The Mean Girls Club, or What’s Wrong in Nursing

 

Upset nurse sitting on the floorI always knew I wanted to be a Nurse Practitioner (NP), even before starting nursing school, but I didn’t realize at the time one of the major benefits of being an NP: You’re not really considered a nurse anymore.

During my undergraduate clinicals, I started seeing the ugly underside of nursing, the side that students only hear about if they have nurses in their family: Nurses eat their young. At times it’s said almost jokingly, like a girl describing the awful band her boyfriend likes with a tone of, “I hate it, but that’s just the way it is, and I love him in spite of it.” As a student nurse, I would talk to any NP that would give me the time of day, and one of questions was about the interpersonal dynamics at the provider level: Are NPs catty to each other the way staff nurses can be? Everyone I spoke with said that the environment among providers was overwhelmingly better than being a floor nurse. So y’all can imagine how disheartened I was after spending the majority of my clinical hours this semester on a unit where the NPs are just as much a part of the Mean Girls culture as the nurses. One of the reasons I wanted to become a mid-level provider was to get above the fray, away from the backstabbing and snideness.

The real problem here isn’t my recent morale-crushing experience in the ICU, but rather the general Mean Girls culture in nursing, and the way little seems to be done to combat it. Channeling Regina and Gretchen might be okay in high school (if you haven’t seen the movie, go watch it now), but that kind of behavior is not only unacceptable for nurses, it’s dangerous. And it’s unfortunately all too common. When I typed in “bullying among” the first thing Google autofills to is “bullying among nurses.” That says a lot. There have even been articles written for the American Association for Critical-Care Nurses, American Nurses Association, and the Academy of Medical-Surgical Nurses about bullying in the nursing profession. New grad RNs tend to get targeted the most, and much like the Greek system, there is a strong tradition of hazing in nursing that ultimately puts the patient at risk.

Bullying contributes to the high turnover rate in nursing, and it’s not uncommon for nurses to work on a unit for six to twelve months before transferring to another unit or an entirely new hospital. High turnover rates affect health care costs more than you might think. Anytime a new RN is hired, there’s often a six- to eight-week orientation period, regardless of previous work experience, during which the new RN is paired with an experienced nurse on that unit. For those two months of orientation, the hospital is paying two nurses to do the job of one. Since nursing salaries are covered under the fee of the facility that’s billed, patients ultimately end up literally paying the price for nurses not being able to play nice.

But it can get even worse than just an increase in your hospital bill. Sometimes patient lives are literally put in jeopardy because of the Mean Girls culture. While I’ve never had a nurse refuse to help during a patient emergency, I’ve read stories of nurses who were left to fend for themselves while a patient was crashing. And I’ve chosen to handle a patient emergency by myself instead of asking for help from the other nurses (well, one particular nurse) who had created an adversarial work environment. It’s hard to bring yourself to ask for help when you feel you can’t trust the other person.

I’ve experienced the backstabbing, manipulation, and cattiness in almost every clinical and work setting I’ve been in as an RN and NP student. Fortunately, until this semester, I’ve been above the fray by virtue of functioning as an NP. But all of this makes me ask: Why is it that many times, when women are together in a group, they sabotage and tear each other down? Why are women often more critical of each other than we are of men?

I was reading something on Facebook about the division within my church over women’s ordination, and as someone pointed out, the most vocal critics of having women on the platform came from other women. I’m not convinced that it comes down to biology, as some would have us believe, or women wanting to gain the attention of the best potential mate. Women who are married with children can be just as mean as the single gals.

So what drives women to such lengths, even to the point of putting someone’s life in danger? Is it an innate desire for control? Respect? Status? Or are we perpetually stuck in high school, looking for the approval of the popular girls?

 

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  1. PHCheese Member
    PHCheese
    @PHCheese

    Both my mother and my wife we’re nurses and I don’t remember them having those complaints.

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  2. Amy Schley Moderator
    Amy Schley
    @AmySchley

    One of my axioms: Anyone who thinks the world would be better if it was run by women has never been in an organization run by women.

