WHY, WHEN WE ARE DEEMED TO BE CARERS, ARE WE SO MEAN TO OUR COLLEAGUES?

Canadian Operating Room Nursing Journal,  Dec 2006  by Fudge, Lesley

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The second formative event in the author's memory was more of a physical nature. While leaning through a hatch in the OR, another member of the team soundly slapped the author across the backside. The reaction, while wrong, was instinctive and involved slapping the face of the perpetrator... who then had to spend the day explaining the handprint on his face. To this day the author wpnders how the perpetrator might have behaved if they hadn't been in a public place in front of colleagues.

Reporting bullying can have a positive impact for everyone in the workplace. While working in Africa the author witnessed a surgeon behaving badly towards a nurse and reported the abuse. The nurse, who was very junior, was not being allowed to place her instrument trolley in the most sensible position for either a view of the operation or to hand and receive instruments easily. The surgeon threw bloodied swabs in the nurse's direction and was abusive to both her and to the anaesthetist. After the report of abuse his contract was not renewed.

WHAT CAUSES IT?

What causes this behaviour? It is not unusual for human beings to be threatened by new and keen to learn staff. Add in to it pressure from above and personal tension at work, or home, which can often create these types of hostile, and unsupportive behaviour. But a quote from IFPN research undertaken across New Zealand, Australia, the UK and the US shows how certain negative behaviours are pervasive and sometimes accepted "Nurses eat their young, they do it all the time"6.

Brewer's7 research survey of nurses working in the UK showed that nurses from ethnic minorities are more likely to report being bullied by a member of staff than are Caucasian nurses. There was no information as to the reasons for why this was so. Perhaps, it was because these nurses felt that they were subject to racial abuse or perhaps it was because the Caucasian nurses perceived the behaviours as part of normal working situations.

ADDRESSING AISP ELIMINATING BULLYING:

So what are the mechanisms for dealing with bullying behaviours?

Direct confrontation is not without risk, but should always be tackled with a witness present to ensure the safety of all individuals and to provide a third person record of what has taken place.

Healthcare employers in the UK generally recommend dealing with issues through formal channels. This ensures all issues are dealt with in a way that is in-line with policy and that follows structured and safe methodologies. While this route raises the profile of the issues and makes them more public, which can make some uncomfortable, it is also more likely to result in effective resolution. Documentation of incidents should be kept by anyone involved. If the situation becomes formalised they will need all documentation as evidence. These might include copies of off-duty or daily rosters, spiteful notes or similar communications. All should be kept and copied.

Informal methods of dealing with bullying are also often discussed and OR nurses often find their own ways of handling bullies. Nurses in the US have been calling a "Code Pink" when there is an event that needs handling in the OR. For example, if a doctor is shouting or being verbally abusive or throwing his (or her) instruments "Code Pink" is called and all colleagues who can be released from patient care, come into the room and stand, silently, staring at the abuser. This has been shown to be very effective8. Appropriate humour can also help diffuse situations, such as with the nurses seen to pretend to be plucking the air around them and when asked what they were doing responded with "Just un-ruffling your feathers". Another story was of a US nurse down on the floor looking for a tiny lost atraumatic needle and when an irritable coworker asked what she was doing her response was "just looking for the glamour in my job."