The Nurse Bully: A Case Study in Gaslighting Rosemary A. Taylor, PhD, RN, CNL Assistant Professor University of New Hampshire PURPOSE THE ENACTOR Another second career nurse returning to the unit after a medical leave describes being relieved when this younger colleague offered to help her become familiar with some new equipment until she heard this nurse mimicking her in the break room. “Turns out they would give me the help and then run to somebody else that was a staff member and make fun of me. I was just having such a hard time and afraid to ask anybody questions.” Both nurses attempted to confront this individual about these incidents and were gaslighted, told they were mistaken in their understanding of the situation, were the problem, or were incompetent or mentally unstable. This caused them question themselves and their perceptions. The nurses who shared their stories did not refer to their colleague as a bully and did not recognize her actions as reportable. These nurses were unaware that other nurses on their unit had also been targeted. The purpose of the study was to investigate nurses’ perceptions of horizontal violence; the ways the phenomenon is recognized, interpreted, and described by nurses within the context of their unit, and to inform interventions to improve recognition of the phenomenon. The enactor, a nurse in her mid-20s who had graduated within the previous five years, appeared to single out older second career nurses for abuse and undermined the authority of the new nurse manager. Her pattern of behavior only emerged after hundreds of hours of observation and when nurse targets shared their stories during individual interviews. Her demeaning and verbally abusive interactions with colleagues were never reported. BACKGROUND Definitions of workplace bullying describe this form of aggression as an intentional act, targeting an individual on a daily or weekly basis, repeated over a period of three to six months. This case study illustrates how current definitions of workplace bullying would fail to capture the actions of one suspected nurse bully. METHODS This qualitative, descriptive study involved more than 120 hospital employees working within two inpatient hospital units in a hospital facility in the Northeastern United States. Data collection took place between June and November 2012 and included observation, document review, and semi-structured interviews with staff and administrators. Thematic analysis and abductive and retroductive inference were used. CONCLUSIONS & IMPLICATIONS Current definitions of bullying potentially hinder the accurate measure of prevalence of horizontal violence as assertions of intent can be diminished by gaslighting and plausible deniability. Results suggest resources be directed toward addressing the more frequent lower level aggressions committed by the unprofessional co-worker, as these behaviors are disruptive, affect patient outcomes and contribute to an environment where other aggressions are normalized, creating a smoke screen for bullying. THE TARGETS RESULTS One older second career nurse described an interaction with the enactor, a colleague she identified as a friend at the time. “I felt as though there was some sort of miscommunication going on between us, so I set aside time at the end of the shift to inquire and asked if we could talk on the way out to our cars.” She reports that as they were walking the colleague unexpectedly verbally assaulted her in “a barrage of name calling and blaming.” She described her response, “I felt like someone had died. My insides were ripped out. I had plans for after work, but instead I just went home and went to bed.” Analysis resulted in four themes (Taylor, 2016) and use of abductive and retroductive inference identified three types of enactors of horizontal violence: the pathological bully, the self-justified bully and the unprofessional co-worker (Taylor & Taylor, 2017). During the five months of data collection, only one individual potentially enacted bullying as it is most commonly defined; as repeated, aggressive acts, involving power and control over a target or victim (Einarsen, Hoel, & Notelaers, 2009). SELECTED REFERENCES Einarsen, S., Hoel, H., & Notelaers, G. (2009). Measuring exposure to bullying and harassment at work: Validity, factor structure and psychometric properties of the Negative Acts Questionnaire-Revised. Work & Stress, 23(1), 24-44. Taylor, R. (2016). Nurses’ perceptions of horizontal violence. Global Qualitative Nursing Research, 3, 1-9. Taylor, R.A. & Taylor, S.S. (2017). Enactors of horizontal violence: The Pathological Bully, t he Self-Justified Bully, and the Unprofessional Co-worker. Journal of Advanced Nursing, 73(12), 3111-3118.