Faculty from the School of Nursing at the University of Michigan know the value of students making mistakes while treating patients, but when the patients aren’t real it’s a better scenario for everyone involved. This led to the building of a new state-of-the-art Clinical Learning Center which houses six simulation rooms with high-fidelity mannequins that act just like real patients, even capable of bleeding, vomiting, and giving birth.
Some students find the mannequins intimidating because of the things they can do, but they can’t deny the valuable skills they are gaining from the real-life issues being simulated. The mannequins can even simulate high-risk issues that don’t typically occur in a hospital setting, preparing students for how to react in emergency situations. The nursing school has a team of specially trained simulation instructors who sit behind a one-way mirror with screens in front of them, using wireless controls to prompt any possible physiological response in the mannequin.
The major benefit of learning clinical skills through mannequin simulations is that students can learn by trial and error without harming a real-life patient. Students remember the cases where they screw up, and learning from those simulations builds confidence and comfort when working in hospital settings. Many students don’t experience life-threatening or advanced care skills in their clinical rotations, but with mannequin simulations students can practice suctioning secretions from the trachea, electrically shocking the heart into starting again, and administering intravenous drugs.
University of Michigan is far from being the only nursing school that uses mannequin simulations in their curriculum, but they are the only school that allows all undergraduates, even first-year students, to take part in simulation training. Studies have shown that undergraduate students can replace up to half of their clinical hours with simulations without impacting a student’s ability to pass the nursing certification exam. After each simulation, students immediately go through a debriefing session to review what they did well and where they have room for improvement, simultaneously teaching students invaluable critical thinking skills.
Kathy Kump, RN, remembers the first time she was bullied. She remembers the intimidation and disrespect that accompanies such unwelcome acts as early as her first semester. Later, she would encounter it again at the beginning of her career, and even well into her professional journey as she entered into newer positions and ranks. Like many of her colleagues, Kump has been a victim of bullying as a nurse.
Unfortunately, bullying has become all too common in nursing. According to studies, 35% of workers in the U.S. reported having been bullied, while another 15% witnessed workplace bullying.
But there is hope. Understanding why bullying in nursing is rampant and what to do about it can help those effected get a handle on it.
“It Comes with the Territory”
Nurse bullying is so universal that it has its own expression. In 1986, nursing professor Judith Meissner coined the phrase ‘Nurses eat their young’ as a way to encourage nurses to stop bullying new and inexperienced coworkers.
Kump says there are many factors that contribute to the overall cause of bullying in this profession, but sadly the continuing and underlying theme has always been ‘it comes with the territory.’
“Certainly, many of the nurses who contributed to my own early feelings of ineptness or unworthiness as a new nurse most likely experienced the same ramifications when they began their nursing careers,” says Kump, director of nursing at Ottawa University. “Even more disturbing, this negative learned behavior seems to have evolved into a vicious cycle: comparable, in a broader sense, to that of hazing, which was once considered a ‘normal’ ritualistic initiation at some fraternity, sorority, or other group settings.”
The Who Behind the What
The foundational motivation for distinct behaviors of incivility and bullying in nursing may be a reaction to what may be perceived by the profession’s organizational “insecurities” and internal frustrations in the market place. For example, Kump says unlike other health care counterparts in the industry, nurses have struggled to find their “voice” as both a collective and cohesive group, and have grappled with defining their true identity.
Thus, it may be theorized that this superimposed “oppressed” perception contributes to an individual’s sense of powerlessness that may demonstrate itself with unkind words and actions toward others that are seen as less influential and more vulnerable.
“To put it simply and in a real-life context, a nurse may think the following, ‘I can’t take a lunch break because we are short-staffed today and since no one in upper management seems to care, I will take my frustrations out on that new nurse, Sara,’” says Kump.
Call to Action
Kump says whatever the causative factors may be, as long as the nursing profession continues to let this happen, and do nothing about it, it will continue to be a problem for generations to come.
For nurses who may be a victim of bullying, Kump suggests the following:
- Report it. Any incident in which an employee feels harassed, is made to feel uncomfortable in their workplace setting, and/or bullied should report this immediately to their supervisor. There should be a culture of zero-tolerance for bullying at every organization and all leaders should take this initiative very seriously.
- Keep composed and maintain the upper hand. Don’t lower yourself or stoop to the bullies’ level. If you feel comfortable and safe in doing so, calmly confront the bully by acknowledging and pointing out the negative behavior and asking them to stop.
- Be a role model: do not bully others. The negative cycle of bullying will only continue if its victims eventually become the victimizers.
The University of Michigan Board of Regents recently proposed to expand the nursing program to include a new Master’s Nursing Program starting in Fall 2016. The School of Nursing currently offers graduate programs in:
Acute Care Pediatric Nurse Practitioner
Adult-Gerontology Primary Care Nurse Practitioner
Clinical Nurse Specialist
Primary Care Family Nurse Practitioner
Primary Care Pediatric Nurse Practitioner
Health Systems, Nursing Leadership, and Effectiveness Science
Certificate in Health Informatics
Certificate in Nursing Education
Staff Nurse EBP Certificate
Doctor of Philosophy (PhD)
Doctor of Nursing Practice (DNP)
The new program would serve as a way for current BSN students to move forward in their education to MSN and DNP degrees. As planned, the program is structured to be practice-focused and hopes to prepare the next generation of nurse leaders and clinicians.