Bullying in the Nursing Workplace: Literature Review and Analysis

This report addresses the critical issue of bullying in the nursing workplace. It begins with an introduction highlighting the various forms of bullying, including gossiping, intimidation, and exclusion, and emphasizes the negative impact on nurses' mental and physical health and their ability to provide patient care. A literature review examines scholarly articles and research findings, including real-life cases of nurses experiencing bullying in Canada and Australia. The review explores the causes, effects, and consequences of bullying, such as emotional distress, depression, and decreased job satisfaction. The report also analyzes current data on bullying practices, acknowledging the underreporting due to fear and hesitation among victims. It highlights the need for healthcare institutions to establish strict anti-bullying policies and create a safe and respectful work environment. The report concludes by emphasizing the importance of addressing bullying to protect nurses' well-being and ensure quality healthcare services.

RUNNING HEAD: BULLYING IN THE WORKPLACE
NURSING
BULLYING IN THE WORKPLACE

BULLYING IN THE WORKPLACE 1
Contents
Introduction................................................................................................................................2
Literature review........................................................................................................................3
Current data on bullying practices.............................................................................................8
Possible questions......................................................................................................................9
Conclusion................................................................................................................................11
Bibliography.............................................................................................................................12

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Introduction
The discussion reflects on the key issue of ‘Bullying in the workplace’ in nursing. The
bullying behavior includes gossiping, threatening, blaming, intimidation, forming cliques,
refusing to work with colleagues and help. Incivility, bullying, and violence are serious issues
in nursing (Clarke, Kane, Rajacich, & Lafreniere, 2012). The nurse faces these types of
concerns in verbal and physical form in their workplace. They have risen in number as the
health care institutions do not properly address these forms of concern (Karatza, Zyga,
Tziaferi, & Prezerakos, 2016). This is highly unacceptable behavior weather is performed by
colleagues or patients. It lays a high impact on the mental and physical health of nurses. It
minimizes their ability and potential to care for their patients (Condon, Incivility as bullying
in nursing education, 2015). It develops the duty of the health institutions to frame strict no-
bullying policy and offer a healthy, safe and respectful work environment to their nurses
(Watson, 2011). Many female nurses and male nurses have faced this issue as per the
'National Survey of the Work and Health of Nurses'. They have experienced a high degree of
emotional abuse from their co-workers (Watson, 2011).
Focusing on the discussion, it emphasizes on distinct aspects associated with bullying
in the workplace by reviewing the knowledge and ideas of scholars and researchers. The key
theme is ‘Bullying in the workplace is highly offensive and lays a direct impact on overall
work performance’.

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Literature review
Laura Eggertson (2011) focuses on the real bullying experiences of a nurse. The key
objective is to emphasize the impact of bullying and the necessary measures for its
elimination. The author has developed the use of secondary research methodology. The
author relies on to gain knowledge about this concern (Eggertson, 2011). She stated that
Valerie was a registered nurse in Western Canada. She was bullied by her co-workers and
managers for a prolonged period of two years. Her co-worker has refused to assist and share
information with her. She (bully) often refuses to share a conversation with Valerie. This was
not limited to her co-worker but her manager has also taken an active role in bullying her. He
used to blame her and communicate in a negative and substandard manner. This humiliating
behavior has highly disturbed Valerie. The author has also added on the unpleasant
experience of Nicole. She was also one of the survivors of bullying in the health care center.
She was attacked by the charge nurse and the hospital ward. She has reported the bullying to
her manager. However, she has failed to receive any form of support from the top authority.
Her boss has not given attention to her concern and suggested her to leave. These actions
have highly impacted the mental health of Nicole (Eggertson, 2011). She was diagnosed with
depression. Considering Samantha's case, she was also one of the nurses that have
experienced this issue. She was accused to interrupt on patient’s medication. Her manager
envied her due to her qualifications. He questions her judgment and actions. Therefore, she
has complained to the union but failed to receive the required support. The author added that

BULLYING IN THE WORKPLACE 4
the e-learning module and role-playing will offer practices to support nurses to respond to
bullying (Eggertson, 2011). From the article, it is analyzed that bullying is one of the key
issues faced by nurses in Canada.
Bullying practices in Nursing is not limited to a specific country. It is an international
phenomenon and nurses from all over the world experience this issue (Comaford, 2016). The
authors named Melanie Birks, Lea M. Budden, Narelle Biedermann, Tanya Park, and Ysanne
Chapman have highlighted the bullying experiences of nursing students in Australia. Their
key objective is to point the personal bullying familiarity of the nursing students (Birks,
Budden, Biedermann, Park, & Chapman, 2018). As per their perception, bullying is verbal,
social and psychological abuse. In Australia, it has risen to an extent of 6.8%. About 884
students of nursing students were surveyed to determine their views about bullying. Based on
the survey it was acknowledged that a high proportion of nursing students have experienced
bullying. They were bullied by their staff members as well as patients. Considering one of the
cases, a nursing student was forced to deal with the tricky cases that required high
professional knowledge and experience. Some students have reported that they were not
called in a proper and restful manner and they were treated as children. The students
belonging to diverse cultural backgrounds have experienced a higher degree of
embarrassment. It makes them feel discriminated and lowers their morale (Birks, Budden,
Biedermann, Park, & Chapman, 2018). They were the main target of bullies in healthcare.
The authors added that students must possess adequate knowledge to respond to bullying in

