“Shield of White”: A culture of silence among nurses

“Shield of White”:  A culture of silence among nurses

Imagine… a young professional nurse excited about her first appointment to a national committee. In the midst of her happiness she discloses the good news to her colleagues. However, much to her chagrin, one associate defiantly insulted her in front of ten colleagues regarding her choice of accepting the offer to join the committee. After the associate’s tirade was over the remaining colleagues said nothing in defense of the young professional nurse. They kept silent and the subject was changed.

Remaining silent or excusing the reprehensible behavior in an attempt to minimize the effects of lateral violence has become commonplace. I refer to this phenomenon as the “Shield of White” comparable to the “Thin Blue Line” of law enforcement. The culture of silence among nurses must end. Silence equals acceptance. Listed below are a few reasons why nurses remain quiet when confronted with workplace bullying.

Fear of retaliation

Fundamentally, retaliation is not about getting revenge or “getting back” at anyone. Instead retaliation centers on making people afraid to complain or to assert their rights. For example, an individual responds to a group email and the status quo does not like this person’s response; therefore the status quo begins to exclude this individual from leadership opportunities within the group. Organizations or hospitals are unlikely to prosper when people are made to be afraid. A few consequences of retaliation are: (1) neglecting to ask the “tough” questions (2) underreporting of unlawful/unethical occurrences (3) an unwillingness to challenge authority. Most healthcare institutions consider retaliation unlawful and prohibited. In July 2012, a jury made an award of 1.2 million dollars in a retaliation case against a rehabilitation facility in Saginaw, Michigan.

Fear of rejection

Humans demonstrate an essential need of belonging to a group. This need can stifle a one’s ability to advocate for others.  Fear of becoming isolated from promotions or social events may inhibit a person’s willingness to speak – out against injustice.  Also, some are afraid of being ignored or criticized within their professional and social circles. Unfortunately, when people speak unfavorably about misconduct, colleagues may employ devious methods of rejection such as deleting the bullied person’s email address from a governing body listserv before their term is over in a thinly veiled attempt to restrict access.

Ambivalence

Conceptually known as “nothing is going to change anyways” or “why bother” mentality. This attitude is exposed among individuals who feel the misconduct is not happening to them so they do not care. People who are ambivalent regarding bullying are indecisive in temperament. Typically these people may share the same views as the bullied individual privately; however publicly they agree with the majority to avoid confrontation and as a show of solidarity to the perpetrator. These individuals understand acts of lateral violence are wrong but feel powerless to change years of bad behavior from peers that has been validated and in certain circumstances enabled by others.

We cannot afford to stand idly by as our colleagues are enduring abuse at the hands of their peers. As Mohandas Gandhi once said, “You must be the change you want to see in the world. One must be willing to advocate for their beleaguered colleagues in order to initiate the difficult conversations of which will prompt change. If each nurse spoke their truth, we would heal ourselves and become agents of change for a wounded profession.

“Agent of Change: A Push for Legislation to Protect the Healthcare Provider”

“Agent of Change: A Push for Legislation to Protect the Healthcare Provider”

Lateral violence is defined as a set of destructive behaviors occurring between colleagues intended to humiliate, offend or cause distress. It has been noted, the Mother of Modern Nursing, Florence Nightingale’s caustic manner towards nurses of lower social class during the Crimean War planted the seeds for lateral violence to take root in present – day nursing culture. Nightingale’s sarcastic nature throughout her 1859 book “Notes in Nursing” set the tone for the prevailing incivility between nurses.

Many healthcare organizations have attempted to abolish this problem of lateral violence with various strategies such as education or organizational leadership. However, based upon the sheer volume of articles published in reference to lateral violence, these methods are not solving this dilemma. Complicating matters, most United States legislators consider lateral violence an organizational problem instead of an issue which should be addressed legislatively. The U.S. is the last of the developed nations to initiate mandates outlawing lateral violence within the workplace. Internationally, seven countries have instituted anti workplace bullying statues.

The Australian state of Victoria enacted Brodie’s law in June 2011. Brodie’s law became the world’s first anti – bullying law to criminalize bullying. This law was named for Ms. Panlock, a 19 year old waitress who was tormented by three older coworkers. During her employment, Ms. Panlock was called, “fat, stupid, ugly, and a whore.” Also, Brodie’s tormenters physically restrained her in order to pour beer, oil, and fish sauce on her. Consequently, the abuse was intolerable for Ms. Panlock, she committed suicide in September 2006. ‘Brodie’s law makes it unlawful to make “threats to the victim”, to use or perform or direct towards the victim, “abusing or offending” words or acts. Also punishable is acting “in any other way that could be reasonably be expected to cause physical or mental harm…” Mental harm is defined as psychological harm or suicidal thoughts’ (Victoria State Government, 2016).

Within the healthcare spectrum, suicide due to lateral violence is a sobering reality. The continual stress of being bullied has caused some nurses to commit suicide. As result of vicious name-calling when transferred to a new unit, Mrs. Gettins, a 50 year old English nurse committed suicide by hanging in 2010. The Workplace Institute conducted a survey in 2012 of which indicated that 29% of bullying victims contemplated suicide, and 16% had a plan in place for carrying it out. Armed with these disturbing facts the author poses an important question, “Should the perpetrator be convicted of murder if their acts of bullying drive a person to commit suicide?” This an important question to address. The answer is yes.  Unfortunately, stateside, anti – bullying statues contain vague or minimal language in reference to specific ramifications of bullying. Degree of punishment is usually left up to the institution.  One way healthcare providers can address this is the act of petitioning local legislators to expand existing anti – bullying laws to accommodate healthcare providers. In my home state of Georgia, there are six anti – bullying laws. However, all of these laws are centered on education not healthcare. To give practitioners much needed legal protection against workplace bullying simply requires a language change to include healthcare providers. Also, the proposed expansion of existing anti – bullying statues must incorporate clear, concise language detailing consequences of lateral violence.

 Another method of addressing this dilemma is organizing a grassroots campaign. The aim is to create awareness regarding the importance of instituting state and federal laws to protect healthcare providers from the negative effects of an unhealthy work environment. The Healthy Workplace Campaign was created by Dr. Gary Namie in 2001 to lobby for anti – bullying statues across the United States. To date, the Healthy Workplace Campaign has introduced the Healthy Workplace Bill in 29 states. Currently, none of the 29 states have passed this bill into law.

Reference

Victoria State Government. (February, 2016). Criminal Law. Retrieved April 20th, 2016, from http://www.justice.vic.gov.au/home/justice+system/laws+and+regulation/criminal+law/