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Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD


Young nurse hated by the old ER nurses; how to cope with their alienation

Q: How do I handle old veteran ER nurses that are threatened by me being new, popular, and coming into their "territory"? I tried being extra nice, but it just makes them bitchier. :(


Answer by , MD: Hi Noelle,

So you are a nurse? Are you attractive, too? In my experience, many women automatically dislike other women who are more attractive than they are. One of my friends is finishing up her training to become a therapist, and I noticed that even she was guilty of this!

As far as how to cope with their alienation, there are various solutions:

If that doesn't work, write back . . . or write back, anyway!

Pretty nurse
Pretty nurse, but not Noelle

Q: Hi Dr. Kevin,

Thanks for the response! Yes, I'm an RN, and yes, attractive (and intelligent :). I'm also very nice, friendly, and approachable . . . not conceited at all—honest! I've actually tried all your suggestions (except the book), and the cookies worked for the most part, but not on everybody :(

Anyway, I'm no longer in the ED (long, sad, catty story . . .), although I LOVED it. I want to go back someday, maybe even to a small community ER. I wasn't in this ER long, but I now know that I will never be as happy in any other area of nursing.

I did not have enough time to win over these few difficult RNs. I was even approached by the ER Director who very supportively offered to help if anyone gave me a hard time (I appreciated this, but I fight my own battles) and for the most part the staff welcomed me with open arms (which pissed off some people, I guess). How do I get back to the ER? What would you do if you were me? Any suggestions would be helpful ;)

Thanks again,


A: Getting an ER job isn't particularly difficult, considering how short-staffed many emergency departments are. The difficult part is harmonizing with nurses who can be, well, difficult. I hate to say it (because it sounds so crass) but my girlfriend, a nurse and a psychologist/therapist, says, "Most nurses are bitches." My older brother shares that opinion. He never worked in healthcare, but he's known enough nurses to form an opinion. I have worked with far more nurses, of course. I don't think that most nurses are bitches, but I do think that the prevalence of "bitchiness" is indeed higher in the nursing profession than in the general population. To understand why, you need to know only three facts:

Nurse using a PDA

It's not easy being a nurse these days. Nurses are often overworked by administrators who pat themselves on the back for being smart enough (or so they think) to economize by reducing nursing hours. Today's nurses must deal with everything from difficult family members to annoyingly illogical computers and PDAs. Nurses often feel attacked on all sides: by patients, their families, administrators, and doctors. Nurses are not at the top of the totem pole, so—like others in that situation—overt manifestations of anger are generally not permissible or tolerated. Nurses try suppressing that anger, but hey, we're all human. The anger eventually comes out in one way or another.

I think that nurses spend too much time attacking one another (and doctors!), rather than directly attacking the sources of their discontentment. Nursing leaders and lobbyists have done little to improve nurses' working conditions—in fact, nurses are often backsliding rather than making advancements in those areas. I am stunned by how ineffectual your leaders are. Unfortunately, the rank and file nurses pay the price for this incompetence and lack of vision. Nurses sense that little or nothing can be done to improve their "lot in life," so to speak, so they become frustrated, embittered, and angry.

In my books and web sites, I've criticized some nurses for making stupid, inexcusable, and indefensible errors (I've also criticized doctors and administrators for doing the same, but some nurses overlooked that). That led to a handful of nurses writing to me complaining about my supposedly "anti-nurse" stance. Nothing could be further from the truth! I am incensed by the crap that many nurses have to put up with, and I would love to do something about it. The irony is that nurses collectively wield enormous power and could stop getting the short end of the stick in a heartbeat if your pusillanimous leaders had better vision along with the brains and spine to implement the necessary changes. Judging by their pathetic results, what nursing leaders are doing just isn't working. I would love to spearhead the movement to make nursing a better and more rewarding job, and I would gladly accept that position on the condition that my pay would be based strictly on performance—unlike your current leaders, who are happy to be paid even if they achieve nothing for those they represent.

However, nurses will probably continue to elect "by the book" nurses to be their leaders, and those leaders will likely do as little for you as their predecessors have in the past few decades, so don't hold your breath waiting for any significant advancements. Result? For the foreseeable future, nurses will continue to be unhappy.

While it is best to address the root causes of nurses' discontentment, there are many things you can do on a local level to mitigate the problems that nurses face. I could write a book or two on that subject alone, so I will save that subject for the future when I have more time to write.

Incidentally, in two of my books (Fascinating Health Secrets and The Science of Sex) I describe various ways to boost mood and improve sociability. The Science of Sex also describes how to heighten pleasure—and not just sexual pleasure, either. The brain has certain common pathways for feeling good and feeling bad. Knowledge of that information can help you and others lead happier lives.

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