December 5, 2023

Remember to be kind…..

Dr. Noelleen Kiprillis  (She/Her) RN, MACN, MN, PhD

Adult Learning and Teaching

Aged & Acute Medicine

Maroondah Hospital

Eastern Health, Australia

Registered nurses are seen as one of the most trusted professions. We are seen as smart, educated, caring health professionals.  We are also storytellers.  So today I’m going to tell you a story; someone’s else’s story. 

This is a story about a newly licensed nurse, Grace, who has just started working at a hospital. It’s her first job out of university as a Registered Nurse. As much as there are many nice people for Grace to work with, there is one person who is really unpleasant. She is a registered nurse like Grace and is meant to be her primary support. She is quite mean to Grace all the time; she makes her feel stupid. Her body language is negative, there’s a lot of eye rolling, ignoring and nasty rude comments. Mostly this is done in private so no one else can see it. Grace feels like she is going crazy as she can’t understand why this person is being so horrible to her.  This all started on day two of them working together but unlike Grace, with the other newly licensed nurses, this person is really quite nice.

Graces starts dreading being at work and when she is working with this ‘support’ person, she feels clumsy, and she makes a lot of mistakes. On quite a few occasions Grace would cry in the car on the way home. After weeks of silent suffering, one day a friend of Graces said to her:  “I think your preceptor is picking on you, and I’ve noticed it. I didn't say anything as I thought you were okay with it“.

My PhD investigated the prevalence and experience of horizontal violence in newly qualified nurses during their first year of practice.  For part of my PhD, I interviewed newly licensed nurses asking them to tell me about their experiences of transition. Horizontal violence is when someone in your ‘peer’ group is harmful, aggressive, or hostile towards you or a group of coworkers.  Sometimes horizontal violence has been linked with workplace bullying. There is a lot of evidence that horizontal violence is not a good thing in any workplace but new nurses are not always sure of whether it’s occurring or aware of it’s impact.  What we do know is that it occurs; too often and with too much regularity in our ‘caring’ profession.  What is does NOT look like is when new nurses are treated with support, respect, kindness and welcomed into the workplace.

As for Grace, having someone say something to her escalated a series of events which led to an end to the horizontal violence. Her situation changed. Sadly, for so many others this is not the case.  For others they just hang tough while they wait out their first year of employment, put up with the horizontal violence and then quietly move to a different practice area, or leave the institution or the profession all together.  The alarming thought is that the staff committing these assaults of horizontal violence are known to the ward, the manager and many of the other staff. 

How newly licensed nurses cope with this experience varies. Sometimes they tell a good friend, sometimes they seek out counseling, and nearly all of them discuss the situation with their family or their peers. Others are more subtle,reducing their work hours, taking sick leave or detaching while at work. My research indicated that we need to better support our new nurses in their first year of practice to reduce these experiences of horizontal violence.  Just remember to be kind to new nurses, and maybe just be kind to all of your nursing colleagues. 

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