A disillusioning experience.
In this month’s Viewpoint column, clinical nurse instructor John Burkley describes a disturbing incident in which his clinical nursing students were treated with dismissiveness and rudeness by a nurse on a unit to which they’d been assigned. The students ultimately left this early encounter with hospital nursing—which took place at a teaching hospital—with varying degrees of disillusionment.
Nurses may need to develop a certain inner resilience to handle the physical, emotional, moral, intellectual, and organizational challenges of their profession. But bullying won’t help them develop it.
Alienating future nurses does lasting harm. What can be done?
As Burkley notes, negative clinical experiences can have a formative influence on aspiring nurses—they “are alienating, contribute negatively to learning, and should not be tolerated.”
Unfortunately, while many nurses are welcoming and supportive of clinical students, such incidents of subtle or overt bullying appear to be common. Drawing on his own experience as well as current literature, Burkley offers a few possible ways nursing schools and teaching hospitals can address this issue.
The one-page essay, “Adopt Zero Tolerance for Hospital Staff Bullying Nursing Students,” is free to read. We hope you’ll take a moment to do so, and share it with fellow students or colleagues. As Burkley reminds us:
Nursing students are the future of nursing. Treating them with anything less than respect, support, and nurturing is unacceptable and unprofessional.
The answer will come from nurses.
Leave us a comment: What should be done about this problem? Were you ever bullied as a cinical student or a new nurse?
back in the early 90’s I experienced sexual harassment as a student from a qualified male duputy chatge nurse and from a male student . also told that my standards were too high on a long stay elderly mental health ward and very much put in my place.
I think both of these situations could have been dealt with better but I would also say that a lot has changed .
Do not misunderstand me. Rebekah actually demonstrates my point perfectly— when she encountered a poor work situation, it taught her how to be assertive and galvanized her to not be THAT nurse later on in her career. It did NOT make her crumple up and vow never to be a hospital nurse because somebody was mean to her. It does not appear that her learning or progress were impeded by this experience, but rather strengthened. I would be interested to know what her faculty did with her situation, too, if anything.
I did not, and would not, say that nursing students are or should be uniquely expected to meekly accept abuse. On the contrary, I am advocating for them to be taught how to assume an effective approach to professional role that will inevitably bring contacts with disagreeable persons. It’s not the weather (as in, “everybody talks about the weather but nobody does anything about it,” lol). Rebekah proves my point (in the classical definition of “proof” meaning “test”) and makes it, for which I thank her.
I have recently graduated nursing in 2016 and I have experienced bullying and rudeness from staff nurses on my own skin. The previous commentator argues that nursing students are learning “real world” work and should have the ability to deal with negative attitudes and not need “constant affirmation”. She argues that they should be able to be timely, professional, accountable etc. But what about when the student is all that, adheres to all the rules, and eager to learn, and the nursing staff is still being a bully? That was my case. I followed all the rules, was timely, professional even very polite to the nurses and people around, eager to learn. But I remember three particular nurses who had extremely unprofessional negative attitudes toward me. One bullied me outright the entire day, even though previously I had helped her with an issue she had, and I was doing my best in charting and patient care, and never replied in any rude or negative way. Looking back I should’ve stood up to her, and just request my professor to switch me to a different nurse.
In another case, the nurse wished I would just disappear and she gave me curt replies to my honest questions as I tried to learn, and glaring looks when it took me a bit of time to calculate a medication dosage for a patient.
All three nurses had belittling, extremely unprofessional attitudes. I vowed that when I become a nurse, if I see the student is honestly doing their best, I would never treat them rudely and dismissively as they did. I still vividly remember my interactions with those nurses.
I don’t care if snappy people are part of the real world, I have worked in other fields where apprentices and newbies are treated with helpful, constructive and supportive attitudes that are conductive to learning. Nursing students are the most stressed students in almost any university major. They are learning massive amounts of nursing theory while simultaneously expected to perform like a professional in clinical settings.They only get rapid introduction to a clinical skill in school and little time to practice it before they’re expected to execute it in the real world, unlike medical students. While in clinicals, nursing students are still in the learning stage- and many feel overwhelmed, and bullying and dismissing them rudely just completely inhibits the learning process and slows down their progress.
