Friday, July 05, 2013

Nurses and the Scourge of Hostility

My last two posts about nursing and nurses here on Digital Doorway have garnered a great deal of attention and commentary. Nurses indeed want to feel respected, and it appears that the general consensus is that we basically don't respect each other. Where does this hostility originate?

The aforementioned blog posts--"The Nursing Class Hero" and "The Three R's of Nursing"--delved into notions of class, respect, remuneration and recognition, and it seems that many readers resonated with those ideas. And it also appears that the negative ways in which nurses interact with one another is often at odds with how we would like to be viewed and treated by others.

In "The Three R's of Nursing", I wrote:
With rampant nurse-to-nurse bullying (also known these days as "horizontal violence"), I wonder how nurses have managed to internalize so much oppression that they consistently turn on one another. This is a sad state of affairs, and I call on all nurses who want to be respected to say no to the culture of bullying. We need to stand up to bullies, call them on their b*lls#*t, and demand that bullies be removed from practice. We can respect ourselves more if we stand up to those who disrespect us.
These days, it seems that there are factions within our profession who would retain the old ways, the outmoded behavioral norms, hanging onto a vision of days past when new nurses were indoctrinated into nursing in a fraternity-like atmosphere of intimidation, passive-aggression, open hostility and tit-for-tat baiting.

Internalized Oppression?

According to the Urban Dictionary, "internalized oppression is the process by which a member of an oppressed group comes to accept and live out the inaccurate myths and stereotypes applied to the group".

An article entitled "Healing From the Effects of Internalized Oppression" states the following about oppressed groups:
When people from targeted groups internalize myths and misinformation, it can cause them to feel (often unconsciously) that in some way they are inherently not as worthy, capable, intelligent, beautiful, good, etc. as people outside their group. They turn the experience of oppression or discrimination inward. They begin to feel that the stereotypes and misinformation that society communicates are true and they act as if they were true.
Thus, I would hypothesize that nurses have, by and large, experienced oppression (often by physicians) over the course of the development of our profession, and our collective internalization of that oppression has caused many of us to turn our sights on the most vulnerable among us, making new and novice nurses frequent targets of such horizontal violence.

Additionally, media portrayals of nurses haven't helped in terms of developing and maintaining our professional self-esteem. Such images (and the public's limited understanding of who we are and what we actually do) continue to skew our collective self-image, simultaneously causing that old internalized oppression to rear its ugly head, bleeding into our relationships and the ways in which we treat each other. 

Champion the Cause

One way to counteract the scourge of hostility, internalized oppression and horizontal violence within the nursing profession is for each of us to champion the cause in our own professional lives.

How we treat one another on a daily basis has a ripple effect far beyond the original interaction. When we treat one another in the ways in which we'd like to be treated (with kindness, respect, compassion and patience), we're actively modeling the behavior that we wish to see. The ripple effect thus begins with each individual.

Hostile workplaces foster hostile, unhappy workers and relationships, so if we infuse our workplaces with compassion and respect, negative behaviors will no longer be so easily tolerated, and those who thrive on projecting hostility will lose their ability to target others and propagate their negative emotions (and internalized oppression).

Start Within

External change can begin with an internal shift in consciousness. Thus, every nurse who wishes to see a different world around them can begin with his or her inner landscape. Feeling oppressed, bored, victimized or otherwise unhappy can certainly have an effect on our own external experience, so fostering self-awareness is one key to making our inner and outer worlds more parallel.

Watching our own thoughts and monitoring our feeling states are important actions when it comes to changing from within. When we're more aware of how we feel and how we think, we can change our thoughts, feelings and beliefs more easily.

Having said that, there are very self-aware and healthy nurses who work in unhealthy and toxic workplaces despite the "inner work" that they do. Some environments are simply too toxic for us to change, thus continued self-awareness can often lead to healthy decisions, including leaving a toxic workplace and seeking out healthier venues where our expertise and professional skills are respected and welcomed.

Your inner work will help you to see your workplace and professional life more clearly, and positive changes within your workplace will also impact your inner landscape. Maintain awareness of both, protecting yourself from hostility by learning to counteract it. And when you can't counteract it and there's no change on the horizon, perhaps you simply need to move on.

All Hands on Deck

The scourge of hostility won't change just from our inner work alone, but it also won't magically change because our workplace decides to hold a single workshop on bullying. The inner work and the outer work go hand in hand, and neither will be completely successful without the other.

It takes a long time (and great patience) to turn a large ship around and change course. There are many of us calling for change within the profession, and many hands are now on deck in an attempt to shift course. Critical mass is needed, and I believe a sea change is in the air as our profession begins to move in a new collective direction.

Invite your colleagues to join this collective vision of a healthy, vibrant profession that rejects hostility and fosters camaraderie. And as more and more of us join the struggle, those wed to the old paradigm of negativity will abandon ship, leaving those of us courageous enough to steer ourselves towards happier and more satisfying waters.

Moving Forward

If those who resist change can't embrace and accept the new vision of nursing that we offer, let them populate some isolated island where they can't harm anyone but themselves, and we'll leave them in our wake as we move forward.

Meanwhile, some will realize that a healthy and vibrant profession is our right, and they'll join with us in creating change. Others will simply cling to the past. We can't change them all, but we can offer them life preservers as we forge ahead with our new vision.

Personally, my feet are firmly planted on deck, and I'm ready to welcome others who share my vision of a changing profession that's ready to embrace a healthy future that's free of violence, hostility and internalized oppression.  Won't you join me?
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