Burn Out and Bullying

Did you know the term burnout was first used to describe exhausted an disillusioned health care workers in the 60's, it certainly was a very relevant term.  As nurses it is not uncommon for us to suffer from burn out at some point, this condition is especially prevalent in high acuity areas such as the ER, ICU and Oncology but I think you can suffer it in every speciality, certainly more so if you have one of more bullies in your team!  At a time in nursing when nursing informatics is changing the face of clinical care so much (really when I walk on the floor now often nurses are glued to computer monitors and smart phones and not walking the halls and talking to each other!), and we are being asked to do more with less, who would not get burned out.

For me it is cyclical, I can have peace and harmony for a while then juggling all the different roles I have, clinician, nurse educator, consultant suddenly tumbles like a good game of Jenga and I have to step back and breath a little.  For me that means slowing down, making sure I get to that kickboxing and yoga class (really, it helps sooo much), get a good nights sleep and take care of my diet.  Small changes somehow make me feel a little more in control of the chaos that surrounds me, let's face it, it surrounds us all.  My family always knows when I am super stressed as I am in the kitchen making a dinner that Julia Child would be proud of.  Somehow creating something nutritious centers me, not surprisingly the family are not too upset when I get stressed......they know they are going to get fed.

Taking a step back and taking care of myself also helps me put those bullies and the control I am allowing them to have in my life into some perspective.  As I hinted in my last post a bully usually lashes out because they are operating from a place of pain, insecurity, surely someone who is that nasty must be in personal pain of some kind.  It allows me to think compassionately about that toxic person in my life without condoning their behavior and reestablish good boundaries, so I do not let the bully bother me so much and let them know how little they may get away with at my emotional expense.

The last couple of weeks have been that crazy for me and this week even though I perceived I had no time I walked the dog around the reservoir and just took in the colors and the great weather, went that extra mile at kickboxing (boy does it make me sleep better) and determined to make that yoga class tonight before my 4.30am start tomorrow for pediatric clinicals, which is going really well.  Heck I love students.

I promise this is the last post on bullying for a while but probably not the last word on taking care of ourselves as nurses.  We have to give ourselves permission to put ourselves first for at least 5 minutes a day and have/be a great day!!!!

Bullying In Nursing Culture Part 2

There is a point when you get way into your 40's (like me!) that you hope all the bullying and passive aggressive remarks in nursing will 1. Disappear or 2. Float off your back without sustaining the sting they intended.  Sadly I have more luck of the sun not rising in the morning.  Let's face it, we are a female dominated, dysfunction relationship, sad example of girlfriends gone toxic.   

My husband who is very successful in business can have a heated discussion with a co-worker and then go out with him for a beer.  I can interpret the most innocent of remarks as an attack on my performance, intentions, work ethic and character and not sleep for a week!!  This is because men are able to compartmentalize professional and personal and women cannot and therein lies part of the issue.

I was once a part of such a dysfunctional team that management forced us to do group therapy....yep that was about as much fun as cleaning up an over full exploding colostomy bag!!  But I do remember one this the therapist told us.

"Think the best of me and I will think the best of you!"

I have tried (not always successful) to apply that to my work relationships.  Maybe if that colleague called out she really is sick, maybe when your co-worker gave you the stink eye she was thinking about other things like troubles at home, maybe when your team mate snapped your head off it was because her to-do list is so long and she has not slept in 2 nights as she was up with her baby who is teething.  Who knows what the reason is, but the point is peoples bad moods and reactions to us is not always about us and so we should try and take the high road and focus on what we are doing right and not on that one thing we may have done wrong or that one thing that your co-worker wants the whole team to know you did wrong!!

We cannot change the psychosis of bullying within our profession over night but we can start with us.  Chose to be kind, chose not to participate in the gossip, in fact flee from it and make it known you will not participate.  Set an example for the novice nurse and the nurse who is unable to defend herself.  Be a champion of kindness and let's start caring for each other the way we care for our patients.

Bullying Within Nursing Culture Part 1

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Nurses are often called “Angels”.  This term has made me feel uncomfortable when directed at me.  If that patient and their family only knew all my foibles and judgmental thoughts that go through my head in the course of a day.  However, sometimes we are not very angelic towards our colleagues.   

This phenomenon has many terms these days, nurses eating their young, nurse bullying, horizontal violence.  The good thing is, it is being documented and written about more and more in nurse literature, but is it decreasing the incidence of horizontal violence.

I am sure every nurse reading this can remember a time when they were the victim of bullying in the workplace.  The discomfort of being victimized by this never leaves us.  It can be especially bad for new nurses; at a time when they need to be mentored and supported they are wondering if they made the biggest mistake of their lives by joining this angelic vocation called Nursing?!

I once left a job when the bullying got so bad.  I loved the job, but a few burned out cynical nurses who decided to put a target on my back made life at work so toxic I did something I am not proud of.  I handed in my notice and walked out the same day!  This is not something I would recommend, but the situation had become so bad and once I handed in my notice I actually was in fear of the consequences so I just left and never went back.  Not cool, really not cool but I also have to say it was a vote for my emotional safety and I do not entirely regret it. 

The job started well enough, it was a new area for me but I was eager to learn.  The team were supportive, wanted to get to know me but it was obvious that a few nurses who had been there several years were burned out in the high stress area of pediatric oncology and had become victims to their situation, claiming their victim hood as a source of self-soothing for the daily grind.  It started with the usual gossip of other team members; with things as trivial as a perceived bad hair style to accusations of work ethic (really sometimes junior high never ends for some people).  I tried hard not to participate in these conversations; maybe that was my first mistake and the beginning of the target on my back.  I soon was avoiding coffee and lunch with certain nurses because then the trash talking would get really bad.  It set me apart; maybe they thought I was better than them.  Nothing could be further from the truth, not a novice nurse, but one in a new area, I felt I was drowning in information I did not completely understand and had nowhere to turn.  Physicians were too busy to entertain my frequent questions and certain nurses looked at me as if I was asking yet another stupid question.

Then started the withholding information, a power play that made me feel even more isolated.  Sometimes it was just that almost insignificant team stuff that makes you feel a part of the team, so and so if pregnant, isn’t that great?  Drinks after work, would you like to come?  Then this escalated to the team emails, highlighting that one small error I had made in a very public way. Often they came on a Friday afternoon so I would be in agony about the issue all weekend and dreading going back to work by Monday morning.  

Reasonable conversation helped in the short term but then the abusive behavior would start again.  When I took it to my supervisor I was told I needed to deal with this myself, it was the best way.  I had always prided myself as having good communication skills and not lacking in personal confidence in the workplace and a team player.  But I recognized I too was turning into a victim.  I seconded guessed what I was doing.  Once after I addressed the passive aggressive behavior face to face no one talked to me for two weeks!!! Well, clearly that did not work.  Soon I was crying every day on the way home from work and then I was waking at 2am dreading going to work.  My husband begged me to find a solution. I left but for a long time felt like I had failed in that position, when in reality the organization failed me.  It can be a silent lonely experience to be victimized in the workplace.  Bullies have a perceived power that is hard to come up against, it takes a fair amount of courage and emotional energy to make the daily attack that will enable long term change.

This was my story, everyone has one, and sadly I know this is true.  As I start this series on nurse on nurse conflict I would love to hear your story.  Please email me at angiemiller1966@yahoo.com and I will publish your story, anonymously if you prefer.

·        
        What is your experience?

·       How would you have handled it differently?

·       What tools and support do you think would have made the situation better

·       How can we finally stop this happening to novice and expert nurses alike