    • #2
  3. Merina Smith Member
    Merina Smith
    @MerinaSmith

    I’m sorry to hear this, VC, but it is not surprising.  There will always be women out there who never got out of high school.  I think it is related to biology. Maybe it’s because women are hardwired to be somewhat tribal, to protect their family and friendship tribe.  I can think of one mean girl in particular who, I have to hand it to her, has been very good at advocating for her family during a number of family crises, but she is also very nasty when she wants to be.  She’s created communal havoc in a number of instances.  For some reason, such women have a special vitriol for those who try to get along with everyone.

    But for every mean girl, there’s a nice girl, and you have to figure out who those nice girls are and become part of that group.  Mean girls have a special radar for people who are vulnerable to their shenanigans and they go for the jugular, but if you have a network of nice girls with you–women who can walk in someone else’s shoes, who are kind and compassionate, who don’t like to target someone and create social chaos–then you can defeat the mean girls.  You defeat them by rising above their games. You be competent and kind and you don’t return meanness for meanness. Maybe not in every circumstance will you defeat them, but in most.  I have faith in womankind, but mean girls will always be with us.  Good luck finding your group of nice girls.  You deserve them.

    • #3
  4. Fat Dave Member
    Fat Dave
    @FatDave

    You may not be interested in my take as a husband of an RN, but I have watched my wife since we began dating 15 years ago and she was a CNA and nursing student.  I can only imagine the physical stress of the long, odd hours messing with Circadian rhythms (she’s 100 times healthier since she joined a consultative team and has reasonable hours), the emotional stress of losing patients (she has always had numerous “frequent flyers” at a state-funded hospital with urban demographics), and the psychological stress of being in such a high pressure profession.

    My wife has always done her best to remain the cool, calm, collected, aloof, and efficient nurse, avoiding team politics at all cost.  She saw how destructive nursing politics is as a CNA, and she didn’t want to become what you term a “Mean Girl.”  The usual complaint during her evaluations when a floor nurse was, “Not a Team Player,” but she always got the best marks from her patients of anyone on the team.  So during one evaluation with the nurse manager she asked, “So, what could I do to be more of a team player?”  Her nurse manager, who is now a high-level administrator at this hospital, a pre-eminent research and teaching facility, said, “Well, you could discuss your sex life with your coworkers, for one thing.”  Seriously.

    • #4
  5. Vicryl Contessa Thatcher
    Vicryl Contessa
    @VicrylContessa

    PHCheese:Both my mother and my wife we’re nurses and I don’t remember them having those complaints.

    Ask them if they ever experienced cattiness or saw it directed at other nurses. I’d be really interested to know what their experiences were. My mother worked on a unit with really low levels of cattiness, so they do exist, but I’m not sure that they’re the rule as much as the exception.

    • #5
  6. Vicryl Contessa Thatcher
    Vicryl Contessa
    @VicrylContessa

    Amy Schley:One of my axioms: Anyone who thinks the world would be better if it was run by women has never been in an organization run by women.

    Yeah, it can be pretty bad. There’s a reason why you hear a lot of women say “I’d so much rather work with men- less drama.”

    • #6
  7. Merina Smith Member
    Merina Smith
    @MerinaSmith

    Vicryl Contessa:

    Amy Schley:One of my axioms: Anyone who thinks the world would be better if it was run by women has never been in an organization run by women.

    Yeah, it can be pretty bad. There’s a reason why you hear a lot of women say “I’d so much rather work with men- less drama.”

    That’s probably the key–women who like drama and foment it are usually mean girls.

    • #7
  8. Aaron Miller Member
    Aaron Miller
    @AaronMiller

    Could you provide some examples of how these attitudes translates into disruptive actions? What are some specific ways a patient might be affected?

    I might be way off on this, but it seems nursing in modern America is one of the most socially mixed industries around. By that I mean that nurses originate from every economic tier and social background. There are poor blacks from a culture of bad education and passionate outbursts, poor rednecks from similar circumstances but different interests, nurses from wealthy families accustomed to stricter standards of politeness and even further different interests, foreigners from every continent, and so on. With such a diverse mix, there are bound to be many misunderstandings and conflicts of expectations.

