Hostile Work Environment

" He who joyfully marches in rank and file has already earned my contempt. He has been given a large brain by mistake, since for him a spinal cord would suffice." Albert Einstein

For a long time it was very difficult for me to look at these events. I would have to stop several times due to panic attacks. I had never had them until I had PTSD from workplace bullying at the age of 51.Enough time has passed that I can communicate what went on and how I felt and how I feel now. I am trying to focus on going forward. When I think about these issues I use to become paralyzed, now it spurs me to action.
Before I came to Nome I was the healthiest I had been since the early 1990s. I was taking some nutritional supplements that have helped a lot. I was doing lots of walking and I just felt good, I was very happy. I was taking trazadone and gabapentin which helped me with several different issues. I went to the clinic and the doctor I saw refused to give me the gabapentin. It is a very common medication and known to have very few side effects. I then contacted the psychiatrist who refused to see me stating he was only there for the native people. I tried a total of five times to see him. He always had excuses which did not make any sense. Later he said he was not just there for the native people, another time he said he could not help me, another he said he knew nothing about Aspergers Syndrome. I then said,"Ok then you can write the prescriptions for all the symptoms I take them for which have nothing to do with Aspergers. He just did not want any more patients or perhaps just me. I had been doing very well on those medications. I began to deteriorate physically and mentally from lack of this med. One of the travel nurses even went around and asked several doctors if they would write me a prescription as she knew it was a common and safe medication.
There is a definite hierarchy in the inpatient unit at Norton Sound Health Corporation. There is a core of permanent people who feel that their needs are to be placed above all others. This was true of the women, the two male nurses did not feel or act in this way. I had clarified many things with the manager of the unit before I moved there. I do not feel comfortable with children. I have absolutely no pediatric experience. I have not even any of my own children. After I had been here a while the clique(as we call them) started insisting I take care of children. This caused me a lot of stress. Now keep in mind they did not give me the pleasant pediatric cases, their goal was what we call "dumping" in nursing. They were making sure they would not have cases which had a difficult child or parent associated with them.
Before I came, I made sure I took Advanced Cardiac Life Support, which teaches the basic skills for saving a life in an emergency. There is a counterpart to this for children called Pediatric Advanced Life Support. I was promised several times over a two-year period that we would soon have this course. I even went to administration and explained that it is dangerous for us not to have it. This was promised on the telephone before I came to Nome. I was also promised I would receive training in Labor and delivery in Anchorage six months after I was here. She used every excuse she could while I was there to keep me from going. One nurse was sent two times during this time period.
The main abuse by the "clique" was they made assignments in a way that allowed them to not really work. They liked to sit in the break room and visit, get on the Internet and shop, leave the unit to go visit in other parts of the hospital, or talk on the phone for hours. My favorite was when someone would leave the unit to go get their hair done. I was quite shocked by that. They did not take patients which had incontinent stool or urine, were difficult to deal with, were busy, or had an infection. They would assign the patients with infections to other nurses and then refer to that nurse as "dirty girl." They used this bizarre excuse that they could not take these patients because they worked with babies and they might transfer an infection. This was how things were done in the 1970s. We now have Universal Precautions, wear a barrier if possible transfer of body fluids, wear gloves, wash our hands, use alcohol gel, and assume everyone is infected with something. I went to the manager and told her what they were doing. She would just say, "They are not supposed to do it that way," and then do nothing about it. She did announce one day after much complaining on my part that they were not suppose to call us, "dirty girl" anymore. I believe that was as a result of my going to the middle manager and complaining. The practice of manipulating to get out of work or avoid anything unpleasant is called "dumping" in nursing. Most of the nurses here are here because they could not work in a real hospital, most managers would get rid of them and the other nurses would not put up with their antics.
I always thought that after a period of time they would realize that I am a good nurse and stop treating me poorly. I waited a year and then went to the supervisor. I told her that since they used my lack of OB training to dump on me I wished to be OB trained. I called this practice,"playing the OB card". At this point she told me to start watching OB videos when it was slow. I did start this and as if they were jealous they would always come and find a reason to interrupt and get me back on the floor working. Later the supervisor made the statement that I was not watching the videos. I really was, I just had to bring them home to do it. She was not aware of what was going on enough to actually know which makes me angry.
There are two main players. One is a very sick codependent of an alcoholic and most people think she is also an alcoholic. She often came in with a swollen face and would have hand tremors. She is the type who is very functional, workaholic and very controlling. She is very nasty to the people she thinks are beneath her, but then acts even kind when anyone else is around to observe her. She is the laziest one in the group. She would bring me drug boxes back to the ER and would be shaking all over. Being autistic I could never tell if she was angry at me or in withdrawal from alcohol or something else.The other really sick one is an obvious anorexic who uses her small size to get attention. Everyone acts as if it is normal for a woman with severe cachexia to be working with them. I found that odd. She would stand in the nurses station and talk really loud to draw attention to herself and then shush people who tried to talk, very weird. She panics over everything. Normal nursing events such as a normal birth or a new admission do not generally cause anxiety. She would run around screaming and demanding that people do this or that. I would be utterly amazed at the chaos over nothing. They looked like the keystone cops. It stressed the other staff out and frightened the patients.

