "OTHW got very upset with me this morning, and so we need a mediator. I'll let her talk first." And then I sat down and made myself comfortable while she ranted.

This is, again, crucial: you must let the nutjob spew gaskets and bolts all over before you respond in a reasoned, logical manner. Not only will it make you look like a fair person, but it's golden for getting your point across in such a way that showcases the other person's wackiness.

Not only, then, do you show your boss where the problem is, but you do something equally important: you let OTHperson know that you are on it, you are down with it, and you are not afraid to bring it to their doorstep (as the kids say). Not being intimidated is what makes these bullies leave you alone.

And finally, Bully Number Three: She Who Must Not Be Named.

I have no good name for this person. If there's a nurse that eats her young, this is the one: passive-aggressive, condescending, subtly critical, and prone to complain about other nurses to residents and attendings. This is the bully that you have to watch out for, as she can be damaging to your reputation as a nurse and your standing with your boss and the people who aren't there all day (like doctors).

How To Deal With Bully Number Three: Get Ready For The Long Haul

Unfortunately, like all things toxic and explosive, this person is the hardest sort of workplace bully to handle. You can go about it two ways: ignore what's happening and just keep your head down, or write everything down and make a near-Federal case of it when you have enough evidence.

You know how everybody always tells you, "Write everything down", right? Well, it's true: it does give you ammunition when and if you want to confront SWMNBN in the boss's office. (Don't ever do it alone, without a senior person there. That way lieth disaster, verily.) You'll need to be as careful at recording what she says or does as you would be in documenting the care of a very ill patient with litigation-happy family: that's the only way to keep yourself from becoming mired in she-said/he-said Hell.

Try to mitigate this person's actions and words by forging close relationships with the doctors and nurses (and everybody else) you work with. In dealing with our unit's SWMNBN, the reputation that I've developed--carefully and consciously--over the last eight years has been invaluable. You may not have that depth of experience, but it's never a bad time to start building respectful, open relationships with your peers.

And, if it comes to the point that you have to say something to your boss (it might not; often this bully's teeth are pulled when you ignore her or him), it's usually best to meet alone with the boss and show them the evidence you've compiled, then let him or her take it from there. The more ammunition you have, the better--and the higher quality ammo you've got, the better. If a doc reports that SWMNBN told her that you'd not done some vital thing, ask the doc to write that down for you, and keep it with your other documentation.

I wish you luck in dealing with this particular bully. I was fortunate that, when my unit's bully complained to an attending about the care I supposedly hadn't given a patient, she chose an attending with whom I'd just discussed that care, and with whom I have an excellent working relationship. The doc basically nipped that particular bitch in the bud, and I've had no problems since, but it was pure chance that it happened that way.

Tell your fellow Faithful Minions and any new Minions out there how you deal with bullies in the comments, please. And thank you.


Nurse J said...

the thing with my unit isn't really my fault. it's more of a staffing issue. i guess last year, tons of people were encouraged to level up, get extra education, and there was a lot of overtime. well, the budget number for this year came back and Upper Management decided that there were too many leveled people and too much overtime. so a bunch of new people (including me) were hired. the other problem is that we are a very good ICU, so we have lots of folks (mostly doods), that get hired on here, work a year, get their CCRN, and then boom, CRNA skool. so....yeah. so there is a subtle divide between the older, not-planning-on-CRNA-skool nurses and us young'uns. we know and they know it's not our fault, both about the lack of overtime and our career aspirations, and they still treat us very well. i LOVE LOVE LOVE working here and hope i never run into the bullies. i like your wya of dealing with bully OTHM, if i do ever run into these types, i hopes i can kepps my temper.....

Nurse J said...

ps, do you have the Bullies to deal with AND the racists? are all these different groups of co-worker-peeps? seems like a heavy concentration of douchbags in one place....

Anonymous said...

