I took a good look at the last 2 volumes of Holistic Nursing Practice editorials and came to a startling realization. Instead of tackling issues related to how the nursing culture must change, I have addressed peripheral issues such as stupidity in health care, happiness, resilience, storytelling, and self-care strategies. I've encouraged you to empty your mind, focus on happiness, and walk the holistic talk, but my fear of explicitly exposing nursing negativity underpinned the pleas to change self and thus the culture. I wonder! Is not nursing the most trusted profession? And, if we are so trusted by the public, how negative can the culture of nursing be? With this editorial, and at least through the next 7 issues, I promise to tackle the issue of nursing culture head on-for good or bad.
It doesn't matter what you call it-horizontal violence, hostile work environment, incivility, bullying, relational aggression, emotions at work, or the dynamics of oppression-negativity in the nursing culture and health care workplaces is rampant worldwide and is prominently discussed in the nursing and health care literature.1-3 Too many nurses and nursing personnel regularly report that peers and managers treat them with a lack of kindness, respect, and courtesy, with unconstructive critique and scapegoating maneuvers. A few bullies or narcissists among a workgroup of nurses in any setting can perpetuate divisiveness and facilitate the sabotage of other group members or even the leader/manager. Negative behavior unleashed on others can also promote emotional exhaustion and personnel turnover. Ramarajan, Barsade, and Burack4 conducted a controlled study in which they tested an organizational intervention to enhance respect on nursing units in hospitals. They reported a significant decrease in the emotional exhaustion of certified nursing assistants on the units where the organizational intervention was used.
No matter the level of position or the work setting, that is, hospital, home care, or academia, we all have our personal stories about negativity in the nursing culture. I recall meeting a former nursing student who left her first staff position in 6 months because she "was treated so meanly by the older nurses that she could not sleep at night." There was the nursing laboratory manager who reported extreme discomfort at having to listen to the profanity and backbiting that regularly took place among members of a faculty committee and the nurse manager who was so verbally abusive to new medical residents that she was dismissed from her position.
There are many theories on the factors that contribute to negative work cultures as well as emerging strategies to promote healthier workplace environments. Manthey's4 list of self-prompts, Commitment to My Co-Workers, sits on my desk as a reminder that I am responsible for my own behavior in relationships with peers and staff. Manthey emphasizes the importance of mutual respect, direct communication, eliminating backbiting, bickering, and blaming from our communication repertoire, and letting go of grudges. Being a great caregiver takes energy and expertise. Dealing with negativity saps that energy. So let's all promise to improve our work environments by counting to 10 when we have an urge to let it fly and treating each other better. It is really that simple!
-Gloria F. Donnelly, PhD, RN, FAAN
Editor-in-Chief
REFERENCES