My long years in critical care trying to keep patients who were very ill yet very confused from pulling out tubes, ripping off bandages or climbing out of bed gave me lots of tricks. One day as was so typical a patient who needed fluid and IV antibiotics pulled out his IV. I knew I would get him, naturally, he would be difficult and time consuming. Night shift did not even try to put in another IV. I immediately did. His trick was to bite the IV catheter close to the insertion site. This is a very common event in nursing. I went and found a short piece of plastic tubing about 3 inches long. I padded the tubing with gauze so it would not poke his skin and slid it over the IV catheter. I put an arm board over the top of his hand and underneath it. I wrapped it with tape and then with Coban(vet wrap). This kept him from biting the tube in half and gave him layers to remove before he got to the IV and tried to bite it. It was harmless and allowed me to safely take time to take care of other patients knowing that he still had an intact IV and was getting the medical therapy he needed. In this situation you check the patient often and fix whatever damage he does and then leave him again.

Here is the thing that really burned me. They were too lazy to take care of a difficult patient, but then they would come in the room and make complaints about what I was doing. They were like jealous school girls. So, she called the manager who told her to call the doctor on call to come and look at it. The doctor came over looked at it and said."I don’t see the problem." He had an annoyed look on his face. I said to him,"She is as crazy as a bed bug". He said,"yea", with his look that he gets when people state the obvious. Another time I was watching a drunk patient in the ER. She came to give me a break. This was the typical belligerent drunk who would alternately also then became obtunded occasionally. The important thing to monitor is his breathing. I put an SaO2 probe on his finger which he would take off when his neuro status became lighter. This is a non-invasive device that tells us about the saturation of oxygen in the patient’s body and heart rate. My interacting with him made him more agitated as it usually does in these situations. I taped the probe which is just big enough to fit on one finger to his hand. She called the compliance nurse and they wrote me up for using a restraint without a doctor’s order. That is not a restraint by any definition. I believe she was giving me the break to look for something to cause trouble with.
There was a third nurse who was much more pleasant than these two, but she was more clever also. She made people think she was their friend when she really was not. After a while she got ugly and started to dump on me. If it was just me complaining, you could say I might be the problem. There were several nurses who came and left during the period of time I was there. There were screaming matches and many of them complained about the problems with the staff and the unsafe practices. The word bitch was used often. I had never seen nurses scream obscenities at each other before. There was a really good nurse practitioner they all assassinated politically and ran her off. They did not like her personality or the fact that she yelled at them to knock it off when they did their keystone cop imitations. She had to sell her house and leave Nome. There was a travel nurse who had a Master’s degree in maternal child nursing. They argued with her about nursing practices. Most of them have two year degrees. This nurse also was very intelligent and also has a degree in physics. They did not like her , of course not, she knew what she was doing. All of the nurses who have left can be contacted to verify what went on.
This hospital is so dysfunctional that I do not understand why they are not forced to change, sell or close. How the hell they passed a JACHO(organization that certifies hospitals) inspection I do not know. They hire middle managers in administration who are over nursing, but know nothing about it. That was just plain weird. We would all march to the new manager and tell her about the problems with the two serial bullies and their underlings and then after about three months all of them would leave. The manager of the inpatient unit would not allow a staff nurse to have a meeting with her supervisor unless she was present. I have a list of job openings I printed at one time from the job service center. They had openings for the director of almost every department, and several administrative positions including the CEO. What kind of a corporation advertises at the job service center for a CEO? They made life a living hell for the nurses and other staff. There is a member of the staff who says she ended up in a psychiatric hospital because she was so depressed over what was going on. After she got back the manager made an inappropriate comment about her psychiatric situation, which got back to her. In other words the manager was spreading malicious gossip and it was about all of the staff they were targeting. There is a CNA at the hospital who says she also ended up in a psych hospital from what they had done to her. Spreading false information among the underlings is how they get them to do their bidding.
I was their most favorite source of gossip. I would get phone calls on my day off from people telling what they were saying. Apparently their gossip would last for long periods of time and was particularly ugly when I called in sick. The manager’s style of management is what I can only describe as by gossip. All day they would go in and out of her office planting malicious gossip and then she would decide if she would act on it. She of course was a participant, but acted like she was not. It was a living hell. They really talked when male friends came by to give me fish. Oh, it was fine for someone to come by and give them a fish or anything else, but some how it was a sin if it happened to me. I just laughed about it at first because I thought they were pathetic and needed to get a life. I told a couple of people this must be the main form of entertainment in Nome.
One of the nastiest people was the compliance officer who instead of making sure the hospital was in compliance which it certainly was not came to the nurse’s station and spent most of her time. She listened to what everyone said and then she and the manager would go outside and smoke and discuss it. They went out to smoke constantly, as many as five times an hour(I counted). I could not see how either of them could get any work done. By the way, most of the nurses smoke and we all know they always get their breaks whether the rest of us do or not. Also because of this it is impossible to enter or leave the building without walking through cigarette smoke. They smoke just outside the door.

