Nurse Bullying: a Persistent Crisis

Nurse bullying is a pervasive issue that extends beyond targeting new nurses. It is a behavior that is learned and consciously enacted. In some cases, novice nurses may observe such behavior and either accept it as part of the job or attempt to fit in with senior staff, inadvertently perpetuating a harmful culture. These dynamics can foster cliques within nursing teams, which often act as a breeding ground for bullying. Within these cliques, bullies find a shield to hide their actions, resurfacing only when it feels safe to do so.

Consequently, workplace bullying becomes an expanding problem, affecting the well-being of entire healthcare teams.

The pressures of the nursing profession, marked by demanding twelve-hour shifts, exacerbate the issue of workplace bullying. Nurses are constantly pulled in various directions, and this relentless stress can lead to incivility and bullying, which in turn contribute to staff burnout and diminished job performance (Van Der Wege and Keil, 2019). The persistent exposure to negative behaviors and the absence of support from colleagues can prompt nurses to question the value of their profession. While some nurses manage to withstand bullying, others succumb to emotional distress, eventually quitting their jobs. The already stressful nature of nursing becomes unbearable when bullying is added to the mix, resulting in a toxic work environment that erodes job satisfaction, productivity, and attendance. Victims often feel regret and dread about their upcoming workdays and choose not to report bullying due to fears of disbelief or retaliation (Hartley, Sanderson, Pankhurst, and Ambrose, 2019). These fears are compounded by feelings of shame, embarrassment, weakness, and self-blame. Additionally, nurses may be unaware of the procedures in place to address bullying, perceive their experiences as trivial, or believe that speaking up will result in no action (Hartley, Sanderson, Pankhurst, and Ambrose, 2019).

Impact on Workplace Culture

The lack of reporting can lead management to mistakenly assume that no issues exist, as there is scant evidence to the contrary. Therefore, it is imperative for leadership to take a proactive and consistent approach in checking on staff, conducting regular shift huddles, and fostering an environment where employees feel empowered to voice concerns, reassured that their issues will be addressed. Speaking up should not be perceived merely as a complaint or grievance but as a crucial safety concern. Bullying presents a systemic problem for healthcare organizations, demanding attention irrespective of the number of individuals involved.

The problem of violence against nurses in the workplace has escalated over the years. In 2016, The Joint Commission issued a safety notice about bullying in healthcare, defining it as abusive conduct that includes verbal threats, intimidation, humiliating nonverbal behaviors, and work interference. Female nurses, in particular, face a high risk of sexual harassment in the workplace, along with violence from patients during care. Reports have surfaced of nurses being sexually harassed or groped by colleagues or patients. Physical violence is also a concern, particularly when patients under the influence of alcohol or drugs seek emergency care and act out violently. Additionally, individuals with mental health disorders experiencing manic episodes or adverse medication reactions pose a risk. Protecting nursing staff from such violence is imperative to prevent injury and staff shortages. The repercussions of violence in nursing can undermine workforce functionality and, ultimately, damage the nursing profession and patient care. As AHC Media notes, "Creating a culture of caring can help stop bullying and prevent the long-term workplace effects of poor staff morale and high turnover rates."

Strategies for Prevention

Implementing policies, workplace violence training, disciplinary actions for misconduct, and prevention programs are essential steps in curbing bullying within healthcare settings. According to Flynn, there are three types of workplace violence controls: engineering, administrative, and behavioral. Engineering controls aim to shield workers from potential harm and hazards, addressing physical and environmental safety through measures such as controlled access, surveillance systems, and emergency contact programming (Flynn, 2019). Administrative controls necessitate changes in work processes through policies and guidelines, including proactive safety audits, incident reporting, managing high-risk patients or visitors, employee education, and procedures for high-risk employees.

Behavioral controls enhance nursing staff knowledge, skills, and conduct to mitigate workplace violence. Staff should be informed about incidents and policies, learn to respond appropriately to violent situations, de-escalate potential conflicts, report incidents, implement emergency response plans, and promote respectful behavior among coworkers. Being neutral mediators in conflicts is also vital (Flynn, 2019). A common workplace violence program available in hospitals is the Union, which protects staff, assists with work incidents, and negotiates pay contracts, although it requires a membership fee deduction from employees.

It is crucial for nursing staff to report any bullying or violence incidents. Ensuring nurse safety is vital for maintaining a stable workflow and preventing a hostile work environment. Individuals have the right to stand against bullying, advocate for protection, and have their organization take disciplinary action against perpetrators. Even those not experiencing workplace violence firsthand can help by acknowledging its existence. Nurses must report and mediate violent situations to break the cycle of bullying. Hospitals should continually update policies to protect staff and patients, setting the groundwork for immediate action against violations. Nursing staff deserve to work in a positive, supportive environment, making every day a rewarding experience in healthcare, where they can focus on treating, teaching, and trusting their coworkers and patients.

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