BULLYING IN THE WORKPLACE 5
the clinical environment. Additionally, registered nurses must fulfill their duty by assisting
nursing students. The health care service should frame policies that accept zero tolerance
towards abusing. They laid high influence on addressing this rising concern among nurses
and students engaged in this field of study (Birks, Budden, Biedermann, Park, & Chapman,
2018). By considering the author's research, it is assessed that this issue is not limited to the
home country (Canada) but rather it was spread globally.
Workplace bullying is considered pervasive in healthcare organizations. It leads to a
difficult work environment for registered nurses (Forbes, 2020). The authors have highlighted
the key issue of bullying in the workplace. The key objective of the author is to develop a
reasonable solution based on the survey of nurses on account of Bullying. They found
themselves distracted to work under such a stressful situation (Gillespie, Berry, Fisher,
Gormley, & Haynes, 2016). It acts as psychological distress for the registered nurses. It
makes them lose their control over the situation and they are not able to lay proper attention
towards their duty in the healthcare center. After considering the sample of 191 nurses, about
90% of nurses reported that they have experienced high stress after becoming prone to
bullying. They experienced perceived stress and posttraumatic stress symptoms (Gillespie,
Berry, Fisher, Gormley, & Haynes, 2016). The author has stated that nurses should give
proper responses to the malpractices in the healthcare center. They should immediately report
when they acknowledge any form of unacceptable, hurtful or inappropriate behavior. It
develops the duty of healthcare centers to show seriousness towards these issues (Gillespie,

BULLYING IN THE WORKPLACE 6
Berry, Fisher, Gormley, & Haynes, 2016). The authors have stated that only a small sample
of nurses was taken. Therefore, it does not depict a clear result of the serious issue of bullying
in nursing. The finding shows the result of only a small proportion of nurses. This is because
they were hesitating to participate in the survey (Gillespie, Berry, Fisher, Gormley, &
Haynes, 2016). It is evaluated that considering the sample of only a few respondents is not
appropriate to come to consider results for registered nurses.
Management of workplace bullying is essential to minimize the number of cases in
hospitals. The author stated that the workplace is a common issue in the workplace. The
practice of bullying in nursing is occurring frequently in the global world (APA, 2015). It
acts as a high concern because the well-being of the nurses is highly essential to provide
required and better care to the patient. According to the author's view, nurses experience
violence in verbal and physical forms. The failure in offering a safe and healthy work
environment will lead to a high turnover rate in hospitals. It will result in a shortage of staff
in return for the rising demand for healthcare services by people (Steven, 2016). It is also
raising the cost of the institution as they have to provide essential training to the new nurses
for filling the position of the old staff. They also fail to gain quality performance from the
new staff in the healthcare institution. Therefore, it ultimately disturbs the overall functioning
of the center. It is also contributing to lower workplace satisfaction and higher absenteeism.
According to the survey by National Health Service’, it is estimated that 25% of the nursing
staff experiences bullying (Steven, 2016). They have mainly experienced this behavior from

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their colleagues and manager. There has been a slight increase in the percentage of this issue.
The most common form of violence is bullying among nurses. They are experiencing
headaches, respiratory, and chronic diseases. With the rise in several bullying issues, the
healthcare centers are lacking to provide quality healthcare service to their patients. This is
because of their poor mental health and lack of sleep does not allow them to devote their full
potential towards their service (Steven, 2016). It is analyzed that bullying is directly laying an
impact on the health of the victims. Its impact is not limited to registered nurses only but
healthcare centers also gain an indirect disadvantage.
According to Laura R. and Tammy MSN (2014), nursing students are highly exposed
to bullying in a clinical setting. The key objective of the review is to lay deeper knowledge on
bullying issue, its consequences and remedial measures. They have relied on the application
of secondary research as a methodology for the review. A survey has been conducted among
313 nursing students of the second and third years (BSN & MSN, 2014). Around 53% of
respondents indicated that they have experienced bullying issues in their clinical practice.
They have stated that they were ignored, received destructive criticism, resentment and also
humiliated in front of other students. The survey also included the comment section. The
respondents have stated that they were not able to gain adequate support from their senior
authorities and they were feeling alienated (BSN & MSN, 2014). They often have considered
a thought to leave the position as well as the profession of nursing. The authors have stated
that it develops the duty of nurses to follow 'Code of Ethics for Nurses with Interpretive