I could never understand why the compliance officer did not make sure we had the basic requirements. We did not have basic courses and continuing education. The hospital was and I am sure still is filthy. Equipment is not cleaned between patients. Nurses do not wash their hands. The nurse’s station is not cleaned. Normally, this is done daily. Usually it is expected in nursing that if you have a slow day you clean something like the medication cart well. I tried this one day and someone yelled at me. There was no alcohol gel outside the rooms as recommended by the CDC until just before I left. They told me they did not like it because it dried out their hands, good grief. I can assure you most of the nurses still never use it now. I always kept a bottle on the outside counter so could use it as I went by. They would move it often or hide it. These are issues that would freak out any real nurse. This compliance officer is the second serial bully.
Before I came to Nome I was told it would be possible for me to go on some medevacs. Now, understand I believed that meant I would be receiving extensive training and I saw this as a very good opportunity. I also believed I would go as an extra pair of hands, under the supervision of a flight nurse. What a joke! There are specific requirements for becoming a flight nurse. It takes a lot of training. Not only do you need to treat the patient in emergency situations there should be training about plane safety and emergency survival. I noted that only a very few people got to go, none of which had appropriate training. Most of them were obstetrics nurses which would be a good choice for a patient in labor, but nothing else. There were occasionally travel nurses who went on medevacs. I said to one I noticed was going frequently, "Who do I have to sleep with to get to go on a medevac?" She started laughing because I did not know she was sleeping with one of the paramedics and that was why she was going so frequently. I once had a travel nurse say to me,"They will never let you go because you do things the way they are supposed to be done." Another person who has lived in Nome a long time said,"You won’t ever go, you are too ethical." They posted a sign up list and everyone put up their names and then the EMS people called the same old people all the time, members of the clique. This created a lot of hard feelings.

