Workplace Bullying
By: Ashley, Brita, Dani, Sarah, Kortni
EBP Question
Among novice nurses, how does
workplace bullying effect quality of care?
We define quality of care as patient safety, productivity of the nurse, and the well-
being of patients and nurses
PICO P- novice nurses, 0-3 years of
experience I- workplace bullying C- n/a O- quality of care Question type: Prognosis
o Long term effects of workplace bullying
Search terms Workplace bullying Novice nurse Quality of care Patient safety Productivity Working culture Nursing outcomes
Evidence Search
Proquest Science Direct
Study 1
Bullying among Nurses Type of study: Qualitative
o surveys sent out through the mail to nurses in the area
Population: Nurses licensed in Massachusetts from 2001-2003
Sample size: 511 (1000 surveys sent out, 511 returned)
Purpose To determine if
bullying had any effect on nurses leaving their jobs
Found out more about the types of bullying going on among nurses
Results 511 surveys were returned, 184 with extra
comments about being bullied or seeing bullying happen.
4 themes describing bullyingo “Structural bullying”o “Nurses eating their young”o “Feeling out of the clique”o “Leaving the job”
Conclusion “Bullying has been part of
workplace culture since the beginning of professional nursing and has been tacitly accepted by nurses for too long. Nurses are only just beginning to understand the root of this unfortunate phenomenon”
Important 4 themes More research needed
Study 2
Type of StudyWORKPLACE BULLYING IN NURSING: A PROBLEM THAT CAN’T BE IGNORED
Systematic Review Population- none. Draws on many
research publications and the author’s opinion
Novice Nurse, Carol
Purpose
To present the history and seriousness of workplace bullying in nursing and to offer potential
solutions
Content and Results Abusive workplaces result in lack of job
satisfaction, poor retention, and adverse patient outcomes
Negative effects: on nurses, patients in their care, family, friends, coworkers, and health care organizations
Characteristics of bullies and protection No Tolerance Act
Conclusion Standards against bullying
set in place Not completely relevant,
not focused on novice nurses
Recommendations
Study 3
Survey
Cross Sectional Survey Newly graduated nurses
– working less than two years
In acute care hospital in Ontario Canada
Mailed to participants homes
342 nurses surveys were returned meeting criteria
Purpose
The purpose of the survey was to link authentic leadership to new graduate nurses’ experience of workplace bullying, burnout, & job satisfaction
Results
The results were that authentic leadership has a direct negative effect on workplace bullying, and that was significantly related to better job satisfaction and job turnover intention.
Relevancy Because of our definition of quality of care,
this survey was relevant to our study. Nurses’ with authentic leadership that
condones bullying had better job satisfaction which leads to better quality of care for the patients
However, more research would need to be done on the direct effects on the quality of care
Study 4
Bullying and Productivity
Primary research Survey New nurses registered in 2009 or 2010 Sample size=197
Purpose of Study “to determine the prevalence and effects of WPB
on the productivity of novice nurses” (Berry et al., 2012)
Content/Results 23.9%-bullying did not affect productivity 29. 4%-more productive following bullying 46.7%-less productive following bullying Effect of bullying on non-white v. white
No Change In Productivity More Productive Less Productive
Limitations Nurses subjected to bullying may have been
more likely to take survey May not have provided accurate information
about bullying
Relevancy/Conclusion Highly relevant Links bullying with diminished ability of new
nurses to fulfill responsibilities Supports that it’s crucial to reduce bullying to
minimum levels
Study 5
Intimidation and Workplace Bullying
Type of study: concept analysiso 136 articles were
examined o 56 representative
publications Population:
o novice nurses, nursing students, doctors
Sample size: o Cases, interviews, and
surveys that consisted of a wide variety from 1 person to 1,565 people.
Purpose To clarify the meaning
of intimidation within the context of the healthcare environment.
Identify the role that intimidation & workplace bullying play in undermining patient safety (e.g. medical errors) and complete quality of patient care (Lamontagne, 2010).
Results Workplace bullying,
intimidation and hostile behavior can foster medical errors and decrease patient safety.
Deaths yearly because of preventable medical errors?
How much do these medical errors cost per patient?
Negative effects on healthcare providers.
Results Disruptive behaviors can
contribute to:o Poor patient satisfactiono Preventable adverse outcomeso Increased cost of careo Decreased patient safetyo Clinicians to seek new positions
What is the safety quality of patient care dependent on?
Health care organizations need to address the problem of behaviors that threaten the performance of the healthcare team.
Novice nurses reported feelings of:o Being undervaluedo Blocked from opportunitieso Being unsupported, and
neglected
Conclusion Recognize and take specific
steps to immediately halt the occurrence of intimidation.
Adverse affect on healthcare providers, patients, and their families.
Further research is needed to provide a method to quantitatively measure the effect of intimidation by nursing superiors on novice nurses' ability to provide safe patient care.
It is in the best interest of the patient, nurse, and organization to eliminate workplace bullying from the workplace.
RecommendationsClearly, the bullying of new nurses has far reaching consequences. Current practice must focus on minimizing bullying to: provide greater patient safety increase nurse productivity increase nurse job satisfaction Ultimately provide greater quality of care
Preventative strategies and ongoing interventions for eliminating workplace bullying are paramount in the healthcare setting.
ConclusionBullying has a negative effect and it must be minimized to improve overall quality of care. There are many adverse effects that not only involve the nurse, but also patients, families, and healthcare providers.
More research needs to be conducted to identify effective interventions to eliminate bullying in the healthcare setting and the negative effects that it has.
References Berry, P. A., Gillespie, G. L., Gates, D., & Schafer, J. (2012). Novice
Nurse Productivity Following Workplace Bullying. Journal of Nursing Scholarship, 44(1), 80-87. doi:10.1111/j.1547-5069.2011.01436.x
Grau, A. L., Laschinger, H. K. S., Wong, C. A. (2012). The influence of authentic leadership on newly graduated nurses experiences of workplace bullying, burnout and retention outcomes: A cross sectional study. International Journal of Nursing Studies, 49, 1266-1276. http://www.sciencedirect.com/science/article/pii/S002074891836#
Lamontagne, Clare, MS,R.N., C.N.E. (2010). Intimidation: A concept analysis. Nursing Forum, 45(1), 54-65. Retrieved from http://search.proquest.com/docview/194999595?accountid=27045
Murray, J. S. (2009). Workplace bullying in nursing: A problem that can’t be ignored. Medsurg Nursing, 18(5), 273-6.
Simons, S. R., & Mawn, B. (2010). Bullying in the workplace--A qualitative study of newly licensed registered nurses. AAOHN Journal, 58(7), 305- 11. doi:http://dx.doi.org/10.3928/08910162-20100616-02