Bullying in nursing

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The nursing organisation workplace has been identified as one in which workplace bullying occurs quite frequently.[1][2] It is thought that relational aggression (psychological aspects of bullying such as gossipping and intimidation) are relevant. Relational aggression has been studied amongst girls but not so much amongst adult women.[3][4] According to a finding, 74% of the nurses, 100% of the anesthetists, and 80% of surgical technologists have experienced or witnessed uncivil behaviors like bullying by nursing faculty.[5]

Various bullying permutations are possible, such as:

  • doctor or management bullying a nurse
  • nurse bullying another nurse
  • nurse bullying a patient
  • patient bullying a nurse
  • nurse bullying other healthcare providers

Bullying acts[edit]

Lewis identifies the following bullying acts in UK nursing:[6]

Such acts are frequently insidious, continuing over periods of time that may be years. Bullies are often serial bullies. The bullies are invariably aware of the damage they are doing. They undertake such actions basically to gain control and power.


Laschinger, Leiter, Day, and Gilin found that among 612 staff nurses, 67.5% had experienced incivility from their supervisors and 77.6% had experienced incivility from their coworkers.[7] Rude remarks from a patient or family member can distract healthcare professionals and cause them to make mistakes and to provide suboptimal healthcare.[8][9]

Bullying of nurses by managers[edit]

In 2003 the Community Practitioners' and Health Visitors' Association in the UK carried out a survey showing that half of health visitors, school nurses and community nurses working in the National Health Service (NHS) have been bullied by their managers. One in three of the 563 people questioned said the bullying was so bad they had to take time off work. Constant criticism and humiliation were the most common complaints. Others said they were shouted at or marginalised.[10]


Not only does incivility in nursing has negative influence in the well-being of staff, the delivery of quality care, and the culture of safety, but also contributes to the nursing faculty shortage.[11] There is an increase of nurses' dissatisfaction in their jobs, which is contributing to the ongoing struggle with nurses leaving faculty positions and taking early retirement. Therefore, it is necessary for all healthcare faculty members to have a clear understanding of the cause and effect of incivility and possible strategies to reduce incivility rate.

Nurse bullying inventory[edit]

In order to further investigate and understand the impact of workplace bullying on the nursing work environment, an inventory was developed to address specific workplace bullying constructs within the nursing context.[1]

Associated terms[edit]

Horizontal violence[12] is often the same term used when referring to bullying in nursing. This term describes the appalling behavior shown by colleagues in the nursing field. Such demeaning behavior makes the work place stressful and unpleasant. Another term associated with bullying in nursing is lateral violence. This term is used to describe the effect that bullying takes on someone lower down on the ladder of workforce, making it hard to climb that ladder.

Remedial action[edit]

Some health organizations are seeking to educate staff and health care team members on how to improve social interactions, proper business etiquette, and foster positive people skills in the work environment. Nurses are entitled to monetary compensation for bullying.[13][14][15][16] In addition, communication and collaboration are first and foremost steps to improve nursing faculty member's ability to initiate professional relationships with both colleagues and patients. Workshops, open forums, counseling, and mentoring are also possible options to manage bullying in nursing.

See also[edit]


  1. ^ a b Hutchinson, M; Wilkes, L; Vickers, M; Jackson, D (2008). "The development and validation of a bullying inventory for the nursing workplace". Nurse researcher. 15 (2): 19–29. doi:10.7748/nr2008. PMID 18283759. 
  2. ^ Porter-O'grady, T (2008). "Transforming work environments. Interview by Diane E Scott and Amanda Rosenkranz". The American nurse. 40 (2): 7. PMID 18494401. 
  3. ^ Richards A, Edwards SL A Nurse's Survival Guide to the Ward (2008)[page needed]
  4. ^ Dellasega, Cheryl A. (2009). "Bullying among nurses". The American journal of nursing. 109 (1): 52–8. doi:10.1097/01.NAJ.0000344039.11651.08. PMID 19112267. 
  5. ^ McNamara, S (2012). "Incivility in nursing: Unsafe nurse, unsafe patients". AORN Journal. 95 (4): 535–540. doi:10.1016/j.aorn.2012.01.020. 
  6. ^ Lewis, Malcolm A. (2006). "Nurse bullying: Organizational considerations in the maintenance and perpetration of health care bullying cultures" (PDF). Journal of Nursing Management. 14 (1): 52–8. doi:10.1111/j.1365-2934.2005.00535.x. PMID 16359446. Archived from the original (PDF) on 2011-07-17. 
  7. ^ Spence Laschinger, Heather K.; Leiter, Michael; Day, Arla; Gilin, Debra (2009). "Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes". Journal of Nursing Management. 17 (3): 302–11. doi:10.1111/j.1365-2834.2009.00999.x. PMID 19426367. 
  8. ^ Klass, Perri (2017-02-27). "What Happens When Parents Are Rude in the Hospital". The New York Times. ISSN 0362-4331. Retrieved 2017-03-02. 
  9. ^ Riskin, Arieh; Erez, Amir; Foulk, Trevor A.; Riskin-Geuz, Kinneret S.; Ziv, Amitai; Sela, Rina; Pessach-Gelblum, Liat; Bamberger, Peter A. (2017-02-01). "Rudeness and Medical Team Performance". Pediatrics. 139 (2): e20162305. doi:10.1542/peds.2016-2305. ISSN 1098-4275. PMID 28073958. 
  10. ^ NHS nurses 'bullied by managers' BBC News 11 October 2003
  11. ^ Peters, Anya Bostian (2014). "Faculty to faculty incivility: Experiences of novice nurse faculty in academia". Journal of Professional Nursing. 
  12. ^ Roy, Josie. "Horizontal Violence". ADVANCE for Nurses. Retrieved 5 October 2011. 
  13. ^ Trossman, S (2008). "Behaving badly? Joint Commission issues alert aimed at improving workplace culture, patient care". The American nurse. 40 (5): 1, 6, 12. PMID 19024048. 
  14. ^ Martin, William (2008). "Is Your Hospital Safe? Disruptive Behavior and Workplace Bullying" (PDF). Hospital Topics. 86 (3): 21–8. doi:10.3200/HTPS.86.3.21-28. PMID 18694856. Archived from the original (PDF) on 8 March 2012. 
  15. ^ Nurse Work Injury Compensation Eoin Campbell Injury Compensation Zone
  16. ^ Kerfoot, KM (2008). "Leadership, civility, and the 'no jerks' rule". Medsurg nursing. 17 (6): 441–2. PMID 19248414. 