They had a class for flight training and survival after I had been there a while. Only one nurse was scheduled to go to it. This is odd considering the cost of it. (Now, remember we are not getting the basic inservices a hospital would normally have) It was five days long. I was scheduled to work three of the days, but attended on my own without pay or any kind of recognition on my days off. The EMS department promised me some kind of certificate, this never happened. A friend of mine who was in the business for years and designs emergency aircraft rooms for VIPs, military medevac helicopter interiors, and the medevac helicopters for Barrow says the people they used are not recognized by the medical flight personnel organizations as appropriate for seminars. Of course he was stunned when I described the EMS in Nome.
I came on one morning and the night shift nurse in the ER told me the paramedic from the night before left her a medication box and told her to put it in one of the laboratory refrigerators. She knew that was not good due to infection and told him so. He said those boxes were so dirty it did not matter and left it. She had to store it in a refrigerator that was basically open to the public. He was supposed to take it back to the EMS department and lock it up. There were meds that could be dangerous if someone got into them in this box. I wrote this information in a note to my supervisor and also complained that he took over my work area to do his paper work keeping me from doing my work. He had other places he could have gone. It was odd. It was my intention that they would just ask him to stop his behavior. I guess he had other issues and got fired. This was never my goal and I felt bad. The medical director of EMS is a morbidly obese woman. Some of the people in Nome like her a lot because she prescribes a lot of narcotics. I had voiced that I thought it was a problem and sited what had happened with myself years before becoming addicted to prescription narcotics. She is actually a very poor doctor. She was very unpleasant to deal with and seemed to have contempt for nurses, especially good ones. She would put her very large body between the counter and the patient’s cart and then could not figure out why you could not get in there to work. I complained about her on multiple occasions to the manager who told me she treated everyone the same awful way. After that paramedic was fired, the EMS people were very ugly to me, especially this doctor.
When I started there were three native nurses. They ran them all off. They were horrible to one who was a new graduate and she was miserable. She would often say she hated NSHC and could not wait to leave. Yes, they dumped on her and she was having trouble coping. There was a very intelligent native woman who had also worked in an ICU in Anchorage. She agreed with all the things I complained about. As soon as she got pregnant and had an excuse she took a desk job. Her husband also worked for the hospital, she said as soon as her his contract was up they were out of here and I guess they are gone. The third one was on night shift. She is very outspoken and they started writing her up. She finally transferred to the clinic. Now NSHC claims to be a native corporation and they want to have 100% native staff. Yea, right. The nurses would say things to me like,"Come to the VFW tonight it is steak night and there won’t be any Eskimos there." Then I would say I did not come to Alaska because I wanted to avoid Eskimos and I mentioned the place would be full of cigarette smoke. This ticked them off.
After I put up with all of this and complained multiple times to the manager and went to the middle managers on multiple occasions I finally told the manager of the inpatient unit I was leaving. She told me I could train for the ER and then I would not have to work with the manipulating nurses. I should have left, but she told me she did not want me to leave. This was because she was not done trying to destroy me. I agreed to work in the ER and then did train with a nurse for two weeks(which, even for a nurse such as myself with a huge amount of experience is not enough for a new specialty). The nurse who trained me is an excellent nurse and human being. I got a lot of good information and training from him. He was never a part of the bullying. In fact when he would see someone being targeted he would go to bat for them in many ways. For two to three months I worked mostly in the ER and some on the regular floor. When the ER was slow, I would come to the floor and see if anyone needed help. Once they figured out I would do this they saved their most distasteful tasks for me and then started asking me in an almost demanding way to do them. I began coming down to help less. Then I think because I was in the ER these nurses who hated to work there suddenly became very interested in working there. The manager lied about what she said to me and back tracked her statements until I rarely worked the ER. I had been baited and switched. This is an easy thing to do to an autistic. I do not know if they were jealous or what was going on, it was very bizarre and goes to show how sick the whole unit was.
And then there are the alcoholics here in Nome. This is a very sad story and one of the reasons I became so depressed. We know that anywhere there are native people there is alcoholism and there should always be treatment available. The ER has two carts(guerneys). Some days the police would bring in three or four intoxicants. Of course some were very belligerent. It would take two police officers to get them there and then they would just leave them with the nurse. It isn’t an ER. It is a drunk tank. And then you may have up to three others. Most of the time it was two of them which I called dueling drunks. Trying to get one to cooperate and stay and then switching to the other. The police said they could not take them to jail as they did not have the staff and said they could only go to jail and they just have a prison. Yes, they actually said this. There is also a story told here in Nome about an intoxicated patient that died at the local prison. I guess one also died at NSHC, but I got written up for ensuring one had his respiratory status observed closely. It was always a difficult challenge trying to take care of a very sick patient in the ER with a couple of drunks running around and acting bizare. My favorite day was when I had two intoxicated men sing a rousing round of, "I don't know, but I've been told Eskimo ***** is mighty cold", while I had a little old lady who was very ill with her family around her. An article was written not too long ago by a brave reporter. It adresses the alcoholism problem in Nome. www.adn.com/news/alaska/rural/story/9291992p-9206481c.html.

