Bullying behaviors remain prevalent in nursing, resulting in turnover, poor work performance, and emotional trauma. During a session for the inaugural ONS Bridge™ virtual conference, Terri Townsend, MA, RN, CCRN-CMC, CMSRN, of Community Hospital Anderson, and Pamela Anderson, MSN, RN, CCRN, ANP-BC, of St. Vincent Medical Group, shed light on how to eliminate this pervasive issue.

From the Playground to the Nurses’ Station: Understanding Bullying Behavior

Bullying—repeated, unwanted negative behaviors intended to harm a targeted person—exists in all professions. However, a culture of bullying is especially problematic in nursing, where 60% of new RNs quit their first job within six months of being bullied, and one in three nurses has considered quitting the profession because of abuse, the speakers said. Eliminating the issue begins with understanding the characteristics of oppressed group behavior.

“Studies in the 1960s and 1970s indicated the organizational hierarchy [of nursing] lent itself to staff oppression,” Townsend explained. “The behaviors that arose from being oppressed indicated internalization of the belief that the nurses’ role was subservient and inferior to that of management or physicians. Lacking the ability to control their individual situation, oppressed employees will turn on each other, displaying passive aggression and bullying. Bullying and acting out is viewed as a symptom of the dysfunctional social dynamics of the oppressive work environment.”

To address oppressive group behavior in health care, Townsend said that organizations must adopt a more collegial culture, such as by implementing shared governance councils and fostering a collaborative atmosphere.

“Traditionally, organizations perpetuated bullying by downplaying its significance and brushed it off as a form of isolated interpersonal conflict,” she said. “In today’s work environment, bullying is a very serious problem, and the consequences can be devastating for not only the victim but coworkers and even the organization as a whole. With a high percentage of nurses leaving positions due to bullying, the financial cost of bullying appears to speak to the management.”

Everyone Has a Meaningful Contribution to Stop Bullying

Unfortunately, reporting bullying experiences to human resources (HR) often is not effective. “According to a study done by the Workplace Bullying Institute, 85% of HR representatives ignore the reports, or their actions result in worse bullying for the victim,” Townsend said.

This particularly applies when the bully is a manager. “The victim can report to HR but should also discuss the situation with the person a rung or two higher on the organizational ladder,” Townsend said.

On the unit level, Townsend advised that managers should receive education on how to recognize and address bullying behaviors. Staff also benefit from education on bullying behaviors. “Occasionally, the unit bully does not recognize his or her own behavior as abusive, because those behaviors were the only ones learned. Individually, nurses can remember when they were new and can vow to be welcoming, collaborative, and good team members,” Townsend said.

Where to Get Help

For nurses who need help today addressing bullying in their practice, many resources are available. Townsend recommends the American Association of Critical Care Nurses’ Healthy Work Environment documents as a starting point. Many organizations offer employee counseling, and most states and nursing specialty organizations, as well as the Joint Commission, have position statements encouraging zero tolerance policies on bullying.

Most importantly, victims need to speak out and be heard. “Standing up to a bully is difficult, and there are units who have an established signal where everyone stands behind the person being bullied to bear witness and stop the aggressive behavior,” Townsend said.