Which Came First, the Crazy or the Nursing
Are aggressive personalities a product of nursing or does nursing create an atmosphere where aggression can thrive?
9/15/20263 min read
Sometimes I question which came first: the crazy or nursing.
Have you ever met someone who seemed completely unhinged for no reason?
You meet this nurse and, almost immediately, she is territorial, aggressive, loud, or intrusive. And I always wonder: were these traits always there?
Because I cannot imagine these being favorable traits in a new grad—or behaviors that would make it through orientation without somebody saying something.
These were my thoughts this week after an encounter with an unusual nurse.
Within five minutes of meeting me, she moved my things, belittled my knowledge, and attempted to intimidate me. She didn't know my name. She wasn't from my unit. For all intents and purposes, I was a stranger who had never had an interaction with this woman before.
At first, I was frustrated and reactive. Her behavior felt completely uncalled for.
But then I thought about something.
This wasn't the first time I had experienced what felt like a random act of aggression from a coworker. What made this encounter stand out was how easily it happened—and how out of place the behavior seemed in a professional environment.
Part of what makes these encounters so jarring for me is that I have worked in environments where this kind of behavior wasn't unusual.
I was a high school dropout. Before I earned my diploma, I worked in bars and clubs—environments where emotions could run high, arguments happened, boundaries weren't always respected, and professionalism wasn't exactly the expectation.
So I'm not unfamiliar with aggressive personalities.
I've seen territorial. I've seen loud. I've seen intrusive. I've seen people develop an attitude with a complete stranger simply because they felt like it.
But nursing was different.
I went back to school. I entered a profession where everyone had completed an education, passed a licensing exam, gone through orientation, and accepted a job centered around caring for other human beings.
Maybe that's why it still catches me off guard when I encounter the same behavior here.
Because somewhere along the way, I developed an expectation that education and professionalism would create a different kind of environment.
And yet, every so often, I find myself standing in a hospital thinking:
I've seen this behavior before. I just never expected to see it here.
So which came first?
Maybe some people came into nursing this way.
Our profession has plenty of mechanisms for evaluating whether someone can pass pharmacology, perform a skill, recognize deterioration, pass the NCLEX, and safely care for a patient. But none of those things necessarily tell us how that person will treat another human being when they are frustrated, threatened, inconvenienced, or given a little authority.
Maybe nursing creates some of it.
Years of understaffing, stress, hierarchy, trauma, responsibility, and constantly operating with too few resources can change people. Hypervigilance can become controlling. Assertiveness can become aggression. Experience can become territoriality.
But I think there's another possibility.
Maybe nursing didn't make her aggressive.
Maybe nursing simply created an environment where aggression works.
An overly aggressive person can thrive among people who aren't.
When everyone else is trying to remain professional, avoid unnecessary conflict, preserve the working relationship, or simply get through a 12-hour shift, the person willing to make everyone uncomfortable has an advantage.
People move.
People concede.
People stop challenging them.
Eventually, everyone learns to work around the behavior instead of addressing it.
We even develop language to accommodate it.
"She's just old school."
"She has a strong personality."
"That's just how she is."
"Don't take it personally."
And somewhere in all of that accommodation, the aggressive person learns something too:
It works.
That's what makes aggression particularly interesting in a professional environment.
Professionalism requires restraint. Most of us understand that we cannot respond to every disrespectful interaction exactly how we might want to. We regulate our tone. We choose our words. We consider our patients, our coworkers, our licenses, and our jobs.
But that restraint doesn't affect everyone equally.
When one person follows those social rules and another person is willing to violate them, professionalism can become an asymmetrical restraint. The person behaving appropriately becomes responsible not only for regulating themselves, but sometimes for absorbing the behavior of the person who won't.
Perhaps that's how these personalities survive in nursing.
Not because everyone approves of their behavior.
Not because nursing necessarily created it.
But because the rest of us become exceptionally good at working around it.
So maybe I've been asking the wrong question.
Maybe it isn't:
Which came first: the crazy or nursing?
Maybe it's:
What happens when an aggressive person enters a profession full of people trained to accommodate, adapt, de-escalate, and keep going?
Which came first, the Nursing or the "Crazy"
When aggression meets a profession built on professionalism.
