NURSES—ARE WE EATING OUR YOUNG?
(excerpt from my book)

I read an article once in a nursing journal entitled, “Nursing, Are We Eating Our Young?” My answer to this question is unfortunately yes. Probably more often than not bitter old veteran nurses do not take younger nurses under their wing and try to help them. Now why would any veteran nurse do this to some young upstart? I have some experiences and ideas to share that might shed some light on the subject.

Being a student nurse is not easy. As a matter of fact it is one of the hardest things I have ever done. It requires discipline and commitment above and beyond what you think you have in you. Of course that is unless you are super nurse and nothing hurts you except kryptonite.

In our senior year of nursing school we had a Management Class at the local hospital. We met there in a classroom and had clinicals there as well. One assignment was to work as a team in caring for a select number of patients. We formed teams and it was Carol’s turn at being team leader. Of course, I was on her team.

She was a naturally born leader and I was her loyal follower. That day we gathered for the morning report. We were there to listen and to learn but we also were taking assignments and care planning and ultimately providing the care. This particular morning report was led by the day shift charge nurse. I remember her name and I will never forget that face. Nor will I forget the feeling that I was the “young” that the article was talking about and that she was about to eat me.

The report was going along fine and we were all taking notes about the patients we were to care for that day. The charge nurse said, “Now Mr. Jones has had an MI and his blood pressure has been unstable. He has an IV of ½ NS @ 125 cc/hr running in his left thumb.” Left thumb? I thought I must have misunderstood because I had never heard of putting an IV in someone’s thumb. So I said, “Excuse me, but did you say he had an IV in his left thumb?”

Well, evidently that was the wrong thing to say. She jumped up slammed her papers on the table and yelled at me with hate and disgust seeping from her glazed eyes. I thought she was going to seriously eat me. She growled, “Yes, in the thumb, sometimes we just have to put it where we can!” After that she was so mad that she closed report and left. I was left embarrassed and trembling in my newly shined white shoes.

I learned several things that day. I learned that you can put an IV anywhere you can get it and I learned that I would never treat a nursing student the way she treated me that day. I vowed to Carol and myself that I would always be helpful and understanding to student nurses.

Carol, being the team leader was infuriated that the charge nurse had so viciously attacked me. I was upset and she was too. After report we had a ‘little meeting’ and Carol decided that as team leader it was her responsibility to have a ‘little word’ with the charge nurse. She did just that. It was a professional word but the word got across.

Everyone was nicer to us after that but they still gave us all the grunt work. (Or so we thought).

At the time, I had no idea why that nurse was so angry. I was glad I wasn’t her patient. I thought about why she wanted to be a nurse if she was so unhappy and stressed out?

From this experience I realized that nurses go into nursing for different reasons. Most nurses really do want to help people and that is usually why they choose nursing as a profession. But the problem is that nursing is so incredibly stressful that some nurses give in to the stress and as a defense mechanism, they turn bitter, crash and burn.

A good nurse knows her limits and knows herself. When the stress gets to be too much nurses need to know when to take a break for themselves and for their patients as well as any student nurses that they may come in contact with.

It does not matter how long you have been a nurse, you have to remember that students are just that. They are students of the profession and we would all do well to help them learn. So please the next time you have a student with you—be helpful, compassionate and understanding. And if you find yourself wanting to yell at them, don’t. They may remember it and write a book about you someday.

Students are there to learn and as veteran nurses it is our job to teach them and encourage them. How hard could that possibly be?

__________________
www.nightingale.pnn.com
www.angelaposeyarnold.com

I arrived on the acute care floor via the world of emergency medical services. As an RN new to hospital nursing (but not new to patient care), I was surprised at the general irritability between and among nurses and physicians. This lack of courtesy was not present when I worked as an RN for an ambulance company.

What suprised me most about providing nursing care in a hospital instead of in the back of an ambulance, however, was the differences between the culture of acute care nursing and the culture of EMTs. While hospital RNs generally seem to derive a measure of satisfaction from their work, they also seem to practice in isolation and without pride of service. In contrast, the culture of EMS fosters comaradarie, teamwork, and tremendous pride in problem-solving. Perhaps the cultural difference can be boiled down to this: EMTs believe EMTs are heroes; RNs do not believe RNs are heroes.

