When Preceptors Bully New Nurses

When Preceptors Bully New Nurses

Allison was excited to be hired into a New Grad Residency Program in a large acute care hospital.  Many of her classmates were still looking for a job but she had interviewed well and landed a job on Telemetry, her first choice of nursing unit. She liked her new nurse manager and everyone seemed friendly.

Allison eagerly reported for duty as assigned for her first day of clinical orientation on Telemetry. At morning huddle the Charge Nurse looked up from his clipboard and noticed Allison. “Oh, we have a newbie today. Who’s her preceptor?” Every RN looked away and down. Apparently there was a mistake on the schedule and Allison’s assigned preceptor was off.

Allison felt like she wanted to sink into a hole and could feel her neck turing red.  Silence. Finally, Matt, the Charge Nurse, sighed and said “OK, Belen, the new grad’s with you today.” Belen raised her eyebrows and glared at her report sheet. After huddle, she said to no one in particular “Follow me.”

While receiving report from the off going nurse, Belen proceeded to ignore Allison while Allison stood uncomfortably behind Belen. After report, Belen said dismissively “OK, you take the first 2 pts and I’ll take the others. Call me if you need me.”

Excusing Bullying

In the above example, do “raising her eyebrows” and “glaring at her report sheet” rise to the level of bullying? Perhaps not, but for purposes of this article…yes. If a new grad is isolated, ignored and ostracized…then she is being bullied.

Words can be parsed, and terms such as “eating your young” or “hazing” or “lateral violence” can be used, but the concern here is about new grads who are treated poorly, and what to do if you are in this all too common situation.

One problem is not recognizing bullying when it is more passive-aggressive than aggressive. It is much easier to identify the bully who beats up a small kid and steals his lunch money than it is to call an eye-rolling nurse a bully.

One way bullying is excused is by blaming yourself. You may feel guilty that you are a burden to the busy nurse, that you aren’t a help, that you aren’t fast enough. Obviously if the preceptor is abrasive and impatient, it must be your fault. Not so.

The truth is, if you feel like you are being bullied…you probably are.

Preceptor Bullying Behaviors

There are all kinds of ways in which preceptors and nurses bully. The preceptor may be an expert nurse, or the leader of the popular clique on the unit. You may be noticeably excluded from break room conversations or inside jokes. A group of nurses may order takeout food, and forget to include you. They may withhold information, such as doctor’s cell phone numbers.

The preceptor’s job is to socialize and integrate you into the nursing unit, and foster a sense of belonging.

Disappearing Preceptor

The disappearing preceptor vanishes, leaving you on your own. She doesn’t give notice- she’s just not there. You look up the hall, you look down the hall…no preceptor.

Your preceptor should be available to you at all times.  You never know when you are going to need to ask a question, or seek help.

Read how to deal with this in 10 Responses When Your Preceptor Bullies You.

Put-down Preceptor

Sometimes preceptors are demeaning or condescending when asked a question. “Didn’t they teach you that in nursing school (or in orientation)?”or “Remember? We talked about this yesterday”. Adult learners need to hear things several times before it becomes hard-wired, especially under stress.

Jessica, a new grad, overheard her preceptor chatting with another preceptor as she rounded the corner in the hall. They were comparing their residents in a disparaging manner. The preceptor’s job is to have your back, talk you up to others, and not tolerate gossiping.

Preceptors should role model professional behavior and demonstrate patience.

Unmanageable Workload

You are given a workload beyond what you can manage. Instead of being  supported, you are made to feel that the problem is you and not the assignment or patient acuity.

You should be given an assignment that stretches and challenges but doesn’t overwhelm you. Your preceptor should keep a close eye on how you are managing and know when to step in. When the situation is overly stressful learning is inhibited.

Humiliation

This includes allowing a physician or anyone to berate you by not stepping in or worse, by vanishing. Preceptors should not tolerate snide remarks directed towards you at change of shift. Bullying commonly takes place during change of shift report, where it can easily be pointed out that you are inexperienced.

Preceptors should not be disrespectful or criticize you in front of a patient, coworkers or doctors.

No Feedback

It is your preceptor’s job to give you feedback regularly on your progress and to set performance goals. Perhaps the worst is when a preceptor gives no feedback for weeks, but then informs the manager close to the end of orientation that that you are “not going to make it”.

Feedback should be timely, meaningful, and specific.

Reasons Preceptor Bully

Often bullies are angry and frustrated at their own powerlessness and “kick the dog”. Paternalism and gender disparity in nursing is as old as bullying. Even today, male nurses earn more than female nurses. In a hierarchical society, bullying flourishes.

Since bullying involves power, the preceptor may feel they can exert power over a subordinate (you).

Some preceptors will revert to the toxic way in which they were precepted, or an authoritarian  mode of precepting, where the junior team member is expected to obey, and not question.

Rationalizing Bullying

Bullying is sometimes defended by calling it “hazing”. The claim is that that precepting by the sink or swim method is merely a way to toughen you up.

“They sure coddle these new nurses now with those Residency Programs. When I started, I only had 3 weeks orientation, and I did fine.” or “New nurses have to prove themselves, how can they handle the stress of patient care if we make it easy for them?”

If you are targeted by any of these behaviors while you are being precepted, it can make for a miserable on-boarding experience. There are effective things you can do, however, to stop the behavior towards you and others. These are tactics you can employ on your next shift.

Read how in  10 Responses to Preceptor Bullying

 

Best,

Nurse Beth