Further reading[edit]


  • Button SM Bullying of a nursing student: a mixed interpretive study (2007)
  • Dellasega C When Nurses Hurt Nurses: Recognizing and Overcoming The Cycles of Bullying (2011)
  • Nurses and the experience of bullying at work: a report for the Claire Thomson, Working Women's Centre (Adelaide, S. Aust.), Australian Nursing Federation. S.A. Branch - 1998
  • Thompson R "Do No Harm" Applies To Nurses Too! (2012)
  • Webb C, Randle J Workplace Bullying in the NHS (2006)

Academic papers[edit]

  • Cleary, Michelle; Hunt, Glenn E.; Horsfall, Jan (2010). "Identifying and Addressing Bullying in Nursing". Issues in Mental Health Nursing. 31 (5): 331–5. doi:10.3109/01612840903308531. PMID 20394479. 
  • Cooper, Janet R. M.; Walker, Jean T.; Winters, Karen; Williams, P. Renée; Askew, Rebecca; Robinson, Jennifer C. (2009). "Nursing students' perceptions of bullying behaviours by classmates". Issues in Educational Research. 19 (3): 212–26. 
  • Foster, Barry; Mackie, Beth; Barnett, Natasha (2004). "Bullying in the Health Sector: A Study of Bullying of Nursing Students". New Zealand Journal of Employment Relations. 29 (2): 67–83. 
  • Hogh, Annie; Carneiro, Isabella Gomes; Giver, Hanne; Rugulies, Reiner (2011). "Are immigrants in the nursing industry at increased risk of bullying at work? A one-year follow-up study". Scandinavian Journal of Psychology. 52 (1): 49–56. doi:10.1111/j.1467-9450.2010.00840.x. PMID 21054415. 
  • Hutchinson, Marie; Vickers, Margaret; Jackson, Debra; Wilkes, Lesley (2006). "Workplace bullying in nursing: towards a more critical organisational perspective". Nursing Inquiry. 13 (2): 118–26. doi:10.1111/j.1440-1800.2006.00314.x. PMID 16700755. 
  • Hutchinson, Marie; Jackson, Debra; Wilkes, Lesley; Vickers, Margaret H. (2008). "A new model of bullying in the nursing workplace: organizational characteristics as critical antecedents". Advances in Nursing Science. 31 (2): E60–71. doi:10.1097/01.ANS.0000319572.37373.0c. PMID 18497582. 
  • Hutchinson, Marie; Wilkes, Lesley; Jackson, Debra; Vickers, Margaret H. (2010). "Integrating individual, work group and organizational factors: testing a multidimensional model of bullying in the nursing workplace". Journal of Nursing Management. 18 (2): 173–81. doi:10.1111/j.1365-2834.2009.01035.x. PMID 20465745. 
  • Hutchinson, Marie; Vickers, Margaret H.; Wilkes, Lesley; Jackson, Debra (2009). "'The Worse You Behave, The More You Seem, to be Rewarded': Bullying in Nursing as Organizational Corruption". Employee Responsibilities and Rights Journal. 21 (3): 213–29. doi:10.1007/s10672-009-9100-z. 
  • Johnston, Michelle; Phanhtharath, Phylavanh; Jackson, Brenda S. (2010). "The Bullying Aspect of Workplace Violence in Nursing". JONA's Healthcare Law, Ethics, and Regulation. 12 (2): 36–42. doi:10.1097/NHL.0b013e3181e6bd19. 
  • Lewis, MA (2001). "Bullying in nursing". Nursing standard. 15 (45): 39–42. doi:10.7748/ns2001. PMID 12212387. 
  • Murray, JS (2009). "Workplace bullying in nursing: a problem that can't be ignored". Medsurg nursing. 18 (5): 273–6. PMID 19927962. 
  • Murray, Colonel John S. (2008). "On Bullying in the Nursing Workplace". Journal of Obstetric, Gynecologic, & Neonatal Nursing. 37 (4): 393–393. doi:10.1111/j.1552-6909.2008.00263.x. 
  • Randle, Jacqueline (2003). "Bullying in the nursing profession". Journal of Advanced Nursing. 43 (4): 395–401. doi:10.1046/j.1365-2648.2003.02728.x. PMID 12887358. 
  • Smith, Pam; Cowie, Helen (2010). "Perspectives on emotional labour and bullying: Reviewing the role of emotions in nursing and healthcare". International Journal of Work Organisation and Emotion. 3 (3): 227–36. doi:10.1504/IJWOE.2010.032923. 
  • Stevens, S. (2002). "Nursing Workforce Retention: Challenging A Bullying Culture". Health Affairs. 21 (5): 189–93. doi:10.1377/hlthaff.21.5.189. PMID 12224882. 
  • Cleary, Michelle; Hunt, Glenn E.; Horsfall, Jan (2010). "Identifying and Addressing Bullying in Nursing". Issues in Mental Health Nursing. 31 (5): 331–335. doi:10.3109/01612840903308531. PMID 20394479.