Spite in White: Expert in RA Addresses OR RN Convention

March 28th, 2012


By , BSN, RN

There have been a lot of great speakers at the convention I’m attending this week and they have drawn big crowds. Big names in government and healthcare, a television news celebrity and pretty famous city mayor have all stepped up on stage and encouraged us to keep up the good work as nurses. One speaker was little different.

Cheryl Dellasaga, PhD, isn’t famous in a celebrity kind of way, but she’s earned a name as an expert in a field that fills the news and is coffee talk all around this country. And, to be quite honest, as nurses, particularly OR nurses, we are not doing our best job and she knows it. Dellasaga is an expert on relational aggression (RA), specifically in girls. Yes, that’s right, we are again and still talking about bullying and nurses.

The big convention hall here at the Association of periOperative Registered Nurses 59th Congress (AORN) filled to the brim for Dellasaga’s session—that quite literally translates to thousands of nurses filled the seats. This in itself disturbs me because it is clear how much we realize nurse-on-nurse aggression is a problem but encourages me because maybe we are ready to do something about it.

Dellasaga didn’t start out focusing on nurses specifically but on studying RA in girls, and she wrote a book about it, Girl Wars. She has interviewed everyone from college coeds to retirees to learn about the subject. “10-20 percent of women in retirement centers are bullied by their peers,” Dellasaga told us. “And I kept hearing from nurses about how they treat each other.” It ended up being a chapter in the book titled The Healers.

So here we are, people charged with the health and well-being of our fellow humans and we are behaving badly to each other. Those behaviors come in a wide variety of forms and some don’t even seem that dangerous until viewed in the larger picture. Here are just a few of the behaviors Dellasaga cited:

  • Gossip
  • Intimidation
  • Ridicule
  • Saying something mean then pretending you were joking
  • Cliques
  • Betraying confidences

And there were many more. After this list Dellasaga asked the nurses in the convention hall to stand up if they had ever witnessed any RA like this in their own workplace. The only thing I can tell you is that there were very few who didn’t stand and I think those others just didn’t have the energy to get up.

According to Dellasaga’s study 27-30 percent of nurses report being bullied by coworkers or supervisors. Forty-two percent report having witnessed bullying and here’s a statistic that probably won’t shock the nurses reading this—80 percent of that bullying was woman-to-woman. In fact, Dellasaga also works with incarcerated women and hears the same stories. “In prison, working with adult women offenders I asked for a list of behaviors and it was just like this one,” she said.

High Tech RA

Making this matter worse is that RA has found a whole new medium in the era of computers. “It’s so subversive,” Dellasaga explained. “Now you can exhibit these behaviors with technology. Online behaviors are really at the forefront of the problem. With a computer screen you can say and do things you wouldn’t normally do. It’s a new form of relational aggression.”

”Has anyone ever looked up why animals eat their young,” Dellasaga asked the audience. “I hear sorting out the weak, I hear hunger,” she continued. “The nest is built, the eggs tended to, there’s a lot of nurturing—this happens in the workplace too,” she explained. And then we gobble them up.

As there are different personalities there are different bullies out there eating the young. Dellasaga puts nurses into several different categories:

  • The Aggressor/Bully
  • The Victim
  • Super Nurse – the one who always does it more or better than everyone else
  • PGR Nurse – putdowns, gossip and rumors
  • Resentful Nurse – “Well, she probably got that job because—fill in the negative blank
  • The Drama Queen
  • The Backstabber
  • The Clique

I think we all know at least one of two of these kinds of people at work. And, where these behaviors are exhibited patient care suffers, nurses’ health suffers, and the institution, as a whole, suffers. Dellasaga calls it, “RN RA:”

  • Giving another nurse “the silent treatment”
  • Spreading rumors
  • Using humiliation and put-downs, usually with regard to another nurse’s nursing skills and ability
  • Failing to support another nurse because you don’t like her or him
  • Excluding another nurse from on- or off-the-job socializing
  • Repeating information shared by one nurse out of context, so it reflects badly on her or him
  • Sharing confidences you were asked to keep quiet

Dellasaga did offer some suggestions for dealing with relational aggression in the workplace including seeking out new role models, encouraging positive talk about yourself and others, finding like-minded coworkers, and striving for more positive confrontation styles. However, most of her presentation was really about holding a mirror up to the problem and hoping we recognize ourselves.

What Did We See In the Mirror?

As the final piece of her appearance, Dellasaga called for six volunteers to come up on the stage. She got 12 because she offered chocolate as a reward for participation, which did lighten the mood in the room. She assigned the role of mentor to one nurse and student to another.

The scene assigned: It’s been a few weeks in a new surgical service and the new nurse isn’t catching on as quickly as the preceptor nurse would like. We’ve all heard the things our preceptor/actress said. “You are taking too long, you’ve been doing this for weeks—why can’t you get this right, you just can’t do this job.” Sound familiar.

The new nurse responded as many do. “I just need more time, I just want to get it right, I need to do a few more to be comfortable.”

Dellasaga now asked the nurses remaining on stage to take a side in this issue. It played out in a way that, in my opinion, is how it goes in most hospitals. Only one of the remaining participants stood beside the new nurse, explaining we don’t all learn as fast or the same way as everyone else thinks we should. All the others took the preceptors side, seemingly accepting what and how she was criticizing the new nurse.

This is a reflection I accept as true but really am embarrassed by. I saw many nurses in the room accept this behavior and support for it as ok. I do not see it that way. Dellasaga made her point to me and I’m sure, to others. But, what I saw in that lecture makes me sad for at least my specialty area, the OR.

As we filed out of the convention hall everyone was talking. I heard a lot of agreement with how the play-acting had played out. I was very encouraged by how many nurses recognized there is a problem when we all filed into the presentation. I think we still have a long way to go to really putting RA or simple bullying out of our profession.

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