Dr. Renee Thompson: How to Best Work With a “Crusty” Nurse

Dr. Renee Thompson: How to Best Work With a “Crusty” Nurse

This post is part of a series of posts on nurse bullying and conflict in the workplace written by Dr. Renee Thompson, DNP, RN, CMSRN. Dr. Thompson is one of the top professional development and anti-bullying thought leaders in nursing.

Jackie, a new nurse, was warned about the group of older nurses who worked the night shift. They were known to be rough and a bit “crusty.” As Jackie went through orientation, she grew to dread giving them report, interacting with them, or working the same shift. In their eyes, Jackie couldn’t do anything right. They picked on her, were tough on her, and always made her feel like she was stupid.

By the time Jackie completed orientation, she concurred – they were rough and crusty.

“Crusty” nurse description

Crusty nurses are not openly warm and friendly. They tend to glare and stare at the new employees, and rarely offer any words of encouragement or support. Crusty nurses are generally older and love to talk about how bad it was back in their day. Every statement starts with, “You don’t know how good you have it. Back in our day…” Although extremely knowledgeable and clinically competent, they aren’t always professional.

Crusty nurses can be really hard on the new nurses. Sometimes it’s because they think by being hard, they are helping (hazing) but sometimes it’s just because they want to squash them (bullying). Learn more about the difference between hazing and bullying by clicking here.

On the outside, crusty nurses are rough, tough, and hard to chew. On the inside, crusty nurses may just want to be respected, valued, and acknowledged.

Strategies to soften a crusty nurse

  1. Acknowledge them – don’t hide from them. By hiding from them, you are actually making yourself more of a target. They won’t have the opportunity to get to know you, therefore, they won’t include but rather will find reasons to exclude you.  It’s actually better to spend more time with them – not less. By spending more time with them, you are acknowledging them and at the same time, demonstrating that you’re not afraid of them.
  2. Validate their experience and knowledge. These nurses want to be respected for “time spent in the field.”  Validate them by asking questions about what it was like when they were new. Ask about their scariest, happiest, and most heartbreaking moments. Be interested in them and what they’ve been through. By demonstrating interest, you’ll validate them.
  3. Ask them for advice. These nurses actually have great wisdom and advice to share with others. They just don’t always act like it. Ask them for advice in this way, “If you were me, how would YOU handle  _____________.” 

Remember, although they may appear crusty on the outside, many of them are actually soft on the inside.

Disclaimer – now, not all crusty nurses are actually soft on the inside. Some are crusty through their core and the strategies above will not work on them. However, why not try these strategies? If it turns out that they are really hard inside, at least you will send them a message that you are not insecure, not passive, and not afraid of them.

Back to Jackie – after six months, Jackie had the opportunity to work with one of the crusty nurses during a very difficult patient crisis situation. She was amazed at how this nurse handled the situation and how she showed admirable compassion to the family. For the first time, she saw this “crusty” nurse through different eyes. After the incident, Jackie started asking this nurse for advice and frequently sought her guidance regarding complex clinical situations.

Over time, Jackie developed a good relationship with her and the other older nurses (well, truth be told – most but not all). Once she acknowledged and recognized their knowledge, experience and skill, all of a sudden, their outer crust melted, which exposed their true inner soft side.

Don’t always assume that a crusty outer shell reflects what’s inside – after all, you should judge a book by its cover. Thanks for reading. Take care and stay connected. 


Dr. Renee Thompson is a keynote speaker, author, award-winning nurse blogger, and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate workplace bullying. To find out more about Renee, please visit her website. American Sentinel University friends and family can get 25% off Renee’s great anti-bullying products – simply enter in the code: AMSENT16.

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