Unit Growth: Bullying, Culture, and Incivility
Unit Growth in the NICU: The Culture We Create Matters
We talk a lot about growth in the NICU.
We focus on skills, knowledge, certifications, and experience. We talk about becoming more confident, more efficient, and more clinically strong. And all of that matters.
But there is another type of growth that often goes unspoken.
The environment we grow in.
Because no matter how strong your clinical knowledge becomes, the culture of your unit will shape how you learn, how you communicate, and ultimately, whether you stay.
Turnover Is Not Just a Staffing Problem
When we talk about nurses leaving, it is easy to focus on the obvious factors. Workload. Scheduling. Pay. Burnout.
And those are real.
But there is another layer that is harder to measure and easier to overlook.
How nurses are treated.
New nurses entering the NICU are stepping into one of the most complex and high-stakes environments in healthcare. They are expected to learn quickly, think critically, and recognize subtle changes in fragile patients. That level of responsibility requires support, guidance, and psychological safety.
When that support is missing, learning becomes stressful instead of structured. Questions feel risky instead of encouraged. And over time, that changes how a nurse shows up to work.
Some leave the unit.
Some leave the profession.
And some stay, but disengage.
Burnout Looks Different in the NICU
Burnout in the NICU is not always obvious.
It does not always look like someone ready to walk away. Sometimes it looks like a nurse who is still showing up, still doing the work, but feels disconnected.
It can look like:
going through the motions of a shift instead of feeling engaged
increased frustration or irritability
avoiding asking questions or speaking up
feeling emotionally drained after even a “normal” day
The NICU carries a unique emotional weight. Long-term patients, complex family dynamics, ethical decisions, and high expectations all contribute to that load.
When you combine that with a culture that does not feel supportive, burnout accelerates.
Bullying and Incivility Are Not Minor Issues
There is a tendency in healthcare to downplay negative interactions.
“It was just a stressful moment.”
“That is just how they are.”
“You have to have a thick skin.”
But repeated patterns of dismissive, aggressive, or exclusionary behavior are not harmless.
They change how people practice.
A nurse who feels uncomfortable asking a question is more likely to hesitate.
A nurse who feels unsupported is more likely to second-guess themselves.
A nurse who feels judged is less likely to speak up.
And in the NICU, hesitation matters.
This is not just about workplace satisfaction. It is about communication, teamwork, and patient safety.
What Bullying Can Look Like at the Bedside
Not all bullying is loud or obvious.
Sometimes it is subtle enough to be brushed off, but consistent enough to have an impact.
It can look like:
dismissing questions instead of answering them
withholding information during handoff or teaching
using tone or body language to shut someone down
avoiding helping and then criticizing the outcome
repeatedly giving difficult assignments without support
These behaviors create an environment where nurses feel isolated instead of supported.
And over time, that environment becomes the culture.
Why Culture Matters More Than We Think
Nurses stay in environments where they feel supported.
Not because the job is easy.
Not because the patients are simple.
But because they feel safe learning, asking, and growing.
Strong NICU units are not defined by perfection. They are defined by how the team responds in difficult moments.
Do people step in to help?
Do questions get answered without judgment?
Do newer nurses feel guided or evaluated?
Those small, daily interactions shape everything.
What You Can Do, Starting Now
It is easy to feel like culture is something controlled by leadership or systems.
But culture is also built at the bedside.
It is built in how you respond when someone asks a question.
It is built in whether you step in or stay silent.
It is built in the tone you use during stressful moments.
You do not have to change the entire unit to make an impact.
You can:
answer questions in a way that teaches instead of dismisses
step in when you see someone struggling
normalize saying “I do not know”
check in with a coworker after a difficult situation
give feedback that is constructive, not critical
These are small actions, but they are not insignificant.
They are what shape the environment people come back to.
Growth Is Not Just Clinical
As NICU nurses, we are always working to improve our clinical skills.
But growth is not just about what you know.
It is about how you show up.
It is about how you contribute to your team.
It is about how you support others in high-stress moments.
It is about the kind of environment you help create every shift.
Because the strongest NICU units are not just clinically excellent.
They are places where nurses feel supported, respected, and safe to grow.
And that is what keeps people there.
