Workplace BullyingThe High Cost of CaringOver 75% of novice nurses experienced or witnessed workplace bullying (WPB) behaviors in their first job as a registered nurse.1 Nurses continued to have high frequencies of WPB behaviors from peers, nurse leaders, and physicians 18 months later, with 60% identifying themselves as WPB targets.2

WPB behaviors create stressful environments for nurses more vulnerable to that abuse. However, we are all vulnerable to WPB stressors. As WPB escalates, stress and anxiety symptoms increase, and may lead to post traumatic stress symptoms.2

Self-Label as Target of Workplace Bullying60

50

40

30

20

10

0

Never Yes, but rarely Yes, now & then Yes, several times a week2010 51 20 8 12012 35 29 16 0

Organizational Costs

Productivity is negatively impacted as WPB behaviors increase on the unit.1 Intent to leave is positively correlated to WPB with bullied nurses three times more likely to express intent to leave employment.3,4

Unaddressed interpersonal WPB behaviors leading an employee to terminate employment potentially can cost health care organizations $22,000 to $64,000 per replacement posing a significant burden to the financial viability of any health care facility.5

If a large facility with 1,000 RN’s lost 40% of its staff yearly to WPB behaviors, estimated replacement costs would be between $8.8 and $25.6 million.

For those nurses who continue to work in an organizational culture that ignores, enables, or rewards WPB behaviors, these behaviors become normalized.6 After 18 months, 20% (n=9) of the nurses who remained in the same unit where they were bullied, adopted WPB behaviors.2

The transition from novice to competent nurse requires more organizational support at hire and extended mentoring.

1. 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.x2. Berry, P.A., Gillespie, G.L., Fisher, G.S., Gormeley, D.K., & Haynes, J.A Path Analysis for the Adoption of Workplace bullying Behaviors. Unpublished Manuscript.3. Simons, S. (2008). Workplace bullying experienced by Massachusetts registered nurses and the relationship to intention to leave the organization. Advance in Nursing Science, 32(2), E48-E59.4. Johnson S.L,, & Rea, R.E. (2009). Workplace bullying: Concerns for nurse leaders. The Journal of Nursing Administration, 39(2), 84-90.5. Robert Wood Johnson Foundation (2009). Business case/cost of nurse turnover. Retrieved from: http:// www.rwjf.org/en/research-publications/find-rwjf- research/2009/07/wisdom-at-work-retaining-experienced-nurses/ business-case-cost-of-nurse-turnover.html6. Hutchinson, M., Wilkes, L., Jackson, D., & Vickers, M.H. (2010). Integrating individual, work group and organizational factors: Testing a multidimensional model of bullying in the nursing workplace. Journal of Nursing Management, 18, 173-181.

Workplace Bullying Exposure Levels

No WPB exposure (0-24) 50% (n=40)

Moderate WPB exposure (50-124)25.5% (n=10)

Low WPB exposure (25-49)18.8% (n=15)

Psychological Distress Symptoms

Post Traumatic Stress Symptoms

Anxiety State

Perceived Stress 0 10 20 30 40 50 60

Perceived Stress Anxiety State Post Traumatic Symptoms negative 41 40 52 Positive 39 40 28

High WPB exposure (125 or above)18.8% (n=15)