I remember standing in line in sixth grade waiting to leave the cold, lonely cafeteria to go back to class. I looked at the girl’s folder in line ahead of me and on it was written, “We Hate Rachel Club.”

I had sat alone at lunch that day. Every table I went to seemed full and other students were unfriendly, acting as if there was nowhere for me to sit. Sometimes one lunch table would start a chant and students at other tables around me would shout, “We Hate Rachel! We Hate Rachel!”

My experience is not unique.

According to the U.S. Department of Education, 20.8 percent of all students between 12-18 years old are bullied.

More than 13 percent report they are made fun of, called names or insulted.

Over 12 percent say they feel they are the subject of rumors, while 3.9 percent are threatened with harm. More than 5 percent are pushed, shoved, tripped or spit on, and 5.0 percent are excluded from activities on purpose, and close to 2 percent have property destroyed.

These statistics are staggering when the sheer numbers are considered.  Out of 24,243,000 students queried in this report, the 13.3 percent means 3.2 million kids.

And sometimes the bullying of children and teens results in suicide, called a “bullycide.” Recently, Ashwanty Davis, a 10-year-old in Aurora, Col., committed suicide following her own bullying and abuse that was caught on video and shared on social media.

Obviously, my experiences were not at this level, but they still had a lifelong effect.

I did not tell anyone at home about the hate club named after me until a few years after it appeared. As a 12- year-old, I didn’t know if it was normal, if there was something wrong with me or when it would end. The same girl who started this club in sixth grade badgered me throughout high school. She wrote “Lardfest” on my locker.

Though that was decades ago and I am a successful director of ambulatory nursing at a major hospital system, still, to this day, there are times when I worry I am an annoyance, where I feel insecure to speak up or when I feel crushed by seemingly insurmountable unhealthy politics and interactions.

The experience of being bullied and the deep pain that comes with it can be the motivation to do and behave differently.  Being kind and promoting kindness helped me to diminish the pain over time. It made me want to be a champion for invisible voices, for healthy and respectful behavior and to equip the under empowered with tools that improve outcomes that matter to them. I chose my profession in part because of my own experiences.

I know that I became the leader, nurse, mother, and friend because the women in my life showed me the strength of their influence was bigger than the abuse I suffered. My journey as a nurse has been buoyed by strong, professional nurse leaders who have mentored me at each step.

By the time “Lardfest” happened in high school, I was spending time singing and writing, thanks to the encouragement of teachers and family to embrace my strengths.

My mother taught me to focus on my talents, see the good in others and lead out of compassion.  She helped me to see that I had a choice—to be fearful and kept down, or to move ahead. My grandmother led initiatives in the community, showered praise on me and always told me I was exemplary, smart and talented. I had wonderful teachers who helped to bolster my confidence.

I know that parents, educators, and community can shift the effects of bullying.

Stopbullying.gov states, “Solutions to bullying are not simple. Bullying prevention approaches that show the most promise confront the problem from many angles. They involve the entire school community– students, families, administrators, teachers, and staff such as bus drivers, nurses, cafeteria and front office staff– in creating a culture of respect.”

Bullying doesn’t end with adolescence.

Adults can also be bullied particularly in healthcare and the medical profession. The National Health Service in Great Britain recently reported that 25 percent of doctors have felt bullied, harassed or subject to abuse within the last 12 months.

These findings have spurred a national initiative in Great Britan, “Let’s Remove It,” seeking to provide education, awareness, and pathways for reporting bullying and abuse. “Bullying harms your profession and your patients,” according to the site. “We all have a role to play if we want to change the culture of the surgical and dental workplace.”

Similarly, in the United States, the American Nurses Association has taken a significant stance on incivility, bullying and workplace violence. With the creation of a toolkit, resources and continued advocacy to legislators related to regulations on healthy culture, the ANA is pushing forward with this important agenda understanding that a healthy culture for caregivers means better outcomes for patients.

The American Association of Critical Care Nurses recently issued the report, “Standards for Establishing and Maintaining Healthy Work Environments,” laying out simple elements to help any organization refocus on this important aim.

Compassion and respect towards each other have always been linked to the environment created for the care of patients. Without it, a nurse or physician may forego asking an important patient safety question putting the patient at risk. Lack of respect can lead to burnout for the caregivers.

My role as a nurse has been largely connected to the creation of healthy work environments, because I know what an unhealthy environment feels like.  I remember.

Education and awareness of bullying, as well as the teaching of kindness and open communication, can have an important effect on the bullied, the bully and the outcome at any age. The violence can be made small by a larger relationship. The pain can be diminished with healthy behavior—for children and adults.

That is the hope in all of this.

Rachel Start is the director of ambulatory nursing, nursing practice and magnet performance at Rush Oak Park Hospital, and is former co-chair of American Academy of Ambulatory Care Nursing. She is a Public Voices Fellow through The OpEd Project.

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