I'm actually a student nurse and on my most recent practicum unit we had a type 3 who felt she should dictate over the students. No adjustment we made, no care that we provided or documentation that we did was fit for her standards. I can understand and appreciate good work ethics in people who strive to maintain standards, but being dictating and condescending is a whole new ballpark.
Anyways, we did, as students, document each of our encounters individually and submitted it to our college. However, because we are guests on the unit it is beyond our grasp to be able to speak to management to resolve any of these issues. I can only hope to leave my unit better for the next batch of eager students than the way I had found it.

Anonymous said...

Very happy to see this post. Im a nurse with about 3 months of experience and am feeling pretty low about work at the moment. I have had to deal with a certian person in my area who is difficult, condenscending and patrionizing. The small amount of confidence I had bulit is feeling pretty eroded at the moment! I am trying not to take it to heart but guess I am learning the hard way that in nursing I am going to need to have a thick skin!

Jo said...

Nurse J: The bullies and the bigots are two separate groups. Scary, isn't it? I'm not sure what put all the jerks into one unit.

Anons #1 and #2: THIS is what makes me crazy. What you guys experienced as a student and a new nurse is not at all what ought to happen. I'm not one who uses the words "nuturing environment" much, but in y'all's cases I will: you guys need nurturing.

Not touchy-feely, fluffy BS, but real and honest guidance and confidence building. The only way you will ever gain enough confidence to deal with big crises as a nurse is by being walked through smaller ones carefully and with an eye toward education.

Crap. I'm sorry all you guys have had to deal with this. I know it exists, and I've been lucky not to have to see it myself until now, but a new nurse? I would've left the profession.

nurseXY said...

I believe the term for Bully #3 is The Splitter. They employ the classic technique of splitting--complaining and criticizing the other members of the staff to whoever will listen. It feeds their need for control, and in getting you to commiserate in their complaining about other staff, they have insta-ammunition against you with other staff when needed.

The most effective way I've found in dealing with bullies of all types as a student nurse is the following: Bullying isn't about the victim. Most times it's by random chance that the victim is targeted. Bullying is about the bully. Some place inside of them is some insecurity so big they have to distract you from seeing it by assaulting you instead. Maybe they weren't hugged as kids, or the dog stole their lollipop, who knows. The point is, when I have to deal with a bully--I'm already a step ahead.

Other than that, there's some great advice here. Thanks for writing about this!

me said...

From a long-time nurse ~

EXCELLENT advice!!!

Marjorie said...

This seems to be a popular topic lately... You've got some good advice to offer. Thanks!

I've been dealing with a group of Type 3's. If there were only one or two, it wouldn't be so bad. But several people who fall into that category? It's enough to drive a person nuts.

I'm two and a half months into my new gig and have made it a point to be nothing but professional. It's tough to stick it out when I'm in a stressful situation. At some point, I've got to decide if it's worth putting myself through this crap on a daily basis.

Thank goodness for options!

Anonymous said...

I would respectfully disagree with the "bullshit" part - I'm a second degree student, so I've seen enough of the real world in my other career to know that what I have experienced in nursing school is a different animal altogether: intimidation, defensiveness, power games, retaliation, entrapment, character assassination, nepotism, and just plain incompetence.

Maybe it's just my school, but I'm already feeling burned out on nursing, and it's your blog that gives me hope that it's not going to be like this once I get out there and start working. However, I've heard similar stories at other schools, so I'm starting to think it's endemic, and it's making me and my intelligent, motivated classmates think twice about our starry-eyed dreams of becoming nurse educators someday and helping to "Advance the Profession." If this is what my co-workers would be like? Fat. Chance.

Brian said...

Yeah, these are not at all specific to nursing, or even health care. I'm just about to start nursing school, but my first career was as a computer programmer, and you can find all the same kinds of bullies over there. The bad apples are the same in every industry I've had experience with.

