Bullying In the Workplace: Changing Nursing Behaviors

About this course

Bullying is a complex and detrimental phenomenon characterized by persistent, aggressive, and harmful behaviors directed towards one or more individuals within the healthcare workplace. It extends beyond occasional conflicts and disagreements, involving a pattern of mistreatment that creates an intimidating, hostile, and often abusive environment. Bullying can manifest in various forms, including verbal, physical, or psychological abuse, as well as manipulation or sabotage of professional relationships. This course discusses bullying in healthcare settings, defining its attributes and psychological effects. It also addresses how bullying can be reduced, nursing behaviors can be changed, tools for victims, and intervention methods to resolve and reduce future occurrences.

Learning objectives

• Identify various forms of bullying.
• Differentiate bullying from other types of behaviors.
• Recognize how organizational culture can influence nursing behaviors.
• Understand the psychological effects of bullying.
• Review the steps to intervene when bullying occurs.

Course outline

18 sections · finish in any order across devices

1. 1

   Introduction

   Bullying is a complex and detrimental phenomenon characterized by persistent, aggressive, and harmful behaviors directed towards one or more individuals within the healthcare workplace. It extends beyond occasional conflicts and disagreements, involving a pattern of mistreatment that creates an inti

   4 min

2. 2

   Bullying Definition

   Bullying is a form of aggressive behavior to intimidate, harm, embarrass, or distress others. It involves intentional and harmful actions, creating a hostile environment for the individual being targeted. Bullying can manifest in various forms, including incivility, verbal abuse, social exclusion, c

   4 min

3. 3

   Key Elements of Bullying in Healthcare

   Certain key elements distinguish bullying from other types of behaviors. Understanding these signs can aid in identifying such acts to create environments that discourage and actively address such behavior. At the core of healthcare-related bullying is a power dynamic where the perpetrator wields a

   4 min

4. 4

   Who Is Likely to Experience Bullying

   While it is true that older nurses are known to target their younger colleagues, bullying behavior transcends age, gender, and experience level. New nurses, often in their early career stages, are most likely to encounter bullying due to their perceived lack of experience or knowledge. While often p

   4 min

5. 5

   Psychological Effects of Bullying

   The psychological effects of bullying can have profound and long-lasting impacts on the mental well-being of nurses. These effects can manifest in several ways, contributing to a range of emotional and behavioral challenges. Bullying often leads to heightened levels of anxiety and stress. The persis

   4 min

6. 6

   Impact on Job Performance

   Bullying creates a stressful work environment, diminishing the victim's ability to focus and perform at their best. The constant fear of mistreatment can decrease productivity as nurses struggle to concentrate on their tasks. Nurses who experience bullying may seek to avoid the hostile work environm

   4 min

7. 7

   Why Bullying Occurs Amongst Nurses

   Bullying among nurses is often linked to hierarchical structures within healthcare settings, where power dynamics play a significant role. The traditional hierarchy in nursing, with clear distinctions between roles and ranks, can create an environment where power imbalances thrive. Nurses in positio

   4 min

8. 8

   How Bullying Can Be Reduced

   Reducing bullying involves a multifaceted approach that encompasses awareness, education, cultural change, and individual empowerment. First, it is essential to define what constitutes bullying behavior clearly. This includes providing employees with explicit guidelines ensuring everyone understands

   4 min

9. 9

   How to Intervene When Bullying Occurs

   Intervening when bullying occurs is crucial to creating a healthy work environment. Here is a step-by-step guide on how to effectively intervene when bullying takes place. Remember, the key to successful intervention is an initiative-taking and comprehensive approach that prioritizes the well-being

   4 min

10. 10

    Recognize the Signs of Bullying

    Intervention begins by recognizing the signs of bullying. This crucial process demands identifying subtle and overt indicators of bullying, such as changes in behavior among their colleagues. This may include increased irritability, withdrawal, or a noticeable shift in interpersonal dynamics. Additi

    4 min

11. 11

    Maintain Confidentiality

    Maintaining confidentiality during workplace bullying investigations is paramount. Confidentiality protects all parties involved, reducing the risk of retaliation, and ensuring a safe space for reporting. Confidentiality not only encourages victims and witnesses to come forward without fear, but als

    4 min

12. 12

    Involve Human Resources

    Before addressing workplace bullying, it is essential to involve Human Resources (HR) as they possess the expertise to conduct impartial investigations, ensuring fairness and adherence to organizational policies. Their involvement contributes to a transparent and systematic approach, fostering trust

    4 min

13. 13

    Implement Temporary Measures

    In response to reported workplace bullying, temporary measures should be implemented to mitigate ongoing tensions. These measures, such as modifying work assignments or schedules, are instrumental in creating physical and emotional distance between the individuals involved during the investigation p

