Dr. Renee Thompson – From Oppression to Reflection: Freire’s Solution to Nurse Bullying

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.

Hospitals should be safe havens for employees and patients, not places where unprofessional behavior, such as intimidation, insulting, cursing, and sabotage occur. In 2008, The Joint Commission mandated that healthcare organizations develop codes of conduct that specifically address workplace bullying. Requirements include educating staff regarding professional behavior, holding individuals accountable for behavior, instituting “zero tolerance” for disruptive behavior, and documenting attempts to address bullying.

Workplace bullying has been linked to intent to leave, poor patient outcomes and poor productivity. Estimated costs are $30,000 to $100,000 per year per individual and if it’s a specialty nurse, the costs increase to $145,000. We are hemorrhaging really great nurses to these problems.

Yes. We know that workplace bullying is a problem. But is it a new problem? The answer is no. Humans treating humans horrifically has been documented since we began walking upright. I’m sure there is a caveman drawing somewhere depicting bullying behavior. Although I’d like to believe we’ve evolved a bit since the caveman era, humans treating humans badly still exists.

The nursing profession is not immune to this behavior. Bullying just seems more perverse in a profession dedicated to caring and compassion. Like an oxymoron – they are at opposite ends. Caring and bullying should never co-exist! It just doesn’t make sense. How can nurses, who are equals, pick on each other? Isn’t nursing challenging enough without having our own peers making it worse?

I just don’t get it. Neither did Dr. Paulo Freire, a sociologist, who spent time in various countries observing human behavior. Dr. Freire witnessed people oppressing each other – peers oppressing peers. Not administration/government oppressing the people. In his famous book, Pedagogy of the Oppressed, Dr. Freire offers us a solution to oppression by taking an in-depth look at the dynamics between the oppressor and the oppressed. I took the liberty of adapting his recommendations to nurse bullying.

Bully-proofing “Freire-style”

Freire suggests the following steps for the oppressed (target of bullying):

  • REFLECT: Reflecting is the ability to analyze our own behavior and the behaviors of others in an objective way. If you find yourself in a bullying situation, spend time in deep thinking about the situation. Increase your awareness of your behavior and the behavior of the your oppressor. Can you identify patterns and triggers? What is your reaction when the bad behavior occurs? Pretend that you are an observer who bears witness to bullying attacks. What do you see?
  • PRAXIS: This refers to skill development. The ability to stop the oppressor requires enhanced communication skills, an understanding of human behavior and the ability to then apply that learning into practice. Dealing well with nasty people isn’t intuitive. But the good news is that communicating in a way that decreases the bully’s power over you is a skill that can be learned. 
  • REHUMANIZE YOURSELF: It’s time for you to stop allowing other people to make you feel terrible about yourself. Stop giving power to the oppressor. Think of yourself as Norma Rae! Even if you have to stand up on a table and shout, “I’m not going to take this anymore!!!” Believe that you deserve to be treated with respect as a human. Believe that you deserve to work in a supportive and nurturing environment. Believe that you are a good nurse! My favorite quote of all time is from former First Lady, Eleanor Roosevelt, “No one can make you feel inferior without your consent.” Stop giving the bullies power over you.
  • REHUMANIZE YOUR OPPRESSOR: What?!? Be nice to my oppressor? Yes. Remember, kindness begets kindness. While I’m not asking you be buddy-buddy with the bully, I am asking you to treat others (even the bullies) with kindness, compassion, and respect. Someone has to demonstrate that humans have evolved since the caveman era. It starts with each one of us. Another one of my favorite quotes speaks to re-humanizing your oppressor, and comes from Dr. Martin Luther King, Jr.,“returning violence for violence multiplies violence, adding deeper darkness to a night already devoid of stars…hate cannot drive out hate: only love can do that.” Nurse bullying happens because it can. It’s up to each one of us to do our part to stop the cycle of bullying. In the words of the late Paulo Freire, “No one is born fully-formed: it is through self-experience in the world that we become what we are.” 

Let’s make this world a better place! Thanks for reading, take care and stay connected!

-Renee