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Stopping the Bullying Cycle

Creating a safe environment for staff has been a personal and professional mission for one noted nursing leader.

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No matter how old you are there are still bullies in this world, but it is never too late to break the cycle.

In one of the most caring professions, it seems ironic that nurses struggle with bullying within their own field. One article states that 73 percent of new nurses reported being bullied in the past month (Berry, et al., 2012).

But new nurses are not the only ones feeling the heat and pressures from co-workers, experienced nurses still experience bullying.

No matter the reason behind bullying, the result is the same. Whether it is the "old eating their young" approach, a mix of low self-esteem or a learned behavior from a young age, bullying has a tremendous amount of negative consequences that do not just affect an individual but the entire healthcare industry.

Bullying can cause nurses to leave their profession, increasing turnover and destabilizing the patient care system and care process, which can ultimately put patients in danger.

Creating Change

Cole Edmonson, DNP, RN, FACHE, NEA-BC, CNO at Texas Health Presbyterian Hospital Dallas and Robert Wood Johnson Foundation Executive Nurse Fellow, has found that overcoming bullying and creating a safe bully-free environment has been a personal and professional journey for him.

"As a professional nurse, I feel I have a moral obligation to address issues and problems that I see in my profession," said Edmonson.

Edmonson has taken many steps to create an open, safe and positive environment in his work place. Some days it is obvious he is a CNO, while other days he blends into the environment wearing scrubs talking directly to his staff listening, asking questions and presenting himself as a leader in nursing who wants to help the staff achieve their goals.

Conversations With Cole

Edmonson believes the key to overcoming bullying begins by strengthening the individual and helping them to find their moral courage. This will help them stand up against the aggressors and be able to confront bullies in a professional but strong and courageous way.

"As an organization, it is critical that we have open dialogue about any bullying that occurs, that we have leadership support to prevent it through education and training as well as having a strong code of conduct policy including zero tolerance," he stressed.

He encourages an open-door policy because it is vital leaders are able to have unfiltered conversations with their staff. This is why he created "Conversations with Cole," which are lunch meetings that happen once a month with himself and between 35 and 40 staff nurses.

He asks the staff to come join him and share in discussions about professional nursing environments on a local and national level and how it can be improved. It is a time of openness and mutual respect where staff can feel safe and free to share concerns and ask questions.

Support the Anti-Bullying Cause

In his career, Edmonson has seen repeated incidents of work place bullying and incivility. He has taken actions and steps to address these issues at his own facility as well as at the national level by creating a website and a movement to end bullying through education, awareness and a symbol of civility wristband.

"How can this happen in the most caring, trusted and ethical profession in the nation?" he wondered. And so, he set out to make a difference and provide a network of support to fellow nurses from new grads to seasoned professionals.

Earn CE Credit!

Resolving Workplace Conflict

Conflict interferes with successful clinical outcomes, as well as with personal and professional satisfaction.

Edmonson created the website http://www.stopbullyingnurses.com/ because he felt as though there was no comprehensive resource related to healthcare on the issue of bullying.

It is a way for nurses across the country to share their stories, find support and join the movement to stop bullying.

"It was really an outgrowth of my passion for doing something about ending the silent epidemic among nursing that so many people don't even realize exists or do not want to discuss," he said.

STOP BULLYING NURSES! Noted nursing leader Cole Edmonson, CNO, Texas Health Presbyterian Hospital Dallas, is on a mission to end horizontal violence among nurses who can show their support by wearing the wristbands above available for free at www.StopBullyingNurses.com. ADVANCE thanks Cole Edmonson.

His hope is that nurses come to the website feeling safe to share their story, ask for advice or recognize someone who has stood up for them as a nurse. There are resources available to help confront bullying in their own lives and their work environment.

"Healthcare is a complex environment, one that is dependent on relationships and communication between providers in the most difficult and joyous of situations; bullying and incivility have the greatest potential to put that at risk and create unhealthy and dangerous scenarios for providers and patients," said Edmonson.

Seeing Red

On the website, red wristbands are available to make the commitment to end the bullying of nurses by nurses. It was created as a symbol to remind people not to bully, tolerate bullying or be a victim through a positive campaign reminding individuals in the profession that they can do something to change it.

The wristbands say "RN 2 RN" and "STOPBULLYINGNURSES." The wristbands are free and up to 10 can be ordered on the website.

Edmonson's cause was inspired by the words of Martin Luther King Jr., "Darkness cannot drive out darkness, only light can do that. Hate cannot drive out hate, only love can do that."

Taking these words to heart, Edmonson's website and anti-bullying campaign have created a safe haven for nurses, individuals who constantly care for others, but oftentimes neglect to care for themselves. By offering support to one another, they are not only protecting themselves, they are protecting the patients to which they have devoted their lives.

Elizabeth Adams is a contributor to ADVANCE.

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To the ER nurse who is being bullied by the CNO. Have you thought of reporting her to the state board for violating the nurse practice act? Review it and see if the behavior is not addressed. Since you have made attempts at correcting it and she has had those opportunities, it is now time to take the next step.Hope you have documented the behavior and have a paper trail to use as evidence.There is plenty of literature showing how the behavior negatively impacts quality of care and patient safety.

John Kauchick,  BSN,  TravelerNovember 30, 2013
various, MS



I have been the nurse manager of a rural ER for 30 plus years. The new CNO has previous "lateral violence" behaviors which were only controlled through threats of legal actions against her job. She is now exhibiting subliminal lateral violence behaviors to the ER staff. Do we have any recourse?

celia downeyMay 15, 2013



I would like to thank Dr.Edmonson for addressing the issue of bullying. There is absolutely no reason for perpetrating bullying, aggression, or violence within healthcare regardless of the complexities of the work environment.The change has to come from within and has to start now with each individual.

Barbara Jachimowicz,  APRNFebruary 08, 2013
Blackwood, NJ



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