Editor's Column: Meeting the Challenge of Bullying/Violent Behaviors in the Pediatric Arena

Meeting the Challenge of Bullying/Violent Behaviors in the Pediatric Arena 

LaDonna Northington, DNS, RN, BC
Newsletter Editor

                According to Wikipedia, bullying is the use of force, threat, or coercion to abuse, intimidate, or aggressively dominate others. The behavior is often repeated and habitual. One essential prerequisite is the perception, by the bully or by others, of an imbalance of social or physical power, which distinguishes bullying from conflict (https://en.wikipedia.org/wiki/Bullying).

Violence is defined by the World Health Organization as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.” The group acknowledges the inclusion of "the use of power" in its definition which expands on the conventional meaning of the violence. This definition involves intentionality with the committing of the act itself, irrespective of the outcome it produces (https://en.wikipedia.org/wiki/Violence).

            As is evident, these terms have a lot in common, and are sometimes intertwined. Today’s media are overrun with stories of violence and bullying tactics in our society. Individuals are exposed to information on these topics on a daily basis. What the increase in media exposure has demonstrated is that bullying has various forms, including but not limited to person to person (because of race, color, weight, gender, sexuality, disabilities). Bullying can occur in various settings, such as schools, churches, ball games, playgrounds, malls, restaurants, etc. The behaviors can also occur in the workplace (between peers, peers and administrators, nurses and families, faculty and students, student to patient, etc.). Sometimes the behavior is covert and not readily noticeable, therefore, no actions are ever taken. Even when the behavior is overt, sometimes no actions occur. Bullying/violence can lead to physical harm, but can also cause severe emotional and/or psychological stress. To complicate matters even more, the advancement of technology has given rise to the newest form of bullying known as cyberbullying. There is documented evidence of the distress of this type of bullying, up to and including suicide in children.

            Some facts reported by The National Bullying Prevention center statistics for 2016 indicate that:

  • One out of every four students (22%) report being bullied during the school year.
  • 64 percent of children who were bullied did not report it; only 36 percent reported the bullying
  • More than half of bullying situations (57 percent) stop when a peer intervenes on behalf of the student being bullied.
  • School-based bullying prevention programs decrease bullying by up to 25%.
  • The reasons for being bullied reported most often by students were looks (55%), body shape (37%), and race (16%).


            A quick internet search will reveal a plethora of information and statistics related to bullying/violence. These include:


The nursing literature has also addressed the issue:


So now that we are all aware of the issue, what is the role of the pediatric nurse? That is a question that requires thought and ponderance. The role could vary depending on the situation. This could include

  • Being the recipient of information shared by a child during an encounter
  • Receiving information gleaned from a conversation with a parent, teacher
  • Directly observing the behavior


Yet still, the bullying could be in your unit or institution, school, church or any number of settings. As a nurse, our first role is to be VIGILENT observers. Take action. If you are unsure of action to take, then perhaps your responsibility might be that of personal education.

A few basic responsibilities of nurses include:

  • Identifying early and continuous bullying behaviors
  • Implementing interventions, individually or in group settings
  • Acting as an advocate for the development and implementation of policies, procedures, expectations, consequences, etc.
  • Participating in/conducting community wide programs /efforts that raise awareness and address issues of bullying and violence

My challenge to each of us would be this: DO NOT SIT ON THE SIDELINES. Get involved, and do whatever you can. Each of us working collectively CAN make a difference in the life of a child, family, our colleagues, or even ourselves. Nursing is a career that touches children’s lives in many settings and venues. TOGETHER WE CAN MAKE A DIFFERNCE. It is after all, part of why we do this work – to make the lives of children and their families better. I am reminded of one of my most favorite pediatric quotes…..”We may not be able to keep them from suffering, but we can keep them from suffering for the wrong reasons.” YEP, that about sums it up! So, let’s all do our part.

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