On Nurses Who Eat Their Young

If you're like me and are reading this blog or following me on Twitter, you were a dork in high school.

Maybe not a complete and total geek and outsider, like these assholes:

They aren't assholes. Just fucking dorks. Even the blonde one. 

But nonetheless, you were probably smart and kind of a bit of a loner maybe. You did your own thing, marched to your own drummer, didn't blindly follow what all the other kids were doing, all that shit.

Maybe I'm wrong, but I'm willing to bet you probably weren't like these assholes:

Assholes. Like, OMGahhhhh. 

The popular crowd at my high school were a bunch of bleeding, puckered assholes. I was so happy to grow up and get out of there. I was over it. I was ready to start being an adult and doing adult shit like drinking having a job and being responsible.

So imagine my surprise when I have my first big-girl, adult, responsible job after years of hard work and determination and find that my chosen career is not full of people like me. It's another bunch of bleeding, puckered assholes, plus people like me.

And I suppose every job is like that; quite a bit like high school in fact, where there are cliques of people who don't sit together at the same table in the lunchroom and who don't play nice with each other. We never really get away from that high school mentality.

This isn't to say that nurses aren't smart and driven people. Not at all. For the most part, nurses are highly skilled, talented, educated, intelligent people. It's just that a unit in the hospital almost becomes like a mini-high school. There are the popular ones and their hangers-on, the nerds, the fringe people, and the outcasts. Think about your unit and I bet you a billion dollars that you can pinpoint exactly who these people are, can't you?

So given that environment, add in to the mix the fact that nurses are by far the most disenfranchised people ever in the whole world. Pardon my hyperbole, but I firmly believe it's true. We're the ones who have this huge amount of responsibility, but no autonomy. We have this job where we're expected to know so much but can actually do so very little. We have to worry about adequate staffing, being safe on our job, being abused by patients and staff-- verbally and physically, management who cuts corners by taking our health insurance or benefits away, never getting to pee...we aren't even allowed to have bottled water or coffee at the nurses' station, for christ's sake. And since shit rolls downhill, who do you think bears the brunt of bad clinical outcomes? Maybe not in court so much, but we get counselled, written up, suspended and fired.

Wrap it up and tie it with a big pink bow and what do you have? An environment that is ultimately conducive to bullying and lateral violence.

And who gets shit on the most? New nurses.

They come into the hospital with their shiny new badges, all fresh faced and bright eyed and confident, eager for experience and to do all the cool shit they just learned in nursing school... and some old battle-axe preceptor they're paired with rips them a new asshole for forgetting to turn off the IV fluids when they drew labs. And this continues and continues and continues until that new nurse isn't so fresh faced and eager anymore. She's doubtful and timid and prefers just to shut her fucking mouth and get done so she can go home.

Books I've read on the subject say it's been this way forever, since the dawn of nursing, when nurses lived in barracks and got schooled on the proper way to crease a bedsheet and pinroll their hair. It's part of our culture. We indoctrinate new people into this culture because it's the way it's always been done, much like medical residents work 80-100 hour weeks because "that's the way it's always been."

Is this acceptable? What if people had the same attitude about, say, pediatric cancer that they do about lateral violence in nursing: "Well, *shrug* kids have always died from cancer, but that's the way it's always been. It's part of the culture." 

Or worse, they realize there's a problem and bitch incessantly about it on allnurses.com but never take any steps to fix it: "Well, kids have always died from cancer. It's horrible! I hate it! But it's the way things are, I guess. Gotta have a stiff upper lip and deal with it." 

Let's not fucking deal with it.
Let's make a change in our "culture."

First and foremost, if you're one of those people who does this shit? Go immediately to your bathroom, look in the mirror, and tell yourself to fuck off. And then tell yourself "I'm not going to be an asshole to people anymore." This is a hard step, but you can do it. But follow through with it-- don't be an asshole to people anymore.

