I was a junior nursing student the first time I experienced the sting of humiliation from one of my nursing professors. My patient needed bed chucks, so I went to find the supply closet. I was wandering around in the hallway when my clinical professor summoned me to the nurses' station where staff nurses, physicians, and other students were congregating. "You look confused, Ms Ferraro," my instructor said mockingly. Everyone looked my way, at least it seemed that way. "I'm looking for the supply closet, I need some chucks," I explained. "Are they for you or your patient?" my instructor laughed, engaging her audience. I could feel the heat in my face as I stammered, "They are for my patient. I just need to know where the supply closet is located." She did not let up-"A junior nursing student that is not resourceful enough to find the supply closet on her own-now what are we going to do with you Ms Ferraro?" I wanted to disappear. I could feel the tears welling. Just then the nurse manager gently put her arm around my shoulder and led me toward the supply closet. Once inside, she pointed to the chucks, which I gathered under my arm. "Are you okay?" she asked. I nodded yes and returned to care for my patient. I will never forget this nurse's act of understated kindness.
Fast forward 40 years. At a Student-Faculty forum, a junior nursing student approached me to ask what she called "a sensitive question." "I don't mean to complain and I am a good student," she said signalling her caution.
We have a lab instructor that constantly humiliates and demeans us when we go to her for skills practice. She calls herself the "queen of mean." We are all trying so hard to do well and we pay a lot of tuition. Do you think it is right that she takes such pride in her nastiness and in treating students this way?
When I asked her to share the identity of the teacher, she refused. Humiliation is bad enough, but the fear of retaliation from a teacher who demeans is even worse.
Humiliation is a form of social control most often practiced in situations where one party has more power or status than the other. Teachers have power over students; managers have power over staff, and nurses who have worked many years may act as if they have power over new nurses. The tendency to demean another may be a learned behavior or part of the work culture. Those who demean have often been demeaned in the past by others. Furthermore, the work culture may be one of "survival of the fittest" where staff are often publicly challenged or demeaned to purportedly "get them to grow" through defending themselves and their positions. Those who survive this type of experience may feel perfectly free to replicate it. And so turns the vicious circle.
There is a sharp focus today on promoting healthy work environments, particularly for those in health care. Pearson and Porath1 assert that "bad behavior" in the workplace costs billions each year in turnover lost time, loss of reputation, and legal battles. The American Association of Critical Care Nurses (AACN)2 has intently focused on promoting healthy work environments for nursing and other clinical staff. The AACN2 Healthy Work Environment Web site provides tools to assess work environments, literature, and other resources documenting the effects of toxic work environments on patients and staff and strategies for developing and sustaining healthy work environments, where patients and families heal and staff member flourish.
Incivility and negativity are endemic in organizations. Yet, there is no excuse for behaving badly toward one another in the workplace or anywhere else. As an educator, I subscribe to Emerson's believe that the secret to education is respecting the student. Let's extend this notion to every environment in which we live and work. Self-respect and respect for others are key ingredients in promoting health and well-being.
-Gloria F. Donnelly, PhD, RN, FAAN, FPCP
Editor-in-chief
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