Doubling-down on the sorority mentality of nursing school

In the April 2011 issue of AACN's Critical Care Nurse, Susan Luparell suggests that nursing schools need to do more to weed out students with bad attitudes in order to transform the culture of incivility that exists in the nursing workplace.

This is exactly the wrong tactic to use to help nursing develop into a better profession. The assumption that the workplace should be free of interpersonal conflict is not appropriate for a workplace based on openness to enquiry and deference to evidence and reasoning over authority.

Based on my experience of school and the workplace, I would say that a minority of conflict is caused by "bad apples." The majority can be attributed to the stress caused by power imbalances and the desires to enforce or resist conformity. These are what I think of as the "sorority mentality" of nursing, and especially of nursing school, and they are real problems. But the way to deal with them is not to get rid of anyone who doesn't fit in, but to get rid of the idea that we have to like people we work with and to move away from the military model of hierarchies that have pervaded work and school in nursing.

Doubling-down on failed strategies

Although nursing educators want academics in other disciplines to think that nursing is a field on par with history, biology, etc, the reality is that nursing school is more like a cross between college and boot camp. It is part scholarship and part jumping through hoops created by instructors. The fact that nursing schools are accredited is irrelevant, as what exists on paper and in theory can be very different from the reality of school.

Every nurse who had her eyes open in school can tell you stories about students who were or were not cut from their program inappropriately because of instructor biases. This stress combined with the stress of having to meet higher academic standards than other university students is the main cause of poor attitudes among students.

Instructors have an enormous amount of power in nursing school, and the fact that their attempts to wield this power to mold the nursing profession have failed to create a civil working environment should tell us that this is a failing strategy.

Susan Luparell's recommendation does not recognize this fact and actually recommends doubling-down on instructor power. Like a gambler who is addicted to his game more than a winning strategy for wealth creation, Luparell is addicted to the idea that nursing instructors "create" new generations of nurses.

What the workplace needs for civility is more openness and less fear among both staff and management. Rather than asserting themselves more, instructors should facilitate this attitude by asserting themselves less and modeling the type of behavior needed in the workplace.