I asked why BHS did not have an inpatient unit for treatment of chemical dependency. They said there use to be one, but they lost their funding and NSHC could not afford it. I checked the old newspaper stories. Norton Sound Health Corporation's board of directors decided to cut back on chemical dependency treatment years ago and it has steadily been declining. I wonder how much money they get when the drunks are brought to the ER. The BHS staff would also bring violent patients to the ER and just dump them with the nurse. One day they surrounded someone who was deemed violent with five people and walked them to the ER and then they all disappeared. And here is my favorite, BHS refuses to work with intoxicated people, it is a waste of their time I was told by the director of BHS at that time. Having intoxicated people brought to the ER and then discharged only to have them come back the next day or a few hours later caused me to become very depressed, angry and disgusted with the attitudes. I also have issue with the poor psychiatric care.
The whole village of Nome was set up to make money off of the alcoholic. There are way too many bars and liquor stores there. They make millions off of alcohol. I believe there should not be any alcohol sold here at all where there is such a large population of people who’s lives it will destroy. It is all about money. The state even refuses to help. I have called the governors office and complained, no response.

I came to Nome looking for a home. I met some wonderful people. I had some good friends at work. I will not use names of even the good people. I realize it could put them in a situation to be bullied. It was my hope to live there until retirement. For years there have been two serial bullies at Norton Sound Regional Hospital destroying one person after another. They have worked at putting themselves in a position of power. They control everything above them and everything below them. Nothing was ever done about the serial bullying done by the manager of the inpatient unit or the Risk Manager. I asked why the white people were running the native corporation's hospital. I asked why they treated the native people like they were second class citisens. I said,"Don't you think someone is embezzeling money, grants have been given and nothing came of them." I also wanted to know why the "clique" members of the staff got sent on "inservices" and stayed at really expensive hotels. One staff from BHS went all over Nome telling people the hospital put him in "the most expensive hotel in Seattle". I did not go anywhere for even one inservice the whole time I was there. She used several excuses, but others went in my place.

There is so much that went on, if you read about the tactics of the serial bullies on the websites I have mentioned you will get a better idea. It is very complex. When you are in the middle of it is very confusing. I would think they did not want me there and decide to leave. Then they would say how much they loved me and talk me into staying. One time she had me sign a contract to stay two more years for a bonus. This was just before the bullying got significantly worse.

There is a huge body of research that has been done on workplace bullying. There is a website from the UK that has an incredible amount of information about workplace bullying or as it is called when two or more work together to bully someone, mobbing, http://www.bullyinsight.com/. These are two from the United States, www.bullyinginstitute.org/ and www.mobbing-usa.com/. There are the last I heard thirteen states in which legislature has been written to make workplace bullying illegal. None of it has passed yet in this country. It is illegal in several other countries and many more are working on making it illegal.

Workplace bullying causes a type of Post Traumatic Stress Disorder called Complex PTSD. It is the same type of PTSD people who have been held captive get. This is because it has an element of not being able to leave the situation. Often people fear they will not be able to make a living. In my case I was in a village where there was no other hospital to work at. I felt very trapped. I did put in applications to transfer to other positions. I never even got a response about any of them and I am highly qualified for them all.

Workplace bullies are very sick people. They often have particular personality disorders and feel very inadequate. They go after people who have all the qualities they do not have. They believe they are making them look bad. The people they target always have similar qualities, they go to work to do the work, they are knowledgeable, competent, experienced, hard working, have a sense of humour, people like them, and more. When they make their targets sick with PTSD they then usually say what I heard at NSHC several times about several targets, "I am glad she is gone, she was crazy". I would usually say,"She was not crazy when she got here, something happened to her here that caused it". These comments also come from the other employees who are affected by the gossiping and lies spread about the target.

This process wastes the resources of the corporation. They hire and train personnel and then bully them out only to have to hire someone else and train them. At NSHC which is in a very remote area they have to fly the employee, sometimes their family, and pay a moving bonus. This is a huge amount of money per year. It costs the person who is bullied a lot because it is difficult to move your things when you live in the Arctic region. If the person who was bullied can not work because of PTSD they have lost their income. If they apply for Social Security Disability it takes months and in some cases years to finally receive the benefits. They are forced to live at poverty level. The bullied person often looses everything they own. This is also a huge cost to society. People who are bullied are usually very skilled, hard working and competent employees. This is why they are targeted. Not only does society loose what they could have contributed, they also loose financially because this person now has PTSD and the government issues them a check every month.

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