Saturday, April 27, 2013

Thoughts on Lateral Workplace Violence


     I do a lot of continuing education in nursing firstly, because I would be an abyssmal college instructor if I didn't, and secondly because I hold RN licensure in multiple states including my state of original licensure.  This means that there are ongoing continuing education requirements prior to periodic licensure renewal.  Many times, these courses are a rehash of something I was taught, or read later. Sometimes, they are a useful update on the latest treatment techniques, drugs used, or keys to differentiating one disorder from another. This year, there was a mandatory course in better understanding of the management of organ donation and transplantation works in the US.   This week, one of the courses I needed to complete discussed different types of workplace violence, and behaviors in the workplace which could lead to violent acting out.
                    Of course, this is continuing education for nurses and so it examined the group dynamics which occur in nursing.  It has long been joked about within the profession that "Nurses eat their young".  Many times, new graduates fall prey to experienced nurses who play games, some of which include failing to orient them properly or completely. They may give them unreasonably heavy assignments, or criticize a sensitive new player in front of peers, physicians and rarely, even a patient.  The discussion goes on to talk about backbiting and manipulative behavior among nurses even when they work with those who have similar educational preparation and experience.
                     I came to nursing in a different way than most people. I graduated from high school at sixteen and became a biology major, with the intent to be a pre-med major and become a physician.  I did well academically, but I had to accept the fact that I did not wish to be completely consumed with education and the requisite debt that accompanied it, for the next fourteen years or so.  I thought I might like to be a registered nurse, but before I invested years in it, only to find I did not like that, I wanted to place my toe in the tepid water.  The way I chose to do this was to take a year long sabbatical from the college and attend a year plus intensive program in another area which resulted in a diploma in practical nursing.

This is the only cap I could find which has blue stripes.  My LPN cap had two blue stripes.

 Afterward, I could sit for the LPN boards.  Working as an LPN would give me the flexibility to work whatever hours I needed while either attaining an RN, or becoming a physician, or even something else entirely.  In either event, I would learn whether or not I could stand nursing.  The program was gruelling and had us in classrooms for long days, and then clinical at multiple hospitals with hour long or greater commutes.  The work was difficult and demanding, and at the time, I was only eighteen. It was an excellent program and gave the basis for many things I taught in college later.   Eventually, we spent a month in the Princeton area doing clinical at a few different psychiatric facilities. I did well, graduated and passed by boards with a high grade at  age nineteen.  My first job was at the Robert Woods Johnson University Hospital, which has a medical school,  where I made friends among nurses and physicians which I still have today. I was on staff there on a surgical unit for six months before I headed back to college to complete my RN.  After I got my RN, I worked while getting my Bachelor's degree, and I have continued learning ever since.
                   From my own perspective, I do recall some nurses who were unkind when I first began as an LPN and a few, when I was a new RN.  Some sociologists think that because nurses began in a profession that was exclusively women, in a period of time in which women were oppressed and could not own property or have money, that the profession began in a culture and atmosphere of oppression. They believe that those who are oppressed ultimately become the oppressors.  I don't believe this.  I believe that fundamentally nurses understand how important the job they do is.  I have long said that you may survive having a lousy physician, but you probably will not survive having a bad nurse.  I think that experienced nurses may give new nurses a tough time because they have a somewhat misguided wish to protect the public, and they wish newbies to have a full understanding of how pivotal the things they do each day as nurses really are.  I am pleased to say that I have not indulged in giving new graduates a difficult time.  Each of us deserves support, encouragement, and a proper orientation.  I believe that when backbiting, taking credit for the work of another, unceasing gossip, or singling out another for unending criticism occurs in a nursing unit or an intensive care unit, that this is time not being spent assessing patients and their response to treatment.
                 The course I completed this week considered a toxic work environment to be a type of lateral workplace violence which results in more sick days taken, potential PTSD, burnout, and ultimately a failure to retain talented nurses.
                I hope this issue is addressed now with a zero tolerance for this type of behavior. With Obamacare coming in, there are likely to be more stressors rather than fewer, and we don't need younger nurses departing to sell insurance or carpet.   After all, nurses are not just nurses, we are all ultimately patients, as are our families as well.


Gorges Smythe said...

Good points, all.

Anonymous said...

What happened? Are you afraid you will catch something? the mohave rat

JaneofVirginia said...

After time as an industrial nurse in the Northeast before my husband took a job in the South, and a total of twenty-five years as a registered nurse including a Charge Nurse in a critical care unit, I taught nursing in a college. Instructors do come to hospitals for clinicals with students. The hours as an instructor were better for a woman with five children.

Sunnybrook Farm said...

My mother became an RN here in Virginia in 1942, I still remember her hat starched and drying stuck on the side of the refrigerator. It had one black strip I think, from Radford hospital's school. Anyway she has stories of how tough it was back in that time it seems like they made things harder than necessary and probably lost a lot of qualified people.

JaneofVirginia said...

In the forties and right up to the nineteen seventies when I trained as a nurse there were lots of things that were required, I think to weed out those who might not function well in actual practice. Now I think the training may include a broad range of learning, but I do not see nurses able to set up traction, or knowing the names of OR instruments, etc. It is and always will be a difficult job, and the witness to human suffering component of it can never be extracted. I have worked with a lot of Radford grads over the years.