Cheryl Dellasega’s “When Nurses Hurt Nurses”

Penn State health educator and nurse practitioner Cheryl Dellasega has just published When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Bullying (2011). It’s an informed, insightful, and timely examination of bullying, aggression, and incivility between nurses. A few observations:

Relational aggression

The strength of the book lies in its consideration of interpersonal dynamics. Dellasega builds her commentary on the core concept of relational aggression (“RA”) — largely covert aggression or bullying that damages relationships — which has framed her previous writings as well. “Bullying” appears to be the catchphrase to nab buyers and readers, but she employs the more clinical RA throughout the book.

Post-Traumatic Embitterment Disorder

In addition, she invokes a lesser-known term, “Post-Traumatic Embitterment Disorder” (PTED), to describe the impact of RA and bullying on nurses. I have a feeling it will resonate with bullying targets far beyond the nursing profession.


My main quarrel with the book is that it would have benefited from a closer look at the often-interrelated roles — constructive and detrimental — played by institutional stakeholders, such as human resources offices, nurses’ unions and professional associations, and legal and dispute resolution systems. These institutional players reflect, shape, and respond to bullying-type behaviors.


Dellasega provides thorough bibliographic information, and those who seek research materials on bullying and related behaviors toward nurses can thank her for having done much of the work. She also lists helpful sources on gendered aspects of interpersonal communications. However, I was surprised that she does not reference some of the abundant, valuable general research and commentary on workplace bullying.

Insider knowledge

When it comes to workplace bullying, specific vocational and professional settings make a difference. Dellasega has leveraged her knowledge of the nursing profession to write a useful book that speaks of that understanding.

4 responses

  1. Perhaps the term Post-traumatic Outcry (PTO) could more appropirately describe the impact of relational aggression and bullying in contrast to Post-traumatic Embitterment Disorder (PTED)…

  2. more attention on nursing, perhaps reinforcing the hierarchy of respect in healthcare. have we forgot that the lower in the food chain you are..the more likely you are to be abused? how about the nurse’s aides, the physical and occupational therapists, the technicians, the social workers, the receptionists, etc.?

  3. nurses are exhibiting junior high clique behavior and perhaps we need to screen better as to the maturity of the nurse and future nurses- ask yourself would i wanted to be treated inj this manner before you do something-perhaps this wioll help cut down on reating vs acting.

  4. We have to ask ourselves, why is it that so many nurses are so willing to come into a field and take such abuse? I fully believe (after working in many different nursing areas) this toxic workplace stems from various individuals underlying personality issues. The nurse (s) is stunted at the middle school age level of immaturity. For whatever reason, they stop developing there. They go into a field ripe to perpetuate this uncivil climate. They are either; the bully, the target or the audience. They all have a role to play. Now, insurances, Medicare and other government agencies are playing their role. They know they can bully nurses, therefore they will continue to do so. But why do so many nurses allow this? That is the deeper probing question.

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