How to End Nurse Bullying and Create a Culture of Respect

How to End Nurse Bullying and Create a Culture of Respect

Addressing Bullying Behavior: 4 Key Steps for Perioperative Nurse Leaders

Far too many perioperative nurses are all too familiar with the stomach-dropping feeling of being bullied. In fact, one study shows that 61 percent of perioperative nurses encounter workplace bullying.

In a fast-paced and high-pressure profession where precision and teamwork are crucial, the specter of nurse-to-nurse bullying looms large. This behavior not only fosters toxic work environments but also diminishes nurse and patient satisfaction. Additionally, it hampers recruitment and retention efforts, ultimately resulting in poor patient outcomes.

Stephanie Landmesser, MSN, RN, CNOR, CCNS, DNP, is a clinical educator at Main Line HealthCare near Philadelphia. She's determined to stop nurse bullying. Together with her colleagues, she conducted an extensive literature search, stressing that tackling workplace bullying isn't just about policy changes. It requires collective action from every member of the perioperative team. And they've developed proactive strategies for leaders that emphasize fostering a culture of respect and collaboration.

Landmesser spoke recently at AORN Global Surgical Conference & Expo and her entire presentation can be seen when you register for a Virtual Pass (open through July 15) to watch the session, “Addressing the Elephant in the Room: Nurse to Nurse Bullying.” You’ll receive access to 70 sessions from AORN Expo 2024 along with the virtual poster gallery and more.

Here are highlights from Landmesser’s presentation:

Identifying the Telltale Traits of Nurse Bullies

Landmesser said nurse bullies actively seek out targets and frequently exploit their perceived expertise to advance at the expense of others. “The bullies are often seen as nurse experts,” she said. “They often get promoted, and they don’t often play by the rules because they feel they don’t apply.”

Navigating the Perioperative Landscape

While bullying isn’t necessarily different in the perioperative field, Landmesser says the close-knit environment makes it a common occurrence. "As a nurse in the operating room, especially in a specialized area, sometimes there's a sense of being the elite,” she said. “This mindset can create an environment where nurses may feel superior and less receptive to input from others."

Leadership Challenges and Opportunities

Perioperative leaders have their work cut out for them in addressing workplace bullying, Landmesser says. With a nursing shortage looming large and the pandemic adding extra pressure, leaders must juggle multiple priorities, including retaining staff, bridging generational gaps, and managing conflicts.

Empowering Nurses with Proactive Strategies

So, what can leaders and healthcare organizations do to combat nurse-to-nurse bullying effectively? Landmesser says it entails making a concerted effort to promote communication, teamwork, and conflict resolution. She shared these four steps:

1. Emphasize Teamwork and Collaboration

Landmesser advocates for a culture where “each member contributes to the efficiency of the whole group,” nurturing mutual respect, active listening, and trust. She recommends using the 70/30 rule of listening versus talking to enhance understanding among multiple generations working together.

2. Prioritize Conflict Resolution

Need to address a conflict? Promoting direct communication and private conversations is the way to go. Landmesser says leaders should avoid assumptions, stick to the facts, and implement the STOP approach—situation, tell, opportunity, and provide closure — to facilitate productive resolutions.

3. Build a "Just Culture"

Creating a "just culture" is crucial for building trust and transparency. This involves promoting accountability and better outcomes by encouraging staff to openly discuss problems and report errors without fear. Leaders play a key role in shaping this culture by educating new staff on expected behaviors, creating and enforcing anti-bullying policies, ensuring understanding of the Code of Conduct, and setting a positive example.

4. Create Healthy Work Environments

Landmesser underscores the importance of addressing workplace bullying by acknowledging the problem, raising awareness, and actively fostering cultural change. She advocates for developing and promoting a reporting and prevention system that tackle disruptive behavior among colleagues. Additionally, she recommends implementing self-care practices, such as starting staff meetings with mindfulness or relaxation techniques, taking breaks, utilizing designated relaxation rooms, and setting clear boundaries between work and personal life.

Additional Resources

• Register for Virtual Pass (open through July 15) to watch the session, “Addressing the Elephant in the Room: Nurse to Nurse Bullying.” You’ll receive access to 70 sessions from AORN Expo 2024 along with the virtual poster gallery and more.
• The Healthy Workforce Institute (HWI) has developed the self-study course "Eradicating Bullying & Incivility: Essential Skills for Healthcare Leaders," a 5.8 CH course designed to empower leaders with tools to address and prevent disruptive behaviors within teams. What's more, the AORN Center for Perioperative Leadership has partnered with HWI to offer an added bonus upon enrollment: 1-year access to monthly live culture calls aimed at facilitating dialogue and growth in this critical skillset. View Course Details »