    • #8
  9. Vicryl Contessa Thatcher
    Vicryl Contessa
    @VicrylContessa

    Fat DaveMy wife has always done her best to remain the cool, calm, collected, aloof, and efficient nurse, avoiding team politics at all cost. She saw how destructive nursing politics is as a CNA, and she didn’t want to become what you term a “Mean Girl.” The usual complaint during her evaluations when a floor nurse was, “Not a Team Player,” but she always got the best marks from her patients of anyone on the team. So during one evaluation with the nurse manager she asked, “So, what could I do to be more of a team player?” Her nurse manager, who is now a high-level administrator at this hospital, a pre-eminent research and teaching facility, said, “Well, you could discuss your sex life with your coworkers, for one thing.” Seriously.

    Wow!! Like your wife, I experienced the bullying when I was a CNA during nursing school, and certainly as an RN. As an NP student, I’ve been bullied by a PA and his wife that worked together, and the unit that I’ve been on most recently hasn’t been venomous towards me per se, but they’ve definitely not made me feel welcome. And it’s always small, slight things that culminate to make me feel uneasy.

    • #9
  10. Vicryl Contessa Thatcher
    Vicryl Contessa
    @VicrylContessa

    Aaron Miller:Could you provide some examples of how these attitudes translates into disruptive actions? What are some specific ways a patient might be affected?

    I’ve seen nurses tell CNAs to do things that are technically outside their scope of practice, and then when that CNA pisses them off later on, the nurse turns that CNA in for practicing outside their scope, even though it was under their direction. I’ve never seen first hand, but I’ve heard of the mean girl nurses refusing to help another nurse when her patient was crashing. I have seen nurses knowingly let a nurse they didn’t like give the wrong medications to a patient so they would have something to report to the nursing manager in order to get her fired.

    • #10
  11. Barkha Herman Member
    Barkha Herman
    @BarkhaHerman

    I run a all female company and I volunteer with an organization that is about 90% female.  In both cases, I do not share your experiences. Not saying that it does not exist; but I seemed to have avoided the entire genre of the mean girls syndrome.

    Have I encountered a errant apparently mean behavior in a girl here or there? Yes.  Generally speaking, IMHO, meanness arises out of fear.  When the fear is removed, and there is better communication, I find easy to work with men and / or women. One way to accommodate it that has worked for me is to assume good faith and good intentions to the alleged mean person; and clarify the incident. Real evil is truly rare.

    I do wish you have better experiences in the future.

    • #11
  12. Vicryl Contessa Thatcher
    Vicryl Contessa
    @VicrylContessa

    Barkha Herman:I run a all female company and I volunteer with an organization that is about 90% female. In both cases, I do not share your experiences. Not saying that it does not exist; but I seemed to have avoided the entire genre of the mean girls syndrome.

    Have I encountered a errant apparently mean behavior in a girl here or there? Yes. Generally speaking, IMHO, meanness arises out of fear. When the fear is removed, and there is better communication, I find easy to work with men and / or women. One way to accommodate it that has worked for me is to assume good faith and good intentions to the alleged mean person; and clarify the incident. Real evil is truly rare.

    I do wish you have better experiences in the future.

    I went to an all girls high school, and my class was tremendously supportive of each other. There was a shocking lack of cattiness in a setting where one would expect it most. So I know that what you’re saying is true- it doesn’t have to be that way. And I’m not sure why it seems to be so pervasive in nursing. I do think that the leadership has a lot to do with it.

    • #12
  13. Merina Smith Member
    Merina Smith
    @MerinaSmith

    Barkha Herman:I run a all female company and I volunteer with an organization that is about 90% female. In both cases, I do not share your experiences. Not saying that it does not exist; but I seemed to have avoided the entire genre of the mean girls syndrome.

    Have I encountered a errant apparently mean behavior in a girl here or there? Yes. Generally speaking, IMHO, meanness arises out of fear. When the fear is removed, and there is better communication, I find easy to work with men and / or women. One way to accommodate it that has worked for me is to assume good faith and good intentions to the alleged mean person; and clarify the incident. Real evil is truly rare.

    I do wish you have better experiences in the future.

    I’d have to disagree.  There is real evil in all of us.  It’s not rare at all–my goodness, look at the world around you.  But yes–there are good environments where mean girls can’t get traction.  It only takes one determined mean girl to really make things nasty, however.  I know that in our church setting, if there are interpersonal problems, it’s always among the women, and it’s usually directed at a really nice person.

