About a year ago, I was trying to market my 2-day bullying/conflict seminar and sought advice from someone who had been successful in filling seats at her events. We had a conversation about “target audience” and although I had focused my previous seminars on teaching individual nurses how to bully-proof themselves, this time I wanted to focus on teaching nurse managers how to address the bullying behavior of their staff. “Oh.” She said, “That’s easy. Send your brochures to your hospital list but send one addressed to “Critical Care Nurse Manager” and one to “OR Nurse Manager.” When I asked why, she replied, “Because that’s where the mean girls work.”
Hmmm. I thought. Was she right?

Nurses can be so caring to their patients but horrific to each other! But is there is more bullying among critical care and OR nurses and if so, why?
The answer has to do with perceived power
One reason bullying occurs is because the bully perceives she has more power than someone else. It’s called having “a perceived power gradient.” We often see this when an experienced nurse perceives she has more power than a new nurse; a physician perceives he has more power than a nurse; or a nurse perceives she has more power than a nursing assistant.
Or when a critical care or OR nurse perceives she has more power than a medsurg nurse.
I read an article about nurse bullying and the author shared an experience she had as a new medsurg nurse who got pulled to the ICU (it was a long time ago). When she arrived on the unit, the critical care nurse looked at her with disgust and said, “I can’t believe they sent us THIS!” There she was in a white uniform while everyone else was in seal blue. They all stopped what they were doing and glared at her with evil eyes!
Okay. I certainly don’t want to pick on critical care and OR nurses (because I’ve seen horrific behavior among hospice nurses too!!) but I do want to talk about this perception that some nurses have that they are better than other nurses just because of where they work or what they do.
We joke about how ED nurses are mean to ICU nurses; ICU nurses are mean to OR nurses; OR nurses are mean to medsurg nurses: and medsurg nurses are mean to outpatient nurses, etc. 
What makes them believe they are better than the other?
I’m a true step-down-unit nurse. I take care of 3 patients. Everyone is monitored and I do everything for them every 2 hours. It’s my comfort zone. But if you put me in critical care with vents, I panic. Likewise, put me on a medsurg unit with 6 patients and I feel like a brand new nurse again – overwhelmed and confused (at least that’s how I felt). I’ve also worked as a homecare nurse; as the quality manager for a managed care company (yep); as a unit manager, educator, nurse executive and now as a business owner. And although some of these positions may be perceived as powerful, I’m the very same person – same intellect; same values system; same personality. The positions themselves DO NOT give me the right to THINK of myself as better than any other nurse. Each role just required learning a different skill set. 
I am a nurse. Just like the other 3.1 million nurses in this country. I just happen to do (fill in the blank).
The problem is that when nurses don’t value the different roles we have and perceive one role to be more powerful than the other, we then begin to categorize each other into hierarchies – with some being higher than others. 
What we have to realize is that there are no hierarchies!! Just different roles.
From now on, I want you to think of yourself and other nurses in this way:
We are professionals first (and need to behave that way)
We are RNs (same initials – same family)
We each have a functional role (ICU, homecare, medsurg, etc).
If we all respected each other with the above perspective, we would never be mean to each other but rather; we would celebrate and support each other!
I’d love to read your comments about “where the mean girls work” and your opinion on this topic.
Thanks so much for reading! Take care, be kind to each other, and stay connected.
Renee
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