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Health care workers of all types experience the benefits of rank, the power and authority that go with education, training, licensure and certification, and professional role titles. Some position titles overtly reflect rank and its privileges, such as being included in decision-making and other forums: chief nursing officer, head or charge nurse, clinical nurse specialist, and professional development educator. Equally, being a registered nurse (RN) holds rank over other health care titles. A bold "RN" on a name badge gives the wearer immediate authority, privilege, and access to patients and patient information. Even common vernacular, such as depicted in the seminal work of Patricia Benner (1984 ), From Novice to Expert: Excellence and Power in Clinical Nursing Practice, suggests developmental ranks that evolve through experience can be constructive in supporting staff development. Many nurses may not fully appreciate their position of rank in the health care system.
But what happens when rank is abused? "Pulling rank" means the use of rank for self-benefit and gain over others, diminishing others in the process. The common statement that nurses "eat their young" suggests rites and rituals where ranking senior nurses abuse nurses who are new to the discipline or unit through power differentiation. If this abusive form of rankism survives or becomes normalized, the behavior gives license and the victim at some future point becomes the abuser and the cycle continues. When will nurses break this cycle of negative rankism and stop fueling a phrase, "eating our young" that gives perverse power to its usage?
Rankism comes in many forms. It is found in policies and procedures within institutional settings. For instance, the original use of shift or specialty...