A work environment where people are waiting for you to fail can be a reality of the nursing profession.
Research by Chelsea Willmott, of Wanaka, shows nurses can face a “passive-aggressive” environment.
“Nurses eat their young”, Mrs Willmott said.
An “invisible power jacket” where knowledge is used as a tool of oppression can begin as early as nurses starting their year one clinical rotations.
Mrs Willmott is an academic lecturer at the Otago Polytechnic School of Nursing in Dunedin.
Part of her role is looking after students who are in Central Otago and the Lakes District and for the past three to four years has had about 120 students a year.
She is also completing her own nurse practitioner internship in Queenstown, as well as working in general practice and emergency.
Mrs Willmott will be speaking at the Goodfellow Symposium taking place in Auckland on March 28-29 about her research on workplace culture change and horizontal violence in healthcare.
Rural nurses in particular were faced with limited ways to improve the situation.
It could take time to gain a position, including waiting for people to retire.
“When that happens and you can’t change jobs as easily as you want to, it brings a different dynamic to your role.”
Healthcare had a hierarchical system that placed consultants at the top, then doctors and junior doctors, she said.
Nursing over the years had assimilated this culture.
“We have a very similar ranking to medicine.”
There was a power struggle between doctors and nurses, but there was also a culture within nursing to “rip people down”, Mrs Willmott said.
“Typically in a hierarchy environment you would see knowledge being the thing that is valued the most, that gives you the most status, knowledge and experience.”
Knowledge was carefully guarded and only a minority were willing to share it with more junior members.
Nurses with less experience and knowledge were vulnerable to being treated in a passive-aggressive way.
An example might be to increase the workload of a more junior person beyond their skill set “and the senior people are just watching to see how you cope”.
“A kind of baptism by fire or waiting for you to fail.”
A junior nurse asking a question of someone senior could face an unfavourable response, she said.
“Often people rip people down in that situation in front of other people.”
These internal dynamics had the potential to be detrimental to patients.
“Because if you are a junior nurse, and you notice that something is wrong with this patient, you’ve got to have the courage, and the skills and the voice to be able to go up to the senior and say, I’m really worried about that patient’.”