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Bullying in the profession

Nursing: A generational look at bullying in the profession

Sarah Perry BSN, RN

Youngstown State University

Nurs 6900: Healthcare Issues and Trends

Dr. Sheila Blank

August 3rd 2022

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Bullying in the profession

Abstract

Bullying in the workplace is an issue that can occur in any career, yet the nursing

profession is known for its bad reputation of bullies. This wide stem of bullying does not just

occur with nurses but also students, physicians, and other lay people in the workplace. Nursing

has grown a name for itself in that they eat their young. Not only does this type of harassment

have detrimental mental and physical effects on an individual it also creates many problems for

the healthcare system. Just a few issues that can be included are increased turnover rates, an

unhealthy work environment leading to nursing shortages and overall, a decrease in quality of

patient care and satisfaction. This paper will look at the historical aspect of bullying in the

workplace, what nursing implications can be displayed to create a healthy work environment as

well as possible resolutions to this recurring issue.

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Bullying in the profession

Nursing: A generational look at bullying in the profession

The nursing profession has one of the highest turnover rates. A study conducted by Al

Muharraq et al, revealed “The rate of workplace bullying was high, bullying occurred at a

cumulative rate of 33.4%” also noted includes “Among the participants, 31.7% exhibited a high

turnover intention.” The study concludes that increased prevalence of bullying had a direct

correlation with intent to leave the workplace. In conjunction with high turnover rates bullying in

the nursing profession creates an unhealthy work environment and can lead to an overall nursing

shortage. “Nurses across the United States describe that they experience unfriendly work

environments that include bullying behaviors such as being ignored, belittled, confrontational,

sexually harassed and a general lack of feeling supported, all of which influence nurses to leave

the profession.” (MacKusick and Minich, 2010 as cited in JR & LA, 2019) The nursing shortage

does not stem from a lack of nurses but rather nurses leaving the workplace and choosing

different career options. Science Daily 2015 reports “The number of nurses leaving the

workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 by

2020. Meanwhile, the dramatic growth in nursing school enrollment over the last 15 years has

begun to level off." Not only does bullying effect shortages but it also leads to poor outcomes for

patients. New nurses in the workplace can lack confidence in skills, critical thinking and

advocating for patients. When bullying occurs, a new nurse can feel intimidated by asking the

older more experienced nurses questions or help with their patients. This form of bullying can

lead the new graduate nurse to feel isolated. When unable to work as a team this can lead to poor

decision making thus poor outcomes for patients.

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Bullying in the profession

Historical Aspects

A broad history of bullying can be linked to many centuries ago. It is unclear on an exact

initiation of incorporating bullying into the nursing profession however Szutenbach (2013) as

referenced by Daly et al., 2020 noted that “bullying in nursing practice was first cited in the

literature in the 1970s and 1980s” Bullying has been seen throughout the years in this profession

and has almost become a social norm when entering the healthcare field. It is sought to be a rite

of passage for new graduate nurses to earn respect from the older generation. As a young nurse it

is common to be expected to pick up extra overtime or take the most difficult assignment. “In

health care organizations, assigning mandatory overtime to nurses who are new, single, or male

without asking or rotating mandatory overtime is an example of WPB (workplace bullying)

behavior. The exclusive assignment of excessive workloads as a way of “making or breaking” a

nurse to a specific work environment is also WPB.” (Berry et al., 2016). The older generation of

nurses may not recognize their behavior as bullying as they had to experience the same sort of

initiation when they were new to the profession. Bullying in nursing is often seen first when one

is still in nursing school. It is not uncommon for nursing professors or even nurse preceptors to

inform students that they should expect a little harassment when starting their career. “Students

who learn early on that abuse is okay have a hard time speaking out against any kind of bullying

even that enacted by their peers.” (Dillon, 2021).

