Nurse to Nurse Cannibalism (When Peers and Juniors hold knives and forks)

This is the fifth article in which Emma Versluis and Tracy Churchill address the idea of ‘nurses eating their young’. Originally a four-part series packed with practical strategies, they have written a few additional pieces- this piece was inspired by feedback that it is not only older/more experienced nurses eating their young that is an issue in our workplaces. Peer to peer cannibalism exists, as do new nurses towards experienced nurses bullying behaviours. The next piece in the series will be based on the feedback that we have had that ‘When nurses eat their young it’s because we are starving - what are we starving for?’- Food for thought!

 

Many of us are familiar with the term ‘horizontal violence’. In nursing, it refers to people who are at similar levels intimidating, undermining, bullying and attacking each other. While the nurse cannibals favourite food may be vulnerable new nurses, due to the nature of recruitment of graduates this is a limited resource for the cannibal. Having learned these types of behaviours from cannibals who came before them, they will often look for other victims - their peers. Do these cannibals realise that if everyone becomes a cannibal then everyone is also a potential victim?

Tracy- Although I have been lucky for most of my nursing career, there have been times when I have been thrown in the cannibal pot by my peers. For example, when I started a new role in a new department, one of my peers went out of her way to make my life unpleasant. Giving me false information to make me look incompetent, complaining loudly about me to other staff in the department and then ignoring me- and all this on the first day. Luckily, by this time in my career I had dealt with enough of this behaviour that I stood up for myself and addresses the behaviour and the person immediately. This takes courage and resources that not all nurses have. I also let that person know that I would give correct information to the other new staff who started with me so the same ‘mistakes’ did not happen to them, and that I would be checking in with them to see how they were settling into the ward. I was clear that if there were further issues, I would not hesitate to escalate them- as I had gone to the person (cannibal) first.  This was their opportunity to change. There were no further issues (aside from a period of coldness). Day two ran smoothly.

Emma-I applied for a clinical nurse role very early in my career. Our department was looking for new clinical leaders and I was going through a personally challenging time which spurred me onto striving for more in my professional life. I was fortunate enough to be appointed to a clinical nurse role despite my inexperience. What I lacked in experience I made up for in enthusiasm. Many nurses missed out on winning ‘their’ promotions, and even those who also were promoted along with me made sure I knew that I shouldn’t be there. I admit the next two years were difficult for me. I lacked leadership skills, I was not well mentored or supported and I made many mistakes. Some say there are no mistakes only lessons – well I learned many lessons, and ultimately whilst it was a trying time, I am a better leader now because of it.

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Our experiences are not unique. Every nurse we have spoken to since writing this series has shared stories with us, some from their early nursing days and some from later on in their careers.  And some had experienced similar issues from nurses at levels lower than their level a type of upwards cannibalism.

Tracy- I have not personally experienced nurse cannibals from lower levels of work. However, I have had feedback that when nurses take senior positions the framework to support them may be flimsy or absent. Before there was a stronger focus on leadership in nursing, people would step into roles that had never existed before and be expected to perform and provide for nurses in their care without training, resources or experience. In one example I heard, a great senior nurse was put into this exact situation (new role, no resources- plus a HUGE challenge). At the end of their challenge, upon getting feedback it appeared that the group of nurses involved had conspired to leave personal and damaging feedback. This was heartbreaking and almost led to that nurse leaving nursing. It was only the nurse allies surrounding that nurse which helped them remaining in our profession.

Emma- I have also been in many roles where there is little or no support. Most of our leadership roles are continually evolving to attempt to meet the challenges of modern healthcare delivery (increasing service usage, reducing resources, limited education budgets etc) and they should evolve, but the healthcare system needs to ensure that with the evolution and improvement of service delivery we empower and enable our leaders and staff to perform at their best. We believe no one wakes up in the morning and decides to do a bad job – but often our system fails our staff – Is it any wonder we fail each other too?

So, how do we deal with peer nurse cannibals and nurses eating their leaders? One of the most important things to do is connect with a peer who sees your value and can help you stay positive while going through a dark time. That is the first thing- when you are at risk of drowning in the darkness, find your lifesaver and grab on. Here are some other helpful tips that we have used to improve our working relationships.

Peer cannibals

  1. Address the issue immediately. Speak directly to the person. Let them know how it made you feel and see if there were other factors stressing them out on that day. Speaking up for yourself lets that person know that you will not be a silent victim. Asking if they are okay, show you are a kind person. If it happens again, have that same talk and let them know that if you can’t resolve this issue between you, you will need to speak to your manager.
  2. If the issue continues, take it to your manager. They can conduct an informal mediation to try to resolve the issue before it needs to be dealt with at a higher level.
  3. If your manager is unable to resolve this conflict, they may need to escalate it to Human Resources. And if for some reason it is not resolved or escalated then you may go through external pathways (such as your nursing union NPAQ).

TIP: Keep a record of the issues that you have with the person and any action you take to try to resolve this. This may come in handy if this person is one of the very few who need hospital policy to intervene before improving themselves.

Junior Cannibals

If staff below you in the hierarchy are banding together- then it is worth taking some time to reflect. Here are some helpful questions to consider:

  • Have I asked them for feedback individually? Sometimes people lash out when they are hurting. When a pack of upset nurses is startled, it is easy for the herd mentality to take over. Having an opportunity to sit down with them as individuals may be an opportunity for them to see you as human too. If the junior cannibals will not meet individually, (and you feel up to it) you could offer to meet with the pack- with a good plan on questions you want to ask and information you want to share. Junior cannibals sometimes unite as they fear that individually they are powerless and at risk of cannibalism themselves. You can allay those fears by actively seeking out their opinions and being gracious with their concerns.
  • What are their concerns? If we can identify what the concerns are, we are closer to resolving this conflict. If they have concerns, then maybe they have also identified answers or ideas as to how this can be resolved or at least improved.
  • What information can I share? If there is information that you can share with them to let them know what resources or other concerns have led to this outcome- it might help. It might help to humanise you, it might help them see that you are under pressure too and it might help both of you to come together and find a way to collaborate rather than conflict.

 

Nurse to nurse cannibalism hurts us all. It affects us personally and professionally as individuals, but worse- it is damaging to our profession and prevents us from delivering the highest quality of safe care. Nurses in survival mode can’t learn or process information. Cannibalism does not make individual nurses stronger it makes NURSING weaker. If we can’t retain the kind and noble people who have chosen to become nurses, we won’t have people to look after us when we need that care. In our profession, we are known for our compassion. It is time to extend that compassion to ourselves and each other.

 

The Nurses Eating Their Young series:

  1. Nurse Cannibals - Eating their young
  2. Nurses share their lunch (how to lift each other out of the cannibals pot!)
  3. Nurses Hosting Dinner - Protecting other cannibals from the pot
  4. Nurses FEEDING their young- the inevitable end to Nurse Cannibals

 

Authors

Tracy Churchill, Nurse Manager
Emma Versluis, Assistant Director of Nursing: Practice Innovation

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