Workplace bullying in the nursing profession: A cross-cultural scoping review

Pathological narcissism, interpersonal cognitive distortions, and workplace bullying among nurses: A cross-sectional study

AIM

The aim of this work is to examine whether nurses' pathological narcissism and interpersonal cognitive distortions predict workplace bullying when controlling for organizational culture, work-related factors, and demographic variables.

BACKGROUND

To eradicate workplace bullying, a multifaceted holistic approach to identify potential predictors is needed. Nurses' narcissistic behaviours negatively affect collegial relationships and the organization. Furthermore, interpersonal cognitive distortions have been demonstrated to directly affect bullying and victimization.

METHODS

Responses from 236 nurses to an online survey were analysed. The Pathological Narcissism Inventory, Interpersonal Cognitive Distortions Scale, Positive Nursing Organizational Culture Measurement Tool, and The Negative Acts Questionnaire-Revised were used to measure the key variables.

RESULTS

A multiple regression analysis revealed that pathological narcissism (β = .33, p < .001) had the greatest effect on nurses' workplace bullying, followed by positive organizational culture (β = -.31, p < .001), interpersonal cognitive distortions (β = .17, p = .028), marital status (β = -.15, p = .020), and position (β = -.12, p = .047).

CONCLUSIONS

Although prejudice or stigma surrounding narcissistic personalities should be avoided, nurses should be aware of and manage such characteristics so that they do not become a factor in workplace bullying.

IMPLICATIONS FOR NURSING MANAGEMENT

There is a need to protect nurses from workplace bullying and create a positive organizational culture by recognizing narcissistic traits and preparing intervention strategies that support improvement.

Adapting Civility Education in an Academic-Practice Partnership

BACKGROUND

Incivility results in nurse burnout, decreased job performance, and decreased patient safety. Leaders of an academic-practice partnership developed educational activities promoting organizational civility during the COVID-19 pandemic. The purpose of this article is to describe an educational activity about civility that was transitioned to a virtual platform and participants' comfort engaging in and responding to incivility.

METHOD

Face-to-face education was converted to a synchronous online event, supporting 75 nurses, nursing students, and other health care professionals in attendance. Activities consisted of cognitive rehearsal techniques, breakout rooms, simulation videos, group debriefs, and panel discussions delivered via Zoom and Mentimeter software.

RESULTS

Workplace Civility Index results were significantly different from pretest to post-test. Seventy-two percent of participants were not comfortable gossiping about others, but only 30% were comfortable responding to incivility.

CONCLUSION

Promoting civility awareness through a virtual education platform using cognitive rehearsal techniques and reflection can provide support for current and future nurses. [J Contin Educ Nurs. 2021;52(12):575-580.].

The mediating effect of workplace incivility on organization culture in South Korea: A descriptive correlational analysis of the turnover intention of nurses

PURPOSE

The purpose of this study was to understand the mediating effect of workplace incivility on the relationship between nursing organizational