A man walked past a few kids with a bucket of sea crabs. One of the crabs was crawling to the top of the bucket, so the man told the boys to get a lid. “Mister, you don’t know anything about crabs,” the boys said. “As soon as that crab gets to the top, the others will pull him right back down. Never fails.”
The expression “nurses eat their young” comes from this story, and it isn’t all that far from the truth. It might sound like your unit—where you feel constantly pulled down by your peers’ cutting remarks, backstabbing, and eyebrow-raising. Kathleen Bartholomew, RN, MN, author of Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other, speaks on why nurses can’t seem to help each other rise to the top.
RealityRN: What is the theory behind nurse-to-nurse hostility?
Kathleen Bartholomew: It’s called horizontal hostility, which is aggressive behavior (bullying, verbal abuse, and violence) directed at co-workers who are on the same power level. And it’s born out of a sense of powerlessness.
Studies show that nurses are typically seen as unequal in power to doctors—they are “oppressed,” so to speak. It’s called Oppression Theory. Nursing has never been considered an empowering profession. Since its inception, nurses have been considered handmaidens to the physicians in a male-dominated society. As a result, nurses assume the label and become unprofessional--cliquey, catty, mean-spirited, and intimidating, especially toward new nurses.
Why do nurses work against each other, rather than work together to improve their position?
Nurses remain silent because they are a powerless group without a voice, and they don’t feel safe. Ironically, this is why nurses eat their young. Seasoned nurses stick close together, and they keep everyone who’s different outside of the group. So new nurses show up, and the group doesn’t want to let them in. It’s a way for seasoned nurses to find power in a powerless position.
Also, when a nurse does speak up, she’s pushed out. I’m standing outside organizations because according to the theory, any oppressed group is going to kick out the person who draws attention to the group, even if their motives are good.
Why isn’t nursing recognized as an empowering profession?
Intellectuals and professionals don’t gossip. Smart people don’t sit around and talk about who did what. Doctors think that nurses are gossipy—and that reinforces that nurses are substandard.
Do the institutions where nurses work add to the problem?
Yes. In institutional situations, the voices that matter are usually from the top. This leaves nurses with very little power. Sure, there is the illusion of a union for many; however, the unions don’t have the same goals that we do. Their goal is power, and our goal is quality care.
If a union empowered nurses, educated the public about what nurses do, and did all those things that raise the self-esteem of individual nurses in the profession, unions would go out of business. So it becomes counterproductive for the unions to empower their nurses. Yet, here and now, unions still serve a purpose because nurses do not have the time or energy to come together, and even when nurses try to speak up (and few actually do), they are not being heard.
Where’s the hope?
The good news is that out of the chaos, there’s a chance to form something new. That’s what my work is about. Let’s look at the chaos, sift out what we want, choose our role and how we want our relationships to be, and next time we walk on the floor, let’s become that.
And if people on your unit refuse to change, you can refuse to work there. You don’t ever have to put yourself in a position where you don’t feel valued, recognized, or appreciated for all the gifts and talents you bring everyday to the floor.