Cliques, favoritism, and bullying can shape a nurse’s first year as much as any clinical lesson.
When in Doubt, Ask
By Lesline Rostick, RN, BSN
She answered my question about an IV line. A few moments later, I overheard her telling another nurse that I had asked it.
I was a new medical-surgical nurse, just off orientation. I needed help, and she had helped me. But hearing my question become a conversation with someone else stayed with me. I told her I was still learning and would keep asking questions, even if people talked. My priority was keeping my patients safe.
Years later, I still wonder how many new nurses have a question they need to ask—and hesitate because they fear what will be said after they do.
New nurses have enough to learn without also having to learn which coworkers are safe to approach. A question might catch a medication concern, clarify an order, or help someone recognize that a patient is getting worse. We should want nurses to ask it.
I want to be fair here. Nursing is demanding, and none of us gets our tone right every time. A stressful interaction does not automatically mean someone is a bully. New nurses also need honest correction. If something was missed, say so. Explain why it matters and what needs to happen next.
But there is a difference between helping someone learn and making them afraid to ask again.
When Belonging Changes How People Are Treated
Friendships at work are normal. We spend long shifts together, rely on one another, and sometimes become close. The concern is when a group’s friendships start affecting the work.
Who gets help when the unit is busy? Who receives important information without having to chase it down? Whose assignment concern is considered, and whose is dismissed? Is one nurse’s mistake handled privately while another nurse’s becomes a conversation at the desk?
These questions matter even when favoritism is hard to prove. A nurse may not know why they are being treated differently. They do know when the rules seem to change depending on who is asking.
For a new nurse, that can be deeply unsettling. They are still finding their footing. They need to trust that the information they receive is complete, that feedback is fair, and that asking for help will not make them an outsider.
A review of 41 studies found that workplace incivility was associated with poorer teamwork, less open communication, and lower ratings of patient safety reporting. That does not mean every unkind remark leads to an error. It does remind us that the way we treat one another affects the conversations care depends on.
Correction Should Leave Someone Better Prepared
I would rather have a colleague tell me directly that I missed something than let me continue without knowing. That is part of professional respect.
What helps is being specific: “This information needed to be included in handoff because the next nurse must watch for this change.” Now I understand the concern and what to do differently.
What does a new nurse learn from sarcasm, public embarrassment, or being told, “You should know this already”? Perhaps they learn to hide uncertainty. That is the last lesson we should want to teach.
The American Nurses Association distinguishes incivility from bullying, which involves repeated hostile behavior. We do not have to use the same label for every interaction to recognize when something needs to change. If a conversation goes badly, we can address it. If the behavior keeps happening, we need to look at the pattern.
“When in Doubt, Ask”
Years ago, during my orientation, an HR guest speaker said something I have never forgotten: “When in doubt, ask.”
I carried those words with me when I asked about that IV line, and I still believe them. If you are unsure about a medication, an order, or a change in a patient’s condition, ask. I would rather ask again than guess and risk harming a patient. The stakes can include someone’s life and your nursing license.
This matters especially when a new group of residents rotates onto a unit. They are learning the patients and the unit’s routines while managing many requests and responsibilities. Nurses are managing demanding assignments too. Everyone is human, and mistakes can happen at any point in the process.
A provider writes an order, but the nurse caring for the patient brings a bedside assessment to that plan. When an order does not fit what you know about the patient, questioning it is part of your responsibility. It is not an accusation that the doctor is careless. It is a chance for the team to check the order together before it reaches the patient.
I cannot emphasize this enough: if something does not look right, pause and ask. Clarify the concern through the appropriate clinical channels before proceeding. You may be catching a simple misunderstanding—or something with far more serious consequences.
If you do not feel comfortable approaching one person, find another appropriate resource. Speak with your educator, shift director, an experienced nurse, the ordering provider, or the clinical response team suited to the situation. Keep going until you have the information or help you need. A dismissive response from one person should never be the reason a safety concern goes unanswered.
I know that is easier to say than to do when you are new and worried about how others see you. But asking for help is part of practicing safely. The people teaching new nurses should make that easier, not harder.
The Rest of Us Have a Responsibility
Advice to new nurses can only go so far. We cannot tell someone to “speak up” and then leave them alone to deal with what happens afterward.
Experienced nurses can answer a question without belittling the person who asked it. We can share information consistently, offer help outside our closest circle, and correct gossip when we hear it. Leaders can make assignment decisions and expectations clearer, take concerns seriously, and follow up after a report instead of treating the conversation as the end of the matter.
This is a leadership issue as well as a peer issue. In a survey of hospital nurses, a better work environment was associated with less coworker incivility, and nurse manager qualities were an important part of that relationship. Culture is shaped by what leaders address, what they overlook, and whether the same standards apply to everyone.
I do not expect a unit where every shift is smooth or every conversation is comfortable. I do expect us to remember what our words and actions teach the nurses who come after us.
A new nurse who asks for help is trying to do the right thing. The way we answer may determine whether they feel able to ask the next time.