Then, I also met a few nurses who were stellar. One of them was a nurse in PACU. She was not in any way a lenient nurse. In fact she was very strong willed, but she had so much positive interest in my learning, explained interesting details whenever possible, and exuded an “I believe in you” attitude that enabled me to be myself and just flourish under her guidance. She wasn’t just coddling and sugar coating things for me, or praising me at every step- students don’t expect that. But she was supportive, treating me as a “business” partner, and trusting that I was competent, willing to have me alongside her in everything. She acted as if I was already a registered nurse she can count on, and did not put me down if I sometimes faltered, in fact if I apologized that I didn’t do something “perfectly” she would just dismiss it as normal and affirm that I knew it already, it just took time to get the hang of it. That is the kind of nursing guidance we need for students. Not bullying.
How come seasoned nurses and any other worker in the “real world” have a right to be respected and have a right to report bullying from other co-workers, but nursing students are apparently supposed to swallow it as acceptable? No, it is unacceptable and should be reported more often by students!
In spite of the negative experience with some nurses, I learned a lot. I developed a more assertive attitude toward all medical personnel and finished nursing school with high honors. I passed the NCLEX on my first try. This demonstrates that it was not my inability to deal with the real world and the demands of nursing, but a lack of proper support on the part of some nurses out there that makes the transition from school to real world difficult. This has to change.
This has always been a hot button issue for me, but I can’t bring myself to respond in the indignant way I see expressed in this and so many similar viewpoint pieces.
First, I’d like to know the ages of these students. Are they young, perhaps admitted to college from high school, and for whatever reason not yet experienced in how to deal with less than complete validation and support? I can’t see an older, more seasoned second-career person expressing such devastation at churl (and churl it was, no argument there) as to conclude that they would properly generalize this example of bad manners to an entire hospital, or to all hospitals. For good or for ill, I hear many students astonished, dismayed, and baffled that they are not “included” and constantly validated by everyone around them. We do them no favors by letting this very inexperienced mindset go unexamined, by faculty and staffers, sure, but also by the students themselves.
Third, why didn’t the author go on to tell how he handled this with the students in post conference as a learning experience? Surely, I thought, he would perceive that there could be many, many reasons why this nurse dispensed churl instead of rainbows and unicorns. He could have the students brainstorm about that. He could explore how they deal with other frustrating situations. He could model responses. He could ask the unit manager to join them for a few minutes in post conference, help them understand how different the world of work is from learning lab, tell them that staff are too busy to give safe care already and don’t get any extra help or pay for acting as adjunct faculty. He could have them explore why and how student clinicals are a transition time.
Or did he — or do we— just metaphorically throw hands in the air for them, mentally plan to dash off another facile “nurses eat their young” thang, model helplessness, and reinforce the lack of agency these students seem to feel?
Instead, let us plan ahead to take this the learning experience as it presents. A thoughtful faculty realizes that clinical isn’t all about patient care, not by a long shot. It’s exposure to the world of work. We teach students how to be there and be there on time, wear professional clothing, give and take report, be accountable, and many other activities involved in being a team member. Dealing with difficult people is part of that, whether they’re patients, cranky physicians, busy social workers, or other nurses.
You probably realize that since that NETY sound bite hit the popular nursing press decades ago it’s been an excuse for students to feel their aggrievedness is always justified. I haven’t seen an awful lot of constructive response aimed at helping students develop the ego strength to deal with adversity. They’re going to run into a lot of it from many sources, from angry patients, critical family members, uncaring administration, senior colleagues who challenge their newbie decision skills with Socratic questions, and managers who give them evaluations with goals for imporovement instead of uncritical affirmation. We would do our profession and those we serve a far greater service if we could find a way to facilitate maturity and the dread “thicker skin” in our novices rather than continue to wring our hands at how bloody awful the mean girls are and call, yet again, for an end to bad manners. You know what they say about doing the same thing and expecting different results.