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Statements'. They should follow the ethics to develop a compassionate and caring
relationship with their staff members (BSN & MSN, 2014). This should offer fair treatment
to all the individuals of the healthcare center as it will enable them to easily resolve conflicts.
They should lay active participation in reporting such a form of behavior to their respective
authorities. The authors stated that new nurse graduates should attain high awareness about
the issue of bullying. It will allow them to effectively report such form of problem in the
future. Their study should include the possible causes of abuse as it will assist in taking the
right measures at the situation. The rising issue of bullying can be minimized by raising
awareness. They should know how to deal with the stressors associated with bullying (BSN
& MSN, 2014). It is analyzed that almost all nurses were acquainted with the issue of
bullying. Additionally, it can be solved if its prior attention is laid towards the following code
of conduct and raising awareness among the newcomers in this profession.
Current data on bullying practices
There is continuous fluctuation regarding data on bullying. There is not fix data on
several bullying practices in Canada. This is because only a few victims respond and report
such practices to their authorities. Therefore, higher numbers of cases have not been reported
due to a lack of confidence, insecurity, and hesitation. It is evaluated that there is a rise in the
number of bullying cases. The registered nurses have reported more than 4000 incidents of
bullying between the years 2008 to 2013. It is assessed that bullying practices have also

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taken the life of many registered nurses. Doctors and higher authorities lay active
participation in bullying their staff.
Additionally, it is researched that workplace violence is highly common in Nursing. It
makes nursing as one of the dangerous profession of Canada. A high number of bullies were
not punished because they are patients suffering from mental illness. There is an installation
of more than 360 security cameras in healthcare institutions. The nurses are given training to
self-defense themselves against violence and bullying practices. Personal communication
devices were also worn by nurses to immediately seek help against bullying practices.
Therefore, a high number of steps have been taken to minimize the number of cases
associated with violence and bullying in nursing in Canada (Cribb, 2015).
Possible questions
There are several key questions associated with bullying in nursing. It includes the
following:
1. Why the number of bullying case is rising in nursing practice?
2. What are the best possible measures to eradicate and minimize this key concern?
3. Is there a possibility that this issue can be eradicated from its root? (Szutenbach,
2013)
4. What is the key cause of bullying practices in nursing?

BULLYING IN THE WORKPLACE 10
5. What is the ratio of bullying in Canada in proportion to the global world? (Etienne,
2014)
6. What are the conditions that gave rise to bullying practices in healthcare centers?
7. What are some of the legal policies against bullying practices in Canada?
8. Is it possible to develop Canada as a county with non-bullying practices? (Ovayolu,
Ovayolu, & Karadag, 2014)
9. What are some of the duties of a health center concerning the victim?
10. What serious actions should a health care center opt against the bullies? (Condon,
Incivility as bullying in nursing education, 2015)
11. Do different authors have the same viewpoints regarding bullying practices?
12. What are the methods users by the researchers to gain data about the bullying
practices?
13. What are some of the serious health issues associated with Bullying?
14. Is the bullying issue is a common concern of the workers? (Granstra, 2015)
15. How the awareness of Bullying is can be raised to a large number of people?
16. How to measure the level of the problem caused by bullying? (Cleary, Hunt, &
Horsfall, 2010)
17. How to assist the victim in reporting bullying cases to the respective authorities?
(Wilson, 2016)

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18. What is the duty of a victim towards him in the health care center? (Wright & Khatri,
2015)
Conclusion
The report summarizes the significant issue of bullying in the workplace. It is
acknowledged that bullying is a common practice in Nursing. It is gradually rising in Canada
as well in another part of the world. It is a serious issue as it develops a high number of
problems for registered nurses (RN). It is evaluated that males, as well as females, have been
the victims of this issue. It is analyzed that bullying is laying a direct impact on the health of
the RN. They are facing an issue of lack of sleep/sleeping and eating disorder, headache,
depression and other chronic diseases. It is also affecting their quality of work at the health
care center. They are not able to offer their full attention and devotion towards their patients.
It is affecting their overall work performance resulting in poor results. The bullying issue is
not limited to nurses only but its serious drawbacks have also been experienced by the health
service center. They are facing concern with staff turnover, a rise in overall cost, and poorly
satisfied staff. It is assessed that there is a high need to raise the awareness of bullying among
the new nursing students. This will be done by including this issue in their study material.
Additionally, it develops the duty of the healthcare institution to frame strict policies against
bullying and nurses themselves should lay high attention in following code of conduct and
giving rise to a peaceful work environment. Hence, the bullying issue is a major concern in
nursing.

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