    • #13
  14. Paula Lynn Johnson Member
    Paula Lynn Johnson
    @PaulaLynnJohnson

    Thanks for this important glimpse into nursing culture. One of our clients is a nurse and she echoes what you have to say about the cliques and the backstabbing. Sounds like some of the nastiness is older nurses feeling threatened by younger nurses? Similar dynamics happen in teaching.

    Having said that . . . chicks be cray-cray. If you’ve ever been in a PTO meeting and witnessed grown women arguing ad nauseum over what appetizers to serve at the fundraiser, you know what I’m talking about.

    Vicryl Contessa: Is it an innate desire for control? Respect? Status?

    OK, I’ll try to answer this beyond the flip “women are psychos” (I’m a bit of a female misogynist)

    I’ve observed that some women need to be emotionally validated.  They want their thoughts, opinions, and ways of doing things “supported”. This often means they need you to agree with them.  You disagree with a guy, he takes it or leaves it, then you go have a drink with him. You disagree with some women, they take it as a personal judgment and give you the cold shoulder, or worse.  Hence, they have to surround themselves with women that think and do things their way; non-conforming women are a threat to that sense of safety and must be punished.

    I blame a lot of this on Oprah and others who spread the notion that women’s feelings and “spirit” are sacrosanct and need validation.

    • #14
  15. Manny Member
    Manny
    @Manny

    The “backstabbing, manipulation, and cattiness” sounds like normal human interaction, sinful of course, but normal, and that goes for men as well as women.  But hazing is unacceptable, anywhere, but especially in something like nursing.  My cousin is a registered nurse.  Next time I meet up with her I’ll have to ask about it.

    • #15
  16. Paula Lynn Johnson Member
    Paula Lynn Johnson
    @PaulaLynnJohnson

    Amy Schley: One of my axioms: Anyone who thinks the world would be better if it was run by women has never been in an organization run by women.

    Amen. This is why in polls, employees consistently say they prefer male bosses.

    • #16
  17. Amy Schley Moderator
    Amy Schley
    @AmySchley

    Paula Lynn Johnson:

    Amy Schley: One of my axioms: Anyone who thinks the world would be better if it was run by women has never been in an organization run by women.

    Amen. This is why in polls, employees consistently say they prefer male bosses.

    I’ve had good female bosses, but I agree that organizations take their cue from the people at the top … and when an organization gets too female-dominated, the women at the top are generally the cattiest mean girls.

    This is why education is so bad as well — my sister lost her job as a teacher because she didn’t realize that ingratiating herself with her colleagues was more important to her career than helping her students learn.

    • #17
  18. The King Prawn Member
    The King Prawn
    @TheKingPrawn

    It’s not just women. On my first boat the sonar division had 13 new people over the 4 years I was stationed there. At the end only one was left. 12 young men washed out submarines because the sonar techs were horrible people. They ate their young. So, it’s not just women…well, I am talking about sonar techs.

    • #18
  19. Tenacious D Member
    Tenacious D
    @TenaciousD

    Do you think there is an age-related dynamic? Older, more experienced nurses without any official authority trying to put younger ones in their place through social pressure? I have family members in nursing and the one who complained about this kind of behaviour experienced it on her student placement.

    • #19
  20. skipsul Member
    skipsul
    @skipsul

    Welcome Back!

    • #20
  21. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    Vicryl Contessa: And I’m not sure why it seems to be so pervasive in nursing. I do think that the leadership has a lot to do with it.

    It’s certainly true that this is what comes up first when you Google, “Bullying among … ” I thought, “No, for sure this is autofilled based on past searches,” but nope, it seems nurses really are the meanest people in the world. And that is strange and hard to understand. I don’t think that’s true of other professions dominated by women, is it? Ballerinas, maybe.

    • #21
  22. skipsul Member
    skipsul
    @skipsul

    Amy Schley:One of my axioms: Anyone who thinks the world would be better if it was run by women has never been in an organization run by women.

    One of my own related axioms:

    I have never observed a male who could not work around / for other males (though I have observed males unable to work with females).  I have observed, however, that there are females who are utterly unable to work around other females without trying to destroy them.

    • #22
  23. Fred Cole Member
    Fred Cole
    @FredCole

    When will nurses learn? Other nurses aren’t the enemy. The *doctors* are the enemy.

