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Adopt Zero Tolerance for Hospital Staff Bullying Nursing Students

Burkley, John, MSN, RN

AJN The American Journal of Nursing: May 2018 - Volume 118 - Issue 5 - p 11
doi: 10.1097/01.NAJ.0000532811.74089.c0
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Negative clinical experiences can have a formative influence on aspiring nurses.

John Burkley is a clinical nursing instructor at Lehigh Carbon Community College, School of Health Care Sciences, Schnecksville, PA. Contact author: jlb2126@hotmail.com. The author has disclosed no potential conflicts of interest, financial or otherwise.

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Any nursing instructor knows that nursing students are often victims of bullying by hospital staff nurses. Anthony and Yastik (Journal of Nursing Education, 2011) have characterized types of staff incivility toward students as “exclusionary, hostile or rude, or dismissive.” Such incidents are alienating, contribute negatively to learning, and should not be tolerated. It is a shared responsibility of nursing instructors and clinical sites to provide a rich learning environment, and the American Nurses Credentialing Center identifies “nurses as teachers” as one of the 14 characteristics of Magnet hospitals. One recent experience served as an impetus to write this article.

After arriving at the clinical site, I requested that a nurse recommend some patients who were more complex and required complete morning care, explaining that such patients keep students engaged and out of the halls. The nurse replied, “That's good, because as far as I'm concerned students are just in the way.” This wasn't the warm reception I had expected. Because this nurse immediately walked away, I received guidance from two other nurses.

I met the students in the cafeteria, conducted a brief preconference, and gave them their patient assignments. We returned to the unit, and I instructed the students to introduce themselves to their patients’ assigned nurse in order to receive shift report. After several minutes, two upset students returned to me, explaining that when they requested report from their nurse (the nurse who had earlier told me that students were in the way), she ignored them, giving them no verbal response.

I approached the nurse and asked if she could give the students report. She replied, “No, not now.” I spoke to the unit manager, who told me she would talk to the nurse. But nothing changed. The staff nurse continued to avoid the students, only begrudgingly answering their questions with curt, single-word replies. Her behavior was reported to the school's director of nursing, who contacted the hospital's nursing administration, though subsequent changes were negligible.

When I met with students afterward, one of the two students who had been assigned to the nurse remarked, “I never want to work at this hospital.” This was the first hospital experience for the second student, who said, “I guess hospital work isn't for me.”

This clinical site is a teaching hospital, which should not imply that hospital staff bow and scrape to physicians, residents, and medical students while disparaging nursing students. Nursing students are the future of nursing. Treating them with anything less than respect, support, and nurturing is unacceptable and unprofessional. Such behavior disregards the American Nurses Association's Code of Ethics for Nurses with Interpretive Statements, which states that nurses are required to “create an ethical environment and culture of civility and kindness, treating colleagues, co-workers, employees, students, and others with dignity and respect.”

This type of experience is common and leaves a permanent impression on nursing students. However, because of the shortage of clinical sites, schools are unlikely to eliminate offending institutions. Smith and colleagues (Journal of Nursing Education, 2016) suggested strategies to better educate students and clinical instructors to recognize and respond to bullying behavior—among these, role clarification and education on possible sources of support. Anthony and Yastik have proposed the use of dedicated education units, and educating all team members on an organization's code of conduct and the importance of role modeling. My own experience suggests that a warm, welcoming orientation involving the unit manager may establish a healthier alliance and foster collaboration. All hospitals and nursing schools need to adopt and proactively enforce zero tolerance for the maltreatment of nursing students.

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