Eating their young

I confess to being a little addicted to “HawthoRNe,” the hospital drama/soap opera in its second season this summer on TNT (it airs at 8 p.m. each Tuesday).

Like so many television dramas, it often strains the boundaries of believability. I’m not even sure why I keep watching it. Maybe it’s the fact that it’s one of the few current shows whose main character, Christina Hawthorne, is a nurse. Maybe it’s the feistiness that actress Jada Pinkett Smith brings to her role as a director of nursing at a troubled urban hospital. If I were a patient, I’d definitely want Christina on my side.

This season started out with the shutdown of the fictional Trinity Hospital in Richmond, Va. Christina and the gang have been transferred to the James River Hospital, where they all miraculously have been given jobs and have promptly encountered nonstop drama, romantic entanglements and internal politics.

There’s all kinds of subplots cooking away this season. Viewers need a scorecard to keep track. The one that really made me sit up and take notice, though, occurred in last week’s episode involving Kelly Epson, a naive and perpetually perky rookie nurse, and two of her nursing colleagues with whom she unfortunately keeps clashing. These two nurses have personalities that are about as pleasant as a nuclear waste dump, and they’re out to get Kelly. I found myself thinking, “Yeah, right, like real nurses would ever do that.”

Or would they? As it turns out, you bet your sweet life they would. Nurses even have their own expression for it: “eating their young.” It takes many forms: hostility, bullying, back-stabbing, sabotage, intimidation. New nurses in particular tend to be the targets of this aggression – and it’s very real, as the online comments on a nurse managers’ forum attest. One nurse who entered the profession in her 40s said her “first and only job was a nightmare!”

Another RN confirmed that “this lateral hostility is still alive and festering.”

It seems more prevalent in the critical care areas (maybe because these nurses are many times aggressive by nature). Many critical care nurses feel their knowledge level is above “floor” nurses and they look down on them and consider them inferior.

Why would nurses, who profess to be so caring, behave this way? One nurse observer suggests it’s because nursing is a high-stress profession in which frustration with working conditions tends to be redirected against colleagues. Theresa Brown, an oncology nurse who writes a column for the New York Times health section, describes in vivid terms how this happens (and be sure to read the comment thread for reactions to the piece):

Spending our shifts feeling pulled in an impossible number of directions, day after day after day, can in the end be too much. A lot of nurses find a way to regroup and stay, while some burn out and quit. But a few nurses will, like cornered animals, bare their teeth and fight back.

The problem is that they don’t fight back against the people who put them in the corner. These overwhelmed and angry nurses take their frustration out on the rest of us stuck in the corner with them, or on anyone – like interns – they perceive as being less powerful than they are.

Not all nurses are like this. In fact, I’d venture to guess the majority are not. I’d also venture to guess that many, if not most, workplaces would like to see this nurse-on-nurse hostility stamped out, not only for the sake of nurses but for the sake of safe patient care.

In the case of “HawthoRNe,” it seems, art is imitating life – in fictionalized, exaggerated fashion, perhaps, but with a kernel of truth behind it.

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