Workplace bullying is one of the most common work-related psychological problems in any work environment, and the adverse consequences of bullying may have a more significant impact compared all other work-related stressors combined.1 The effects of perceived workplace bullying in nurses can have significant impacts on nurse, patient, and health organization outcomes including: psychological and behavioral responses, job satisfaction, work productivity, medical errors, and intent to leave.2,3
Defining Workplace Bullying
Workplace bullying, also termed lateral or horizontal violence, is defined as persistent and systematic victimization of a target with repeated use of negative acts over a long period of time to the extent that the target struggles to defend himself or herself.3,4To be classified as bullying it has to occur repeatedly and on a regular basis (e.g. weekly) over a sufficient period of time (e.g. about 6 months). An isolated incident cannot be deemed bullying.4In the workplace, bullying can take place through harassment, intimidation, social exclusion, offending someone, or by negatively affecting a person’s work tasks.5,6
Prevalence of Workplace Bullying Among Nurses
Studies in the past have suggested 13-48% of nurses have been exposed to workplace bullying during their professional careers.3This range may even be lower than the actual number of nurses who are currently experiencing workplace bullying, because nurse bullying behaviors are often underreported and can be tough to identify. A recent study done by the American Nursing Association discovered 50% of nurses have been bullied by a peer, while 42% have been bullied by a person in a higher level of authority.3It has also been suggested that nurses who work in increasingly stressful environments, such as high-volume trauma centers and emergency departments, are more prone to experiencing workplace bullying.
Consequences of Workplace Bullying
Bullying not only takes a toll on the individual victim, but also may negatively impact the entire workplace culture and economic health of an organization.2The Joint Commission has released an alert linking workplace bullying behaviors among nurses to errors, increased costs of care, personnel turnover, poorer patient satisfaction, and preventable adverse events.3Nurses who report experiencing workplace bullying also have higher rates of poor physical and mental health, as well as job dissatisfaction.6
What Can Be Done?
Health organizations should foster an environment that prevents bullying. Promoting common core values that embrace respect fosters camaraderie between healthcare staff. Employers need to set expectations from the beginning on how employees should treat and communicate with one another, as well as create clear pathways and protocols that make it easy for employees to report their experiences.7Building purposeful reporting channels that employees can trust will help someone who has been bullied to feel comfortable coming forward. Experts also suggest implementing role-play opportunities for employees in order to teach them how to effectively handle disruptive communication.2
Workplace bullying is a persistent problem in nursing that solicits meaningful consideration. In order to optimize the care of patients and achieve desired health outcomes, employers need to be certain the workplace culture nurtures teamwork and respect. If these values are overlooked, the associated negative consequences can be substantial to those directly and indirectly impacted by the bullying behavior.
1.Gullander M, Hogh A. 2014. Exposure to workplace bullying and risk of depression. J Occup Environ Med. 56(12): 1258–1265.
- Sauer PA, McCoy TP. Nurse bullying and intent to leave. Nurs Econ. 2018;36(5):219-224. Accessed at: https://www.medscape.com/viewarticle/903849.
3.Meires J. The essentials: Here’s what you need to know about bullying in nursing. Urol Nurs. 2018;38(2):95-98. doi:10.7257/1053-816X.2018.38.2.95.
- Einarsen S, Hoel H, Zapf D, Cooper C. The concept of bullying and harassment at work: the European tradition. In: Einarsen S, Hoel H, Zapf D, Cooper C, editors. Bullying and harassment in the workplace: Developments in theory, research, and practice. 2nd ed. Boca Raton, FL. CRC Press; 2011.
- Hilton L. Workplace stress from bullying can turn nurses away from profession. Mediakit.nurse.com. http://mediakit.nurse.com/blog/workplace-stress-from-bullying-can-turn-nurses-away-from-profession/. Published July 3, 2018. Accessed January 20, 2019.
- Cooper A, Purpora C, Sharifi C. The prevalence of nurses’ perceived exposure to workplace bullying and its effect on nurse, patient, organization and nursing-related outcomes in clinical settings: a quantitative systematic review protocol. JBI Database of Systemic Review and Implementation Reports. 2015:13(9):51-62. Accessed at: https://www.nursingcenter.com/journalarticle?Article_ID=3470302&Journal_ID=3425880&Issue_ID=3470019#P26.
- The 5 simple ways to stop nurse bullying, according to hospital executives. Advisory.com. https://www.advisory.com/daily-briefing/2018/10/23/bullying. Published October 23, 2018. Accessed January 20, 2019.