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Incivility and bullying of new graduates

By: AJ Cook

Together we can bring about change.

Bullying and incivility are all too common in nursing and continue to drive new graduates from the profession. Although great strides have been made in providing support to new graduates through mentorship, beginning from the time a student enters a nursing program all the way to retirement, more work must be done to demonstrate our code of ethics in our professional relationships.

Many reports and studies indicate that the problem of bullying and incivility begins before nurses enter the workforce. The National Student Nurses’ Association’s (NSNA) recent study of nursing students and faculty shows that bullying continues to be prevalent in pre-licensure nursing education. The need to foster a culture of respect and demonstrate the values of a role model by upholding ethical behavior should begin from acceptance into a nursing program, according to the recent report, “Answering the call to the profession” by Van Der Wege and Keil in the Kansas Nurse.

The American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements echoes throughout clinical practice, educational institutions, and within the heart of the NSNA Code of Ethics (Code). NSNA believes in forming professional values from the time students first begin their education. The Code is the core foundational document that provides guidance to students as they develop critical thinking and clinical decision-making skills. The first half of the Code focuses on the expectations of nursing students in professional organizations and academic and clinical settings. The second half concentrates on protections for students and helps to create an open learning environment. Together, the ANA and NSNA codes of ethics introduce students to the moral principles and standards of behavior required of them as future nurse leaders.

Mentorship is a lifelong responsibility based on wisdom and experience that helps bestow knowledge and confidence among new graduates. As nursing students graduate and enter the workforce, they rely on the mentorship and support of practicing nurses and nurse managers to help them interpret and implement the ANA Code of Ethics into daily practice. Every day we are faced with ethical dilemmas that, if not addressed, persist and intensify. A new graduate needs support to practice with integrity and to learn how to guide patients and families through some difficult decisions. Support from preceptors and nurse leaders builds a strong foundation to ensure the retention and resilience of new graduates as they pursue a lifelong career in the most trusted profession. Continuing to challenge our peers to uphold high standards helps create a future in nursing that is built on moral courage and advocacy.

Nurse leaders are empowered with the ability to not only uphold sound practice but to pass along the professional and personal values required of the profession. Nurses have an obligation to care for patients and the public and also care for each other. New graduates need an open environment where they are free to learn and ask questions and to grow with mentors who will be there to support them as they begin their journey. Upholding a strong code of ethics and becoming a mentor for those who follow will continue to strengthen the delivery of high-quality patient care. Together we can create an environment where we foster the growth and development of new graduates rather than drive them away.

— AJ Cook is president of the National Student
Nurses’ Association.


Van Der Wege M, Keil S. Answering the call of the nursing profession. Kansas Nurse. 2019;94(2):12-4.

Reinhart RJ. Nurses continue to rate highest in honesty, ethics. Gallup. January 6, 2020.

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