In my opinion, if RNs would change their view of themselves, they would create an environment which increases job satisfaction, which supports and welcomes newcomers, and which successfully encourages both collegial and collaborative approaches to care.

Joy

If hospitals would change the way they treat RNs then possibly they would be able to change.
And if Doctors had to do all that nurses have to do just for one day--their attitude might change too.

__________________
www.nightingale.pnn.com
www.angelaposeyarnold.com

I agree. Angela. That said, I think the growth of any profession must begin within the profession. When we nurses behave as if we believe that nursing is a profession worthy of respect and we demand to be treated as collaborators in healthcare, our professional standing can only continue to grow. As is all to often the case, however, we become stuck in the "if only management/physicians would..., then we nurses could..." mode and do not see the opportunities for the advancement of nursing.

It is not my intention to offend anyone. And I hope I have not given offense. My only point to my posts in this thread is that nurses and nurses alone are responsbile for their actions. That "Nurses eat their young" is repulsive to me. Its continued presence within the profession of nursing is both reprehensible and indicative of a (few?) who do not wish to accept the accountbility that is theirs but who would rather make life miserable for the weaker among them.

OK. I am stepping OFF of my soap box!! Did I tell you how I really feel? No tomato throwing, please and thank you!

I completely agree Joy. I have been constantly saddened and disappointed throughout my career to see how little nurses stick up for their peers, how they tend to ridicule and are so often threatened by the knowledge and skills of others that they say the kind of awful things you and Angela mention above.

I don't always agree with the extent to which our medical colleagues watch their own backs and those of their colleagues, and the way in which they sometimes close ranks. But at least you tend not to get the back biting in perhaps jealousy that appears to be prevelant with nurses. This is an interesting topic and deserves a wider debate.

__________________
Julie
http://www.lifeinthenhs.wordpress.com

Yes, nurses do eat their young. It is a subject of particular interest to me as I have not only been the prey upon which elder nurses have feasted, but now see it upon returning to the profession after a lengthy absence. Age and some maturity have helped strengthen me against some of the bullying, attacks, backstabbing, and horrible gossiping that goes on where I work; however, I cannot stand by and watch this continue without figuring it out.

Conversations with fellow nursing friends have given me some insights, but I would like to study this further. If anyone has some suggestions/resources where I might find more information on the subject, please email me privately (mks1420@gmail.com). My thanks in advance.

My friend suggested that the behaviour may be brought on by a sense of powerlessness that nurses feel. We are the lowest man on the proverbial totem pole and therefore the only power we can exercise is upon each other.

MKS,

There is a phrase in the world of USA business which, if used and attended to, can facilitate a corporate culture change: "fostering a Hostile Work Environment." What this means, essentially, is that management has knowingly allowed a hostile work environment to exist - which is illegal. So what does this mean to you? That your company is legally liable for damages if they (manager, risk management, and/or senior management) knowingly fail to ensure an emotionally safe work environment. My counsel to you is to document, document, document your communication with your manager, et al. If appreciable improvement fails to occur and/or no workplace policies are in place which outline what is and is not acceptable behavior (and which include a progressive discipline plan), you and the others being hurt by the hostile work environment may very effectively address this issue through your nursing union and through a court of law.

Changing a corporate culture is not easy, especially if the harmful behavior is entrenched. It takes a very persistent and strong leadership (both titled and untitled) committed to change for improvement to occur.

Please keep us posted.

Joy

OK, for the heck of it I did a quick lit search (one thing a PhD program does it makes you pretty good at "lit searchers on the fly" Looking in CINHAL (the Cumulative Index to Nursing & Allied Health Literature - the database of nursing and allied health research), and putting in "nurses eating their young" I came up with two articles:

Longo J., Horizontal violence among nursing students.Archives of Psychiatric Nursing. 2007 Jun; 21(3): 177-8.

Which cited:

Conti-O'Hare M, O'Hare JL. Don't perpetuate horizontal violence. Nursing Spectrum Career Fitness Online 2003 Retrieved December 31, 2006 from http://nsweb.nursingspectrum.com/cfforms/GuestLecture/ HorizontalViolence.cfm.

Farrell GA. Aggression in clinical settings: Nurses' views: A follow-up study [Electronic version] Journal of Advanced Nursing 1999; 29: 532-541.

Hastie C. Horizontal violence in the workplace. Birth International 2002 Retrieved April 5, 2006 from http://www.birthintemational.com/articles/hastie02.html.

MacIntosh J. Experiences of workplace bullying in a rural area. Issues in Mental Health Nursing 2005; 26: 893-910.

McKenna B, Smith N, Poole S, Coverdale JH. Horizontal violence: Experiences of registered nurses in their first year of practice [Electronic version] Journal of Advanced Nursing 2003; 42: 90-96.

McNeese-Smith D. A content analysis if staff nurses descriptions of job satisfaction and dissatisfaction. Journal of Advanced Nursing 1999; 29: 1332-1341.

Nurse Advocate. A horizontal violence position statement. 1998 July 19 Retrieved November 21, 2001, from http://www.nurseadvocate.org/hvstate.html.

Randle J. Bullying in the nursing profession [Electronic version] Journal of Advanced Nursing 2003; 43: 395-401.

and

Sweeney I. Bowman N. Different views on nurses eating their young. [Journal Article, Letter] RN. 2003 Jun; 66(6): 14.

Also the following key words for search terms

Intraprofessional Relations
*Nurse Attitudes
*Staff Nurses / pf [Psychosocial Factors]
*Students, Nursing / pf [Psychosocial Factors]
Violence / pc [Prevention and Control]
Violence / pf [Psychosocial Factors]
*Violence

A google search found this book:

Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other (Paperback)by Kathleen Bartholomew

So, MKS, I know you asked for the info privately, but I figured there might be others who are also interested.

__________________
A Window For Your Home: Stories of dying and doctoral education

http://awfyh.blogspot.com/

magic is the deliberate manipulation of coincidence

I had worked at a downtown Toronto teaching hospital when I first started out in Med-Surg ICU, and the reception by about 5 different older Nurses was a cautiously guarded one. They were not quick to help, yet would watch for me to make mistakes. Ask question galore in report that were off topic, and sneakily read my notes when they had no business with my patient. I chose to have a reserved, professional stance with them which quickly showed that not only was I on my "p's and q's", but I was not the spring chicken they pegged me as (I look younger than I am). They got off my case after a couple of weeks.

However, this ridiculous attitude was also thrown at other greener ICU Nurses and scared them away from our ICU in short order. Some individuals didn't even finish the ICU training and dropped out of the program because of these old biddies. Some younger Nurses who did finish the course quickly ingratiated themselves with these reptiles and became their "pets".

Of course this led to the formation of cliques, and various work assignment arrangements, and what have you. Luckily, I liked my rotation, and got along well with most of the individuals in our group, that is why I stayed for 7 yrs. Then with the introduction of a new crazed manager, drop in pt. acuity, and young employee exodus, the atmosphere was too much for me and I resigned.

I thankfully, did not turn into a bitter, bullying Nurse just collecting a pay check before I left, and I am enjoying agency Nursing at several ICU's in the city of Toronto now.

Never be afraid to search for that good fit in Nursing. Staying someplace just for a pension or out of fear of the unknown will make you into a person who does NOT belong in Nursing.

__________________
Awaken to Consciousness

I was "adopted" by a Coronary Care Unit as a relative new grad with only three months med/surg experience, so I was quite lucky.

I make it a point to give positive feedback to new nurses and find out the latest in techniques from them.

Precepting takes a special personality, and not all of the older, burnt out just-doing-this-until-I-get-to-retirement nurses have that personality!

__________________
The ER is the only place where you are rewarded for efficiency by getting more patients!

Kim
http://www.emergiblog.com