The first provision of the Code of Ethics for Nurses addresses the need for compassion and respect for all individuals. While the primary focus of nursing practice is the patient, the need for compassion and respect also extends to our colleagues. Thus, nurses are ethically bound to maintain civil and caring relationships with work mates. Nevertheless, we are hearing of increasing bullying and lateral violence in the health care workplace. In fact, I regularly hear from correctional nurses about the struggle to work with mean, harassing, and even threatening colleagues. Many nurses find this even more stressful than working with the inmate population. Consider this example.
Lola is a new nurse in a medium security prison. She was recruited from her emergency nursing position at a local hospital with promises of less lifting (she has increasing chronic back pain) and better work hours. However, she is questioning this move after one week of orientation. Her work colleagues complain constantly about the work conditions and their manager. Although she was promised an extensive orientation, she is passed around among the nurses, sitting in with them as they perform various processes such as sick call and medication pass. This morning her manager is at an off-site meeting and none of the other nurses want to have her with them. Finally, Bob agrees but tells her to “Keep quiet and don’t bother me with questions while I’m on rounds”.
Caring is Not Just for Patients
Caring may be a primary concept in nursing practice but it often does not get translated into colleague relationships. Yet, our Code of Ethics clearly states that respect for persons extends to our relationships with other staff as well as to our relationship with our patients. Disrespect, incivility, and other methods of lateral violence can present overtly and covertly in the work environment. Lola is not getting a warm welcome in her new position and she can feel powerless to do anything about it, having only been there for a few days.
Prevention and Proactivity
According to the American Nurses Association, nearly 50% of nurses have experienced some form of bullying yet most of us stay silent about it. The Code of Ethics calls us to speak out when we experience bullying and, in particular, when we see other colleagues being bullied. By silently standing by, we become participants in the harassment.
Colleagues who are bullying others need to know that this practice is unethical and can be grounds for intervention. Some State Boards of Nursing include adherence to the Code of Ethics for Nurses as a part of their Nurse Practice Act. Hopefully, as awareness of the negative effects of lateral violence grows, more correctional health care workplaces will initiate a Zero-Tolerance policy toward incivility in staff relationships.
Relationship Responsibility
Our ethical responsibility toward healthy interpersonal relationships goes beyond the nurse-patient relationship to include our interactions with other nurses, physicians, team members, and officers. Poor work relationships lead to clinical errors, increased costs, and loss of quality staff (like Lola).
It would be difficult for Lola to change her work environment as a new staff member, but it may only take one staff member coming forward to address the issue of incivility to begin to make a difference. Besides seeking management support to change the work environment, each of us can seek to stop the horizontal violence.
- Don’t listen to or tolerate blame, rumors, and gossip
- Encourage and perform acts of kindness
- Look for common ground in a conflict
- Encourage forgiveness
- Be a safe person to ask questions of or discuss a problem with
How about you? Is there incivility or even hostility in your workplace? How do you handle it? Share your thoughts in the comments section of this post.
The American Nurses Association (ANA) designated 2015 as the Year of Ethics for American nurses. I have personally designated 2016 as the Year of Ethics for Correctional Nurses. This year I will be blogging regularly about the Code as I write a book to help correctional nurses apply the Code of Ethics in our challenging setting. Read all posts about the Code of Ethics here.
Dave Turner, RN says
Great subject Lorry! And more relevant than I’d like to admit. It’s way too easy to take out frustrations and stress on those closest to us and that’s too bad. When a team actively and consciously promotes mutual respect and dignity, and recognizes that we all have good days and bad ones, we become a more cohesive and efficient team. I’ve never really understood why good, compassionate people can be so hard on each other sometimes.
Lorry Schoenly says
I agree that there is often a disconnect here for some nurses, Dave. I liken it to how we sometimes treat outsiders versus how we treat family in our personal life. We can be polite when answering the phone in the middle of an angry exchange with a spouse, right? So, we can be caring with a patient and then return to the break room and have a total meltdown with a fellow staff member who left the med room in a shambles. We need a constant reminder that civility is for all.
Gayle Burrow says
Having a safe place at work to “de-stress” from the issues at work helps us exchange information and go on with our work. It is not a safe place to stress each other out with unkind talk. The balance between work issues and team member issues is what is needed. We all want to learn and grow into better professionals and team members, but we do not learn from degrading comments– I feel for Lola but know it occurs. We all can help by being aware and intervening so behavior changes, thus the work place changes to a more helpful experience.
LauraMac says
I came from a famous teaching hospital in the midwest several years ago wanting to make a difference for inmates. I knew nothing about Correctional Nursing – not even that it was a specialty in and of itself. What a shock to see the hostility, bullying, vulgarity, and abusive behavior among the nurses, and that included the administration. I expected the inmates to be tough but they were nothing compared to the staff! Thankfully, I began looking on the Internet for information on Standards of Practice in Correctional Nursing and found NCCHC within a few weeks of starting my job. Armed with the knowledge that this was all wrong, I stood up for what was right. Yes, I took a lot of heat – until that is – we got a state mandate to be certified by NCCHC. Imagine that! Suddenly, I was vindicated and I didn’t look quite so crazy.
I recently transferred to a sister location as I took a position as the Director of Nursing. These nurses too, have been subjected to years of abuse from the nursing administration on down. It’s a new challenge, but one I am proud to take on armed with the knowledge and the experience that your organization has provided. Thank you with all of my heart for leading the way. I for one, could not have survived without you. I believe that following the Nursing Code of Ethics is essential to good Nursing Practice. They are inseparable if one is to provide High Quality Compassionate Nursing Care. We loose a part of our souls when we treat each other with such profound disrespect. This can’t help but spill over into the work we do.
Lorry Schoenly says
Kudos for your courage, Laura! I am honored to know I helped support you in your successful efforts. We make change one person at a time. I look forward to hearing more about your new adventure.
Laurie says
I do not understand why we need to be rude to coworkers but we are, so many people state while that is just how it is. Sigh
Sherrie says
I’m not rude . I strive not to fall into the bully role. However, I do stand up for myself firmly. I’m in a travel position that is totally upside down. Each regular staff shuffling the blame to another.
Chronic problem inmates don’t have chronic care routine medications KOP
For 1 week to 1 month
Protective( safety) needles not in stock.
Sick Call 1-5 months behind. Multi complaints on KOP & Sick Call
No medical area to Conduct sick call. No security present with medical staff on pods
Comments welcomed