Against any bully, the most important response IMO is not to let them scare you. If you go on the defensive, then you're just reacting to whatever the bully does, and that puts them in control of the situation. You need to stay centered around your own stuff, keep doing your own work in the best way you know how, and not let some antisocial jerkwad take control of your life.

Nurse J said...

to anonymous;

i think its a generational thing. is it the older nursing instructors that give you crap? i had some like that in my nursing skool. one kid got married and had to miss a coupla days of class, and like, they went OFF on him. really? you can't get married? anyways, these same instructors are the same ones that tell stories about the 'old days' when they had to wear whites, and docs had separate 'lounges' for themselves and they had to stand up if a doctor entered the room. that makes me think, if that is what your WORKING conditions were like, what must the skool have been like? methinks they had total boot-camp-from-hell nursing skool, and like many bad things, they may think, 'hell, when i was in nursing skool, i had it rough, so now that i'm a teacher, i'm gonna make it the same for my students.' its hard to break that chain.

like many things in nursing, the hard things are sometime hoops you have to jump thru no matter what. just remember, when you get out there, you ALWAYS have a choice about what king of nurse YOU want to be.

Nurse Jo;

when you get a crashing admit, does all the bs and bigotry go away? can you at least rely on these peeps to have your back when the stuff is actively spraying out of the fan? no matter the personality types on my unit, when we get a crash admit or somebody tries to die on us, we ALL come together to get the job done. i hope in moments of crisis at least you gots peep who have your back.....

how apropo
my word is hostal

Heidi said...

I'm with anon on the respectful disagreement. Horizontal violence does happen, especially towards new nurses, and it's not because someone wasn't all fluffy bunnies, kisses and rainbows. In my experience bullies of the #3 variety are pretty common, and they often disguise their bullying by telling you they're just looking out for you and/or the patient (implying that you're a danger to said patient). The especially shitty thing about this situation is that sometimes you just don't have enough experience to know whether or not you're really as big of an idiot as the bully is making you out to be. Big time confidence under-miner.
Sorry, just complaining. Don't have any good tips on how to deal with the bullying, as I'm just a year into nursing and still trying to get my footing in these situations.

Anonymous said...

I'm a new nurse with about a year's experience. I'm currently looking for a new job because my boss is a bully- I couldn't love my co-workers more, they're an amazing, intelligent, caring, and funny group, but I just can't put up with my manager any longer. There's no working with her, I have no seniority on the floor, and there are other jobs that may be less damaging to my license/reputation. I'm getting out. Thank you for re-affirming that I'm doing the right thing.

Geosomin said...

I work for doctors as a labtech...and yeah...we get that too. Especially with pathologists. They seem to have gone into pathology because they don't deal that well with people :)
Bully #2 in our area has given me so many opportunities to do what you describe. I end up looking fantastic and he looks whackadoo every time. It's all the consolation I get, so I take it :)

Halie said...

Great post Jo! Love how you've broken bully's down and describe ways to stop them!

A NURSE said...

I can't stress enough the "documenting" part of your blog. That's how I got rid of one bad egg in our department - wrote everything down. I had to talk to admin about my documentation, but as long as you just deal with the facts....its good.
That nurse was given the option of anger management course or if declined, give in her resignation. Last I heard she was working in another hospital......don't know who gave her recommendation, but it sure the heck wasn't me.

Guzzo said...

I left my last job because of a truly psychopathic bully.. a combination of #2 and #3.

It was a good job and I would have continued to put up with it, except for one big reason.. a supervisor who promoted that type of behavior.

Those type of supervisors are worse than the bullies themselves. No job is worth getting it from both ends.. and for no good reason.

Alana Gorecki said...

I agree with tip #1: Speak Up! Silence is not the best remedy in issues like this. No one is allowed to inflict any kind of harm to anybody. Nurses know this more than other professionals. Fight for your right and do something to stop bullies. Keep your composure and take control over your temper. And always do the right thing and let those who are in position (superiors and managers) take disciplinary and preventive measures.