    • #23
  24. MarciN Member
    MarciN
    @MarciN

    It would take a post on its own to tell a couple of stories of two personal experiences I had with nurses who were bullying me–the patient–so I have no doubt that nurses can be bullies. Although I’ve seen bullying elsewhere, this was indescribably a different kind of thing. This post was really interesting to me for that reason.

    It could be that something about the work attracts a certain personality type. I wondered about it at the time.

    I worked on a couple criminal justice books a year ago, and there was a chapter on problems in policing, and one thing that was mentioned is that police work does attract a certain overbearing personality type. The people in recruiting and testing are fully aware of this.

    I am sure every profession deals with this problem of attracting extreme personalities in one way or another.

    And I’ll bet if you were to talk to teachers of teachers of nurses, you would get some answers, that it is not your imagination.

    • #24
  25. Paula Lynn Johnson Member
    Paula Lynn Johnson
    @PaulaLynnJohnson

    Vicryl Contessa: why is it that many times when women are together in a group, they resort to sabotage and tearing each other down?

    Okay, one more and I’ll shut up.

    A lot of this stuff would go away if our gender wasn’t so notoriously passive-aggressive.  There’s an advantage to male directness: it settles the score so people can get on with life.  I saw it in action when my kids were younger. Boys would exchange words or even fists — it wasn’t nice, but afterwards everyone knew where they stood and sometimes even the conflict would blow over and the boys would become friends. With girls, its a never-ending, relentless campaign of behind-the-back slights — not being invited to the sleepover, not being let in on the secret, etc. etc.

    • #25
  26. Mate De Member
    Mate De
    @MateDe

    This is why I am in a male dominated field, there are only 2 other women I work with and they are “wired like guys” so we get along, but I would have a hard time dealing with the drama of working with other women. I’m already having issues dealing with some of the other moms I my kids classes.
    I listen to Dennis Prager’s male/female hour and I believe he is correct in his assessment that men haven to fight some negative aspects of their nature, like aggression and their sexual desires, but we usually do not require women to fight the negative aspects of our nature, which can be overly emotional which can lead to irrationality.
    And I agree with Amy, there is no evidence that would determine the women would make better leaders in general then men.

    • #26
  27. The King Prawn Member
    The King Prawn
    @TheKingPrawn

    Claire Berlinski, Ed.: it seems nurses really are the meanest people in the world.

    I think they hide it well from patients for the most part. My one stay in the hospital showed me the other side of nursing. I saw the doctor once while I was there, but the nurses were always present fussing over me, my comfort, and my recovery. I’ve written one thank you card in my 43 years, and it went to the nursing staff who cared for me after my appendectomy. I was never their job.

    • #27
  28. skipsul Member
    skipsul
    @skipsul

    Vicryl Contessa:I’m not convinced that it comes down to biology, as some would have us believe, or women wanting to gain the attention of the best potential mate. Women who are married with children can be just as mean as the single gals.

    So what drives women to such lengths, even to the point of putting someone’s life in danger? Is it an innate desire for control? Respect? Status? Or are we perpetually stuck in high school, looking for the approval of the popular girls?

    I would suggest, thought, that it is biology – just not the causes you cited.  I have no idea what the root causes would be, but when you suggest that this is a behavior more common among women than men, then ultimately it is a biology or “innate wiring” issue.

    • #28
  29. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    The King Prawn: I think they hide it well from patients for the most part.

    That’s for sure. I’m pretty shocked, because I’ve never experienced anything but kindness and selflessness from the entirety of the nursing profession. I’ve always thought, “What good people.” I wonder if the pressure to look kind and selfless on the outside makes people go mental on the inside? Is that possible?

    • #29
  30. OldDan Member
    OldDan
    @OldDanRhody

    “I do think that the leadership has a lot to do with it.”

    Try this on for size: I was part of the commissioning crew of a Naval frigate.  Our first captain was an exceptional man, a submariner enjoying his last command before retirement (e.g. Acapulco for a training cruise).  Under his leadership a culture of geniality and camaraderie among the crew was established that persisted for years after his tenure.  On the other hand, a paranoid and vindictive leader can spread that infection throughout his command.

    One other thing: My wife is a NP, many of her friends are RN, NP, PA, etc.  I infer from their conversations that there is often a clique active in the workplace and, if you’re out, it can be tough.

    • #30

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