Second, if you see this kind of BS happening, speak up. It doesn't matter if it's just like standing up to that popular jock who used to tease you about your braces-- meaning, impossible-- we all need to say something when we see bad shit like this going down. If your boss and the three people who always get to be charge nurse are the "popular" crowd, speak up to someone else if you can't speak to them.

Third, and more importantly I think than the previous two points, go to that person who is being shit on and encourage and empower them. And then go to the assholes and encourage and empower them too. EVEN IF YOU DON'T LIKE THAT PERSON. That is tantamount. There are many people I don't like (meaning, everyone), but I always always always try to be encouraging and empowering to the people I work with. Especially to the assholes, because you never know, they might be assholes because people were assholes to them.

Fourth, guys... seriously let's stand up for ourselves. Advocate for a new grad training program with dedicated preceptors who only do it because they want to, not for money or because they have to. Or, if you can and are so inclined, mentor or precept a new nurse. It's worth it.
Don't be silent when hospital policies make it impossible for you to function in your capacity in one of the most badass healthcare professions. Policies that make it impossible for you to take a break. Or can't have a coffee at the nurse's station. Or it's too expensive to have a break relief nurse because of the census. Or to even HAVE a break relief nurse. Or that your hospital doesn't have a lift team. Or you get written up for clocking out late because report on your patient on 4 pressors and inotropes and mannitol and 3%NS and complicated dressing changes went "too long." If we as a PROFESSION collectively stood up and said "absolutely fucking not" (empoweringly and encouragingly, of course) to a lot of these dumb policies, our environment would be better and thus we would feel better and there would be less assholes. Right?

Making a change, in the immortal words of Michael Joseph Jackson, starts with the person in the mirror. We ALL need to encourage and empower each other.

We ALL need to be the change that we wish to see in the world.

Lead by example: Don't be an asshole.

And here's that picture of a fucking cat hanging from a clothesline that you bought at your elementary school book fair to round out this sappy, sentimental drivel:
Hang in there, Baby. 

We, you and I, can make a difference. Let's end this culture of bullshit.

Love, (and I mean that sincerely)


  1. Perfection. Yes to everything here.

  2. So well said. It can be hard to stand up for what's right but its so important to take pride in supporting one another instead of being so insecure that we only take pride in bringing others down. I love mentoring new nurses and students I learn so much from doing it and love giving other nurses the start and support I never had. And I absolutely hate policies that force nurses to take on education roles that they don't enjoy and aren't passionate about and are extremely bad at just to get a wage rise. Not everyone is a good educator - we need to recognize this and stop forcing nurses who don't want the job to take it on. Hospitals can be as cliquey as school but whether everyone is your best mate is not the goal the goal is to create an enjoyable work environment that leads to exceptional patient care. At least that's the way it works in my dream hospital. :)

  3. Well said, MoJo RN. I'm glad to see some keen intellect and a modern take-no-crap person finally infiltrate nursing. I quit R.N. school because I'd already had a decent career elsewhere, and I didn't appreciate the way R.N. school was trying to force its dysfunctional self-sacrificing servant role on me. Women in other careers have been *empowered* and *treated with respect* for literally decades now. It's past time for nursing to grow up, quit trying to be good little girls who always have to please everyone, and start working like a profession. In R.N. school, I just could not believe how we were being indoctrinated to be doormats and cowards who let everyone dump on them and take advantage of them. Don't have time to pee? Don't have time to get your work done? Tell admin to staff properly if they want the work done, because that's exactly what *all other industries* do: Staff adequately to get the work done in the allotted amount of time.

  4. Yes, yes, yes to everything in this post! I quit my first job due to the BS the older nurses kept dishing out, day after day. It was their loss. Now I actively precept and mentor and teach nursing students, because I want it to be better for them. I don't understand the culture of exclusion that exists in most units. As you said, we are all a team (theoretically), and our damn jobs are hard enough without all the extra high school drama.

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