With National Nurses Week around the corner—it begins on May 6 and ends on May 12, International Nurses Day—I'm tempted to focus solely on praising our profession for the good work we do. In a myriad of ways, from disaster response to midair flight nursing (see this month's cover) to day-to-day nursing care, nurses are the sentinels patients rely on for safe care. I'm proud to be a nurse. But I have to admit there are times when the actions of some colleagues make me cringe. I can't help noticing the frequent contradictions between how we act with our patients and how we act toward one another. I'm concerned that Cheryl A. Dellasega's feature "Bullying Among Nurses" (January 2009) remains among the top three of AJN's most e-mailed and most viewed articles, indicating its continued relevance. At a function I attended last month, a dozen or so nursing students spoke of having witnessed bullying in their clinical placements; a few had themselves been the target.
And while bullying has received much attention recently, it's not the only problem. I've heard many stories—and have some of my own—about another behavior that can negate any sense of a shared professionalism, and that's behavior that shows a lack of collegial respect.
Years ago, I worked in an outpatient setting and often visited my patients when they were admitted to an inpatient unit. Most of the unit nurses were reluctant to speak with me about these patients or to let me see the charts to check lab results, although they knew I provided care in the same facility a few floors down. Yet more than once, I watched as physicians who were visiting patients as family members and weren't affiliated with the hospital were given access to charts and had every question answered. (This was before the patient confidentiality protections mandated by HIPAA—the Health Insurance Portability and Accountability Act—took effect in 2003.)
I've also heard stories from nurses who recount arriving on a unit as a patient's family member, and instead of being welcomed by staff as knowledgeable partners in their loved one's care, found that their inquiries were met with defensiveness and annoyance. One colleague, a national leader in her specialty nursing association, told me that her mother was recently admitted to the same institution where this colleague had been a nurse manager. At first relieved to see nurses she knew, my colleague soon realized they were avoiding her, affording her even less consideration than would be given to a "regular" family member. For instance, she was asked to leave the room during an iv start, although her confused mother was calmed by her presence. I wonder if this isn't a form of bullying, too, when nurses exert authority unnecessarily just because they can.
Experts offer several explanations for such negative behavior among colleagues, from possible biologic predilections to organizational factors to internalized sexism. Whatever the causes, they agree that the effects are harmful. I've witnessed how—through gossip, not-so-friendly "teasing," and exclusion—one person can destroy the cohesion of a group. And it isn't just the targets who suffer. Work becomes more stressful than it has to be, affecting other staff members and patients. Bad relationships can hinder communication, and ineffective communication is a major factor in medical errors.
Our work is too important; we can't afford to be sidetracked by bullying and other forms of relational aggression. Use this Nurses Week as a catalyst for focusing on all that we share and accomplish as colleagues. Instead of a Viewpoint this month, we offer an AJN classic from our archives: "How Can You Bear to Be a Nurse?" by former AJN editor Mary Mallison, who eloquently details the small but oh-so-important victories we accomplish every day.
As you read this, the International Council of Nurses (ICN) is convening in Valletta, Malta, from May 2 to 8. Founded in 1899, the ICN's goals include "to bring nursing together worldwide" and "to advance nurses and nursing worldwide." Surely we can do as much in our workplaces, with colleagues we see every day.