Week 7 Collaboration Café
When I was a RN in a Primary Care Clinic there was a clique of other RN’s. They were
nicknamed the “Mean Girls” and were bullies of the department. They purposely withheld
information from other nurses to make the nurse look bad. They would only help each other with
tasks and if asked for help by any nurse outside of their group they would refuse. Any form of
communication with this group of nurses came with eyerolls and condescending tones and
statements. One of the nurses approached me one day and stated, “I just want you to know that
no one in this clinic likes you. In fact, your own doctor even hates you. If you think anyone is
your friend here, you are very wrong.” She then proceeded to walk away.
I was blindsided by the statement and extremely hurt. I left for lunch and while on lunch called
my boss told her what had happened and that I was not coming back, in fact I’m quitting. My
boss told me to take the afternoon off and come back in the morning. I did go back, but my time
there was limited as I moved to another department. I was going through a divorce at the time
and this incident drove me into deeper depression. I had panic attacks daily when going into
work. I know my performance as a nurse decreased because I was always on guard and
wondering what the Mean Girls were going to say to me or do to me. I lost trust in my co-
workers and the provider I worked with, because at this point, I did not know what was fact or
fiction.
I was not the only one attacked like that and it divided the clinic even further. Management tried
hard to intervene and make the work environment better, but ultimately would not punish or get
rid of the Mean Girls due to short staffing. Multiple nurses left the clinic. All of the above
actions directly impacted patient care. Because of lack of teamwork medication refills were late,
phone messages were not returned in a timely manner, and test results were delayed. The
constant staff turnover cost the hospital extra money. The patients would comment on the tension
they could feel in the clinic. It was a toxic environment instead of a healing environment.
Healthy work environments are associated with improved nurse satisfaction and retention as well
as positive patient outcomes. One way this situation in the clinic could have been prevented is by
setting Standards of Care for a Healthy Work Environment. The American Association of
Critical-Care Nurses (AACN) has an initiative for the Standards for Establishing and Sustaining
Healthy Work Environments (HWE). The 6 HWE standards are as follows: (1) skilled
communication, (2) true collaboration, (3) effective decision-making, (4) appropriate staffing, (5)
meaningful recognition, and (6) authentic leadership. During the COVID-19 pandemic, intensive
care units (ICUs) that adhered to even 1 HWE standard produced more resilient and satisfied
nurses who were less likely to leave the profession (Williams et al., 2023). Another study by
Kester et al. also showed that by implementing AACN HWE strategies in an ICU, nurses who
work in healthy environments stay in their jobs longer; moreover, they experience less moral
distress and deliver higher-quality care (2021). The tenure rate increased in this study and the
turnover rate decreased. Individual coach and counsel sessions could have been conducted with
these employees as well to reinforcement that bullying and negative behaviors in the clinic will
not be tolerated and will result in discipline and possible termination.
When I was a RN in a Primary Care Clinic there was a clique of other RN’s. They were
nicknamed the “Mean Girls” and were bullies of the department. They purposely withheld
information from other nurses to make the nurse look bad. They would only help each other with
tasks and if asked for help by any nurse outside of their group they would refuse. Any form of
communication with this group of nurses came with eyerolls and condescending tones and
statements. One of the nurses approached me one day and stated, “I just want you to know that
no one in this clinic likes you. In fact, your own doctor even hates you. If you think anyone is
your friend here, you are very wrong.” She then proceeded to walk away.
I was blindsided by the statement and extremely hurt. I left for lunch and while on lunch called
my boss told her what had happened and that I was not coming back, in fact I’m quitting. My
boss told me to take the afternoon off and come back in the morning. I did go back, but my time
there was limited as I moved to another department. I was going through a divorce at the time
and this incident drove me into deeper depression. I had panic attacks daily when going into
work. I know my performance as a nurse decreased because I was always on guard and
wondering what the Mean Girls were going to say to me or do to me. I lost trust in my co-
workers and the provider I worked with, because at this point, I did not know what was fact or
fiction.
I was not the only one attacked like that and it divided the clinic even further. Management tried
hard to intervene and make the work environment better, but ultimately would not punish or get
rid of the Mean Girls due to short staffing. Multiple nurses left the clinic. All of the above
actions directly impacted patient care. Because of lack of teamwork medication refills were late,
phone messages were not returned in a timely manner, and test results were delayed. The
constant staff turnover cost the hospital extra money. The patients would comment on the tension
they could feel in the clinic. It was a toxic environment instead of a healing environment.
Healthy work environments are associated with improved nurse satisfaction and retention as well
as positive patient outcomes. One way this situation in the clinic could have been prevented is by
setting Standards of Care for a Healthy Work Environment. The American Association of
Critical-Care Nurses (AACN) has an initiative for the Standards for Establishing and Sustaining
Healthy Work Environments (HWE). The 6 HWE standards are as follows: (1) skilled
communication, (2) true collaboration, (3) effective decision-making, (4) appropriate staffing, (5)
meaningful recognition, and (6) authentic leadership. During the COVID-19 pandemic, intensive
care units (ICUs) that adhered to even 1 HWE standard produced more resilient and satisfied
nurses who were less likely to leave the profession (Williams et al., 2023). Another study by
Kester et al. also showed that by implementing AACN HWE strategies in an ICU, nurses who
work in healthy environments stay in their jobs longer; moreover, they experience less moral
distress and deliver higher-quality care (2021). The tenure rate increased in this study and the
turnover rate decreased. Individual coach and counsel sessions could have been conducted with
these employees as well to reinforcement that bullying and negative behaviors in the clinic will
not be tolerated and will result in discipline and possible termination.
