Nurse bullying: What it is and prevention tips

Nurses are known for being kind, caring and respectful as they care for their patients. However, they’re not always afforded the same level of respect. Nurse bullying – nurses are targeted by repeated harmful actions that are intended to offend, hurt or humiliate them – is a widespread and serious issue.

In a webinar for James Cook University, Professor Melanie Birks and Senior Lecturer Peter Hartin discussed just how common the problem is. “The prevalence of workplace bullying in nursing is troubling,” Hartin said. “We’ve heard some nurses have likened their clinic to that of a battlefield and described the environment in which they work as a place of professional turmoil.”

Highly effective nurse leaders can play a pivotal role in curtailing bullying in the workplace and creating more positive workplace cultures. To do this, however, it’s important to understand what nurse bullying is, the types of bullying that occur, how it affects patient care and what can be done to prevent it. 

What is nurse bullying?

While nursing can be an immensely rewarding profession, nurses all have bad days. These can include moments in which patients are uncooperative, treatments don’t work as planned, or doctors, nurse unit managers or other health professionals don’t treat them with the respect they deserve. 

All of these can be frustrating and hurtful. However, bullying is entirely different from the experience of a bad day.

Nurse bullying isn’t a single instance of being treated poorly. It is a pattern of treatment in which a fellow nurse, a manager or other health professional repeatedly belittles, minimises, name-calls, mocks, withholds information or support or is otherwise repeatedly rude to a nurse in ways that offend, hurt or humiliate. 

With such tumultuous conditions, it’s little wonder that those who identify as having been bullied report significant impacts, including psychological distress, depression and burnout. “The aggressive and destructive nature of bullying can undermine professional confidence, [leading] to a feeling of powerlessness and decreased motivation,” Hartin said. “Job satisfaction and intent to quit is significantly impacted. Many nurses consider leaving the profession or reducing their workload as a way of coping.”

Types of nurse bullying

When people think of bullying, they tend to focus on physical threats. However, nurse bullying can occur in various harmful ways. Below are different types of nurse bullying.

Unfounded criticism

A common form of bullying is unfounded criticism from a nurse’s colleagues, a manager or other health professional. The bully may refer to the nurse as bad at their job or criticise them for other reasons, often without evidence. Unfounded criticism can also take the form of name-calling, in which someone simply calls a nurse useless or incompetent. 

Public criticism

A bully may also publicly criticise a nurse, calling them out in front of others; this can be humiliating. 

Minimising

When a nurse is struggling with a difficult situation, a bully may minimise their pain and frustration. They may tell the nurse to toughen up or try harder rather than acknowledging the circumstances and the nurse’s perspective. 

Ignoring

Being ignored or left out can lead to feelings of isolation and frustration. Someone may bully a nurse by leaving them out of group activities, such as social events. 

They may also choose to ignore a nurse; this can be dangerous. Here, a bully may ignore a nurse’s calls for help, leaving a nurse in a hazardous situation or to complete tasks that they’re not comfortable with. 

Gossiping

Another insidious form of bullying is gossip. A bully may spread rumours about a nurse that are intended to humiliate or hurt them. 

Yelling or physical intimidation

Yelling or forms of physical intimidation, such as pushing or blocking someone’s path, are also forms of bullying that have a detrimental impact on nurses. 

How does nurse bullying affect patient care?

Research conducted by BMC Health Services found many adverse impacts of bullying on nurses. Nurses who are bullied may experience the following: 

• Difficulty maintaining the cognitive, emotional and safety demands required to continue to care for their patients
• Decreased productivity and poor workload handling
• Issues communicating with patients and their families, as well as with nursing colleagues 
• Increase in mistakes, including with treatments and medication, such as late administration of medication. 

How to prevent nurse bullying

To protect individual nurses, as well as patients, and to ensure that nurses don’t leave the profession and exacerbate the already profound nursing shortage in Australia, organisations should implement preventive strategies to ensure that nurses aren’t bullied. 

Below are some of these strategies.

Establish appropriate policies

Every healthcare environment needs to have policies that outline zero tolerance for bullying, including online bullying. 

All staff, including managers, should be trained on these policies and they should be enforced throughout the organisation. 

Empower human resources to act

Bullying complaints are often minimised, or if they’re taken seriously, no remediation is taken. 

To prevent bullying, human resources (HR) departments must feel empowered to investigate and act on complaints, even if the bully is powerful or senior. Bullying that has clear consequences becomes less common. 

Embed cultural change

Cultural change is critical to prevent nurse bullying. This requires managers who model caring leadership and send a clear message that bullying isn’t tolerated. Similarly, nurses need to feel empowered to speak up for their colleagues if they witness bullying behaviour and to report it and not tolerate it. 

What to do if you’re being bullied: Tips and resources 

If a nurse feels that they’re being bullied at work, they should report it to: 

• A nurse unit manager 
• A workplace health and safety representative
• An HR professional 
• A union representative. 

They should also educate themselves on their workplace approach to bullying. Doing so may include the following: 

• Locating their workplace policies and procedures for bullying 
• Consulting organisational values 
• Understanding grievance and disciplinary policies. 

If a nurse continues to struggle with the impact of bullying, they can also: 

• Reach out to a counsellor
• Consult Nurse & Midwife Support
• Contact Lifeline
• Make a complaint to the Australian Human Rights Commission.

Nurse bullying: Things are changing

While nurse bullying has been a longstanding problem, circumstances are improving. Increasingly, nurse leaders are becoming more positive, supportive and empathetic, which in turn creates a culture that’s more caring and less about status and hierarchy. 

If you want to learn more about leadership in nursing and be part of positive change in the future, look into JCU Online’s Master of Nursing course. If you’d like to learn more about the online program, reach out to our enrolment team on 1300 535 919.