    4 min

14. 14

    Conduct Mediation (If Appropriate)

    In situations where both parties are willing, consider conducting mediation sessions facilitated by a neutral third party to promote communication and resolution. Mediation provides a constructive platform for the involved individuals to express their perspectives openly, fostering a dialogue aimed

    4 min

15. 15

    Enforce Consequences

    If bullying has indeed occurred, it is imperative to enforce appropriate consequences. This involves adhering to established organizational policies and meeting legal requirements in determining suitable disciplinary actions. Consistent enforcement of consequences serves as a deterrent, discouraging

    4 min

16. 16

    Seek External Assistance (If needed)

    If internal interventions prove insufficient in addressing workplace bullying, consider seeking external assistance from external consultants or resources with specialized guidance and expertise. External assistance can bring a fresh perspective, impartiality, and a wealth of experience in dealing w

    4 min

17. 17

    Nursing Considerations

    In a healthcare setting where bullying is noted, nurses play a crucial role in reporting instances and ensuring the quality of patient care does not suffer because of a hostile environment. Observers should be attuned to signs of distress in their colleagues, fostering a supportive network and utili

    4 min

18. 18

    Conclusion

    Addressing bullying among nurses is imperative for creating a healthy and supportive healthcare environment. Bullying can affect nurses across various experience levels, and identities extend beyond occasional conflicts. Bullying is a persistent harmful behavior that affects mental health and job pe

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Edmonson, C., & Allard, J. (2013). Finding Meaning in Civility: Creating a "No Bullying Zone." Clinical Scholars Review, 6(2), 131–137. https://doi.org/10.1891/1939-2095.6.2.131
• Clarke, C. M., Kane, D. J., Rajacich, D. L., & Lafreniere, K. D. (2012). Bullying in Undergraduate Clinical Nursing Education. Journal of Nursing Education, 51(5), 269–276. https://doi.org/10.3928/01484834-20120409-01
• Edmonson, C., & Zelonka, C. (2019). Our Own Worst Enemies: The Nurse Bullying Epidemic. Nursing Administration Quarterly, 43(3), 274-279. https://doi.org/10.1097/NAQ.0000000000000353
• Hampton, D., Tharp‐Barrie, K., & Kay Rayens, M. (2018). Experience of nursing leaders with workplace bullying and how to best cope. Journal of Nursing Management, 27(3), 517–526. https://doi.org/10.1111/jonm.12706
• American Nurses Association. (2015). Incivility, bullying, and workplace violence. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/.
• Dellasega, C. (n.d.). When nurses hurt nurses : recognizing and overcoming the cycle of nurse bullying. (No Title). Retrieved November 22, 2023, from https://cir.nii.ac.jp/crid/1130000793844827776
• Smith, C. R., Palazzo, S. J., Grubb, P. L., & Gillespie, G. L. (2020). Standing up against workplace bullying behavior: Recommendations from newly licensed nurses. Journal of Nursing Education and Practice, 10(7), 35. https://doi.org/10.5430/jnep.v10n7p35
• Homayuni, A., Hosseini, Z., Aghamolaei, T., & Shahini, S. (2021). Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00578-3
• American Nurses Association. (2015). Incivility, bullying, and workplace violence. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/
• Sansone, R. A., & Sansone, L. A. Workplace Bullying: A Tale of Adverse Consequences. Innovations in Clinical Neuroscience, 12(1-2), 32-37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382139/
• Hartin, P., Birks, M., & Lindsay, D. (2020). Bullying in nursing: How has it changed over 4 decades? Journal of Nursing Management, 28(7), 1619-1626. https://doi.org/10.1111/jonm.13117.
• Ceravolo, D. J., Schwartz, D. G., Foltz-Ramos, K. M., & Castner, J. (2012). Strengthening communication to overcome lateral violence. Journal of Nursing Management, 20(5), 599-606. https://doi.org/10.1111/j.1365-2834.2012.01402.x
• Parker, Karen M. DNP, FNP-C, RN; Harrington, Ann MPA, BSN, RN, NEA-BC; Smith, Charlene M. DNS, MSEd, WHNP, RN-BC, CNE, ANEF; Sellers, Kathleen F. PhD, RN; Millenbach, Linda PhD, RN. Creating a Nurse-Led Culture to Minimize Horizontal Violence in the Acute Care Setting: A Multi-Interventional Approach. Journal for Nurses in Professional Development 32(2):p 56-63, March/April 2016. | DOI: 10.1097/NND.0000000000000224
• Jean, J. (2022, January 20). Ask a Nurse: How to Combat Nurse Bullying in the Workplace. NurseJournal. https://nursejournal.org/ask-a-nurse/how-to-combat-bullying-in-nursing/

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