Nursing Implications

Entering a career with such high rates of bullying and turnover one must be prepared on

how to handle such situations. Ways to decrease the incidence of bullying in this profession

continue to make rise however there are some key factors that can help a new nurse deal with

potential conflict. Registered nurses are supposed to be caring and courageous for patients, but it
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Bullying in the profession

is time now more than ever that they do the same for their coworkers. A nurse should lead by

example and set a healthy pathway for their unit. This includes taking action when witnessing

unacceptable behavior such as reporting the incident to human resources or a manager.

Registered nurses can help mitigate this problem by taking a new graduate under their wing.

Educating and guiding the new nurse to be a confident and competent employee. When a unit

can work together in creating strong young nurses it paves a pathway for a successful team.

Proposal to solve the issue

Workplace bullying in nursing has come a long way over the years yet is still very

present to this day. While there are policies in place in most institutions such as zero-tolerance

for bullying it is still prevalent. One proposal for this issue revolves around a mentorship

program. Not only would the new graduate nurse be assigned a preceptor but also a mentor. A

mentor can be looked at as someone that will always have your back. The goal for this program

would hopefully create a safe bond with a young nurse and someone more experienced that they

have an outlet to voice concerns or questions. An experienced nurse orienting a new graduate

may be viewed as intimidating and not necessarily a safe space for learning. The mentorship

program would allow the new nurse to have more than just one resource for information as well

as knowing that someone else is looking out for them. In addition to creating new programs to

help support new nurses’ management plays a very important role. “Nurse leaders must be

attentive to staff communication on and off their units as WPB can occur between units and

floors, causing less participation and productivity. Frequent, non-threatening contact (i.e., open

door policy) may provide opportunities for employees to share issues arising on and between the

units with their nurse managers.” (Berry et al., 2016). Having a manager that leads by example
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Bullying in the profession

and creates a safe space for their employees can greatly increase morale and satisfaction of all

staff.

Conclusion

Bullying in the workplace stems from multiple generations of nursing and while there are

continued improvements to prevent this issue it is still commonly seen. Workplace bullying can

be detrimental to the health and wellbeing of nurses leading to high turnover rates. High rate of

turnover and constant abuse can also lead to a nursing shortage. In the event of continued

bullying nurses are more likely to leave the career all together and seek other opportunities. It

can also be noted that bullying creates tension between coworkers and a team that does not work

well together thus leading to poor patient outcomes. It is hopeful that the future of nursing and

creating a more positive work environment will give staff incentive to change the culture of

nursing and become a strong bonded team for their patients. This change has to be created from

within and helping the older generation recognize the benefits of guiding new nurses to be strong

coworkers. A decrease in workplace bullying can be accomplished by creating open door

policies with management as well as implementing programs that support the needs of young

nurses.
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Bullying in the profession

References

Al Muharraq, E. H., Baker, O. G., & Alallah, S. M. (2022). The prevalence and the relationship
of workplace bullying and nurses turnover intentions: A Cross Sectional Study. SAGE
Open Nursing, 8. https://doi.org/10.1177/23779608221074655

Berry, P. A., Gillespie, G. L., Fisher, B. S., & Gormley, D. K. (2016). Recognizing, confronting,
and eliminating workplace bullying. Workplace Health & Safety, 64(7), 337–341.
https://doi.org/10.1177/2165079916634711

Daly, Z., O'Flynn-Magee, K., & Rodney, P. (2020). A call to revisit and address the histories of
bullying in nursing education. Quality Advancement in Nursing Education - Avancées En
Formation Infirmière, 6(3). https://doi.org/10.17483/2368-6669.1249

Dillon, S. (2021, January 7). Workplace bullying in nursing: why it happens and how to confront
it. Retrieved August 1, 2022, from
https://www.bravadohealth.com/2021/01/07/confronting-nurse-bullying/.

JR, Y., & LA, D. (2019). Bullying behavior does not support the normal standard of care.
Journal of Nursing and Healthcare Management, 2(1). https://doi.org/10.18875/2639-
7293.2.101

ScienceDaily. (2015, September 21). Shortage of nurses not as dire as predicted, but challenges
remain to meet America's needs. ScienceDaily. Retrieved August 1, 2022, from
https://www.sciencedaily.com/releases/2015/09/150921153457.htm