Reader’s Theater Scripts to Address Disruptive Behavior
“Only the Strong Will Survive” addresses verbal affront, with some instances of nonverbal innuendo. This script was chosen for the article because it identifies the disruptive behavior occurring in the situation.
Title: Only the Strong Will Survive
Scene: Surgical unit of a large public hospital
- Joyce: Nurse manager.
- Katie: New baccalaureate nursing (BSN) degree graduate who is starting orientation.
- Mona: RN with a BSN who has worked on the unit for 5 years.
- Tom: RN with an associate’s degree who has worked on the unit for 7 years and is completing his BSN degree.
- Joni: RN with a diploma who has worked on the unit for over 20 years.
Narrator: It is the first day of orientation for Katie. She loved her surgical rotations in school and is very excited that she was able to “land” this job on a busy surgical unit. She has heard that the nurses on this unit are very cliquish, but she is sure she will be able to handle this situation. Katie starts her day with Joyce, the nurse manager.
Joyce: Good morning. Are you ready to start your orientation? Do you think you have what it takes to fit in here? It takes a special nurse to work with my nurses. (Joyce laughs)
Narrator: Katie is thinking to herself. “That is one scary laugh!”
Katie: (with enthusiasm) Not only am I ready to start my orientation, but I am very excited to learn and I know I will fit in here.
Narrator: “Well, let’s see how Pollyanna performs,” Joyce thinks.
Joyce: I am going to have you shadow Joni today. She has been working on the unit for over 20 years. I am going to warn you that she doesn’t really like BSN students and she may make comments that you don’t like, but the best way to handle the comments are to ignore them and work hard! (Laughs again) Yes, Joni is a firm believer in the good-ole work ethic.
Narrator: Joyce gives Katie a quick tour of the surgical unit and then introduces her to Joni.
Joyce: Hey Joni, this is Katie the new grad that will be shadowing you today. Don’t be too hard on her. (Laughs loudly)
Narrator: Katie seeing Joni for the first time feels her heart rate increase. Joni is a large imposing woman with a very stern look on her face. Katie had heard about nurses like Joni from other students, but she had always thought they were exaggerating.
Katie: (timidly) Hi Joni, it is nice to meet you.
Joni: (loudly) Well, we’ll see if you feel the same way at the end of the day. Now let’s get busy. There is a lot of work to do and having you tag around like a dog only makes more work for me. I hope you are smarter than most BSN students. The last one only lasted 6 months!
Narrator: Katie doesn’t know how to respond to Joni’s remarks so she just stands in the middle of the report room looking at Joni. She has a sinking feeling in the pit of her stomach and wishes she could complete her orientation with one of the other nurses. Joni rolls her eyes thinking, “Another stupid BSN grad. What do they teach at those worthless universities?” Mona, feeling sorry for Katie, says…
Mona: (pleasantly) Come on Joni, don’t you remember what it was like to be a new grad?
Joni: (defiantly and with emphasis on the I) When I was a new grad I had already worked so many hours in the hospital, and surgery, that I was ready to go. I hardly needed an orientation.
Narrator: Joni and Katie head out of the report room. Tom turns to Mona and says…
Tom: (with a sly look on his face) It should be an interesting day for Katie (laughs and then thoughtfully) I don’t know, maybe it isn’t a good idea for Joyce to put the new employees with Joni. She is demeaning and verbally abusive with them. What do you think?
Mona: We had to go through it. It’s the way of the world. If Katie can’t make it through the hazing, I mean orientation, with Joni then she doesn’t have what it takes to be a nurse. Joni isn’t that bad once you know how to take her verbal abuse. Just yesterday she needed help and yelled, ‘Hey, worthless BSN nurse, get me more sutures stat!”
Tom: (with emphasize) That’s a perfect example of verbal affront.
Mona: Oh baloney! It’s just Joni.
Tom: You are wrong. In the nursing class I’m taking this semester we are reading a book on disruptive behavior. I am pretty sure the author of the book would label Joni’s comments as verbal affront, and her eye rolling as nonverbal innuendo.
Mona: (hurriedly) Listen Tom, I don’t have time for this now. Maybe we can talk about this later.
Narrator: Mona hurries out of the report room to get ready for her first surgery of the day. Tom has a few minutes before his first surgery and spends those minutes thinking about how nurses “eat their young.” He has been very intrigued by the discussions his class has had on disruptive behavior. Before these discussions he would not have questioned Joni’s approach to new RNs on the unit. Tom decides he will talk to Joyce about his thoughts soon. Meanwhile, Joni and Katie are busy setting up a surgical table.
Joni: (loudly) No, that isn’t the way you do it. I can see you are going to be one of the slow ones. You have to be sharp as a tack to work in surgery.
Narrator: Katie turns bright red at this comment. She is a smart person, but does not perform well when criticized and is not used to being treated like she is stupid. Maybe she will ask Joyce if she can do her orientation with Tom or Mona. It was a long day for Katie. The only way she knew to endure the verbal abuse of Joni was by trying harder and turning red. Neither of these approaches seemed to work very well. At the end of the day, Katie met again with Joyce.
Joyce: (cheerfully) How did your first day go?
Katie: (almost in tears) Not well. I don’t think Joni likes me and it makes it hard for me to learn. I always did well in my clinical rotations, but I am not used to being told I am slow and stupid! Joni is so intimidating that I am afraid to reply to her.
Joyce: (reassuringly) Oh that is just Joni. Her bark is worse than her bite. She’s really a nice person.
Katie: (hesitantly) That was not my impression of her. It seems like she takes delight in terrifying new nurses. I am very concerned and don’t feel like Joni is the best nurse to do my orientation. Do you think I could be with Tom or Mona instead of Joni?
Joyce: (with concern) Joni always does the new nurse orientation and she won’t be happy if I put you with the other nurses. I did that once before and she was really hard on the nurse. That nurse made it for about 6 months and then asked for a transfer.
Narrator: Katie did not know what to do. She had started her first day on the unit with enthusiasm and now found herself wondering if she would be able to make it through Joni’s orientation methods. If Joyce, the nurse manager, didn’t see that there was a problem, what could she do? As Katie was leaving Joyce’s office she ran into Tom. Seeing Katie’s look of distress Tom said…
Tom: (with concern) Tough day?
Katie: A really tough day! The more I tried to please Joni, the worse she treated me. I have never had anyone say such mean things to me in my life, and I don’t know how to respond to her. I asked Joyce if I could do my orientation with Mona or you and she said I couldn’t because that would make Joni mad and meaner.
Tom: I am not surprised to hear that you had a hard day. I am going to talk to Joyce about Joni. I don’t know if it will do any good, but I will try.
Narrator: Tom knocks on Joyce’s office door.
Joyce: Come in! (pause) Hey Tom! How’s it going? Have a seat.
Tom: (speaking carefully) I ran into Katie as she was leaving your office. She looked pretty distraught.
Joyce: (casually) Oh, she’ll be OK. All the new nurses feel like that after their first day with Joni. (cackles)
Tom: (with emphasis) I know! I used to think it was OK to go through the “orientation from hell” with Joni, but I am not so sure anymore. Remember that recent meeting we attended on the Joint Commission’s new policy on disruptive behavior?
Joyce: Yea, yea! I believe the Commission has blown the situation out of proportion. You know nursing is mostly women and this is the way women work together.
Tom: I am going to respectfully disagree with you. I am reading a book in my issues class this semester about disruptive behavior. Verbal affront is one of the ten disruptive behaviors considered inappropriate. Joni’s treatment of new nurses is a perfect example of verbal affront, one of the ten behaviors. I know that the Joint Commission and the author of the book believe that there should be zero tolerance for this type of behavior. Once the hospital develops the policy and form for reporting an incidence of disruptive behavior, nurses like Katie could file a complaint against nurses like Joni.
Joyce: (in a tired voice) Tom, I don’t have the energy to take on Joni. She has been here longer than I have and it is easier to let her have her way. Katie will just have to develop thicker skin.
Tom: That reminds me, we have lost several very good nurses in the seven years I have been here. I think it’s time to make some changes on this unit, especially with the Joint Commission backing us.
Joyce: What do you suggest?
Tom: I think we should have some education in-services on this topic. I also think you should talk to Joni about her verbal abuse of new employees, and I’ll be glad to take over Katie’s orientation.
Joyce: (sarcastically) Maybe you should take over as manager too!
Narrator: Tom laughs. For once, Joyce does not laugh!
Tom: (smiling) No, I’m not ready for that yet. But, I am ready to try to change the communication patterns on this unit. Come on Joyce, let’s do it!