How to Prevent Workplace Bullying in Nursing

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Written by Diana Campion, MSN, APRN, ANP-C Education Development Nurse, Content Writer, IntelyCare
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Reviewed by Lynn Barry, MSN, RN Senior Director of Clinical Operations, IntelyCare
A woman dealing with workplace bullying in nursing gets support from a manager.

The uncomfortable truth is that workplace bullying in nursing has existed since the profession’s inception. You’ve likely heard the common phrase “nurses eat their young” to refer to the bullying of novice nurses. Unfortunately, this form of systemic aggression often starts in nursing school and persists throughout their career.

As a healthcare leader invested in workplace safety, you’re in a unique and empowering position to stop nurse bullying at your organization. This may seem challenging, given how long this harmful behavior has been pervasive in the industry. We’ll review what you need to know about bullying and provide some prevention strategies.

What Is Nurse Bullying?

Workplace bullying in nursing, incivility, and violence are distinct terms describing aggressive behavior. If you’re unsure of their exact definitions, you’re not alone. The American Nurses Association (ANA) provides the following explanations to help differentiate between the varying forms of aggression exhibited toward nurses by patients, families, visitors, and colleagues:

  1. Incivility: One or more rude, discourteous, or disrespectful actions towards a nurse that may or may not have a negative intent behind them.

Example: An outgoing nurse rolling her eyes when the oncoming nurse asks them clarifying questions during a shift change report.

  1. Bullying: Repeated, unwanted, harmful actions intended to humiliate, offend, and cause distress in a targeted nurse.

Example: A nurse or group of nurses refusing to help, or finding ways to belittle, “outside” nurses filling shifts at a facility on a temporary or per diem basis.

  1. Violence: Physical, emotional, or verbal acts of aggression toward a nurse that impact their well-being and ability to care for patients.

Example: A distraught family member cursing at and physically attacking their loved one’s nurse upon hearing bad news about the patient’s condition.

What Is the Impact of Workplace Bullying in Nursing on Your Organization?

Aggression toward nurses significantly impacts the nursing shortage, according to one survey of over 12,500 nurses conducted by the American Nurses Foundation. Since workplace incivility in nursing and bullying are on the same continuum of aggressive behaviors, they were assessed together and cited as the primary reasons for the following:

  • 18% of nurses leaving their position in the six months prior to the survey
  • 14% of nurses intending to leave their position in the six months after the survey

The ANA provided a full assessment of safety issues in their position statement on workplace incivility, bullying, and violence. They found that nurse bullying had extensive repercussions, including:

  • Decreased nurse productivity, job satisfaction, organizational commitment, and retention
  • Impaired nursing judgment, and increased medication and patient care errors
  • Diminished nurse physical and mental health, self-worth, and self-confidence
  • Unhealthy work environments
  • Higher rates of turnover and of nurses leaving the profession
  • Increased costs of recruiting, hiring, and training new employees
  • Increased expenses of managing uncivil employees, incidents, and consulting with attorneys

Strategies to Prevent Nurse Bullying

Now that you have a better understanding of what bullying is and its considerable impact, we’ll discuss some ways to prevent it. Given the systemic nature of bullying, minimizing it in your healthcare organization requires an organizational approach.

1. Cultivate a Strong Culture of Respect and Safety

This is an excellent opportunity to review the tenets of your organization to assess whether they adequately address the prevention of workplace bullying in nursing. It must be clear that your organization doesn’t tolerate bullying, protects targets and those who report it, and will hold staff who violate your codes of conduct accountable.

The ANA advocates for nurses and organizations to work together to instill a culture of respect that promotes nurses’ health, safety, and wellness, thus ensuring optimal outcomes across the healthcare spectrum. Your leaders’ behaviors should exemplify these cultural beliefs and establish a positive work environment.

2. Establish a Task Force to Develop Policies and Procedures

Create a task force that includes your organization’s leaders, healthcare staff, human resources (HR), and other stakeholders who are dedicated to mitigating and preventing workplace aggression. The Joint Commission (TJC) deemed that organizations that fail to address unprofessional behavior, such as workplace incivility in nursing or bullying, through formal systems are indirectly promoting these behaviors. It recommends that your task force develop policies and procedures that focus on:

  • bullying
  • reducing fear of retaliation
  • responding to witnesses of bullying
  • how and when to initiate disciplinary actions for those that violate codes of conduct

In addition, your organization’s task force must consider how to prevent nurse bullying by patients, family members, and visitors. Since you’ll be creating processes that involve patients and people outside your organization, obtaining some guidance from your legal department is a good idea.

Once policies and procedures are implemented and enforced consistently by your leadership team, they’ll demonstrate that your organization values and respects its staff and doesn’t tolerate workplace bullying in nursing. This will eventually lead to the prevention of bullying while establishing a safe work environment.

3. Provide Training and Education

Training and education are essential to preventing nurse bullying. To optimize this strategy, the ANA recommends facilities provide staff training and education on bullying policies and procedures during orientation and at regular intervals (such as annual compliance training). This training should include topics that will increase their skill set for dealing with high-stress situations, such as:

  • stress reduction and management
  • crisis and intervention
  • conflict resolution
  • resilience

Training and education provide a cohesive way to tie together your organization’s culture and policies. Providing your staff with clear and consistent messaging increases their knowledge and awareness of your organization’s goal to promote a safe working environment.

Want to Cultivate or Maintain a Healthy Work Culture?

Now that you’ve gained more insight into preventing workplace bullying in nursing, you’re likely interested in other ways to support a healthy work culture. IntelyCare’s free newsletter provides helpful strategies for promoting a positive workplace where your nurses and your organization thrive