Today in the chart

Shifting the Nursing Narrative From the Inside Out

The phrase “nurses eat their young” has existed for too long. Explore practical ways to change that narrative, starting with the internal work. All nurses, regardless of their role, have an impact.

Lisa Abitbol

There is something a lot more difficult and depleting for nurses than the stress of a heavy workload. That, combined with not feeling supported and being blatantly disrespected by colleagues, is another grueling level. 

Many nurses hear the phrase “nurses eat their young” before starting nursing school. If not, it’s often soon after when they hear it, witness it as a bystander, or experience it firsthand. Researchers have found that bullying against newer nurses is significantly higher than that of their more experienced colleagues.

The phrase “nurses eat their young” was first written in nursing literature in 1986 by Judith Meissner - so the problem existed well before it was formally documented 37 years ago. 

Many have hypothesized that the culture of “eating our young” exists as a rite of passage. In other words, “I had to deal with it as a new nurse… It’s just a part of the job.” Others suggest that it is because of the oppressed group theory, which posits that oppressed people are more likely to attack those within the group rather than address concerns with the oppressors. Heavy workloads are also associated with bullying in nursing. 

The current numbers are disheartening:

  1. Almost ⅕ of nurses in the US intend to leave the profession by 2027. 

Nursing, the largest profession within healthcare and arguably its backbone, needs change now more than ever. There is undoubtedly no quick fix to this deeply entrenched problem. 

Literature reviews, guidance documents, and position statements on bullying highlight the need for a multi-pronged approach, including recommendations for governments, organizations, managers/leaders, and nurses. The importance of respectful workplace policies is often emphasized. Many healthcare organizations have these, yet no data suggests that bullying and incivility are better now than in 1986; in fact, some believe that it has become “more visible and even more rampant over the years.” 

There is a dire need for radical change within healthcare, and it can be demoralizing when we don’t see those changes or see too little, too late. In the absence of meaningful change from the “top,” is it hopeless to expect a significant and sustainable change in the nursing culture? On top of that, high-level changes often take a lot of time to impact the frontline, and we know that policies without buy-in on the frontlines are limited in their impact. 

A recent survey found that “caring and trusting teammates” tied for the second most important factor influencing nurses to stay in their current position out of 24 listed factors. The power is in our hands to be “caring and trusting teammates” and to break the cycle of “eating our young.” Where do we start? 

The Internal Work Happens Before the External

Incivility and bullying within nursing are not always intentional. Undoubtedly, we cannot show up at our best when experiencing exhaustion, cynicism, and a sense of ineffectiveness - the three components of burnout.

Mindfulness is foundational to transforming the nursing narrative. Mindfulness, as in being fully present and recognizing what is going on around us and within us, without judgment, can create the space to: 

  • Acknowledge and honor our needs, capacity, fears, and desires and prioritize our well-being.
  • Explore uncomfortable emotions that arise when we are in conflict and respond thoughtfully.
  • Help us navigate challenges with more compassion and less unnecessary criticism.
  • Have the courage to take accountability for our mistakes and the impact of our words and actions, knowing that even with the best intentions, we can cause harm.
  • Embody the understanding that self-care and community care are critical to a sustainable nursing career. 
  • Appreciate the power we hold.

Simple habits, like taking a few deep breaths each time we wash our hands, purposefully checking in with ourselves after every interaction with a patient or client, or closing the stress cycle with a post-work routine, are ways to create regular moments of mindfulness. Building mindfulness into our daily activities is key to sustainability and foundational to having the impact we desire personally and professionally.

A Fancy Title Is Not Required

A formal title is not needed to be a leader and influence change. As Alice Walker said, “the most common way people give up their power is by thinking they don’t have any.” Regardless of our role within nursing, we impact the people and environment around us, for better or worse.  

Most nurses know firsthand the effects on the environment and team of that one toxic nurse. The same is true for the supportive nurse who has their colleagues’ backs and is gracious in sharing their knowledge and expertise. Our brains are wired with a negativity bias for survival, so it makes sense if the negative experiences and interactions stand out more.

“It’s always been this way” doesn’t mean “it always needs to be this way.” Supporting our young and all of our colleagues doesn’t need to be grand, but instead happens in the everyday moments, like when we: 

  • Check-in on one another.
  • Acknowledge and celebrate other’s strengths and gifts.
  • Intentionally create joy at work.
  • Support newer staff and those who are struggling.
  • Strive for excellence, not perfection, and steer clear of expecting perfection from others.
  • Avoid participating in gossip and fueling rumors.
  • Follow our urge to move beyond the status quo; start the grassroots initiative, the workplace book club, the walking group, the lunchtime snack exchange, the study group - whatever it is.
  • Collectively take meaningful action. For example, articulate issues in a thoughtful letter to leadership, sign it together, and request follow-up. 

In the same way, toxicity accumulates and penetrates so many aspects of the workplace, so do the supportive actions. 

The Internal Work + Collective Supportive Actions = Shifts in the Nursing Narrative

There is no magic bullet to solve the longstanding issue of incivility and bullying within nursing. We must believe change is possible and have hope for a brighter future for nursing. Many nurses have experienced supportive environments where they can count on their colleagues. It’s time for it to become the main narrative. This is not to say that there isn’t work to do in advocating for systemic change and building equity in our workplaces. However, doing the inner work is necessary to have the impact we want in the environment around us. Coming together is how we will create systemic change. 

When done en masse, we can transform the nursing narrative and support our young and all of our colleagues. We can hold current leaders accountable from within. We can nurture our young to become the thoughtful leaders we desperately need. It’s not “us vs. them” - our leaders of tomorrow are providing direct care today. We are all a part of the same system. We are so much stronger together, and we can shift to become the profession that supports and uplifts one another.

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