nurse bully
HealthSeptember 01, 2015

Bullying: It happens to nursing students, too

Bullying is a hot topic in schools across the country. Walk into any elementary school and you’ll see posters on the walls that help children recognize bullying behavior and learn what to do if they see a classmate being bullied or if they are bullied themselves. Parents, teachers and school administrators are no longer turning a blind eye, but are instead trying to actively combat what used to be considered a somewhat “normal” part of growing up.

However, bullying can happen anywhere -- not just in the classroom or on the playground. Nursing students are also victims of bullying and it has a significantly detrimental effect on nursing education. In one US study, almost 96% of 4th year nursing students reported that they had experienced at least one instance of bullying while attending nursing school.

What defines nurse bullying?

Experts have defined bullying as a concept of incivility, such as rude or disruptive behaviors, threatening behaviors, and/or physical and psychological abuse. The bullying can be characterized by repeated, negative acts consciously committed by one or more persons against another person. These may be direct acts such as physical and verbal abuse or indirect acts such as purposeful exclusion. In addition, there exists a significant imbalance of real or perceived power between the person who is bullying and the individual who is being bullied. This traumatic behavior affects the student’s capacity to learn, his sense of well-being, and can cause feelings of alienation, lack of control over their learning environment, low self-esteem and powerlessness.

Lingering effects of nursing student bullying

When a student who has experienced bullying enters the workplace, she can continue to be traumatized. The victim may develop problems sleeping, exhibit depression, develop posttraumatic stress syndrome, have low morale, use sick time excessively and eventually leave the profession.

What can nursing schools do to prevent bullying?

Whether the bully is a fellow nursing student, an instructor, or a clinician, students who experience such incivilities often undergo psychological and/or physiological distress. If left unaddressed, the bullying can even progress into a threatening situation. So, what can nursing schools do to prevent their students from being bullied?  And, what can the victims themselves do to shield themselves from bullies?

The American Nurses Association (ANA) clearly outlines the ethical mandate for all nurses to act in accordance with provision 1.5 of the ANA’s Code of Ethics for Nursing with Interpretive Statements. This includes, among other areas, “respect for all individuals with whom nurses interact, compassionate and caring relationships with colleagues and others, and a standard of conduct that precludes prejudicial actions, any form of harassment or threatening behavior, and disregard for the effect of one’s actions on another.”

In response to increasing evidence of bullying within the nursing profession, multiple regulatory agencies and professional nursing organizations have demanded immediate and clear action to address all forms of horizontal and lateral violence such as bullying, and to develop effective individual and institutional-wide interventions.

Nursing schools need to create a positive, safe clinical learning environment. It is critical to promoting nursing students’ self-esteem and professional engagement. It also reinforces their sense of security, belonging, empowerment, confidence, cognitive processes, and continued motivation to learn. Schools also need to adopt the models we see working in grade schools: zero tolerance policies and education on bullying behavior. Victims need to feel protected and secure in early reporting of incidents. Schools need to recognize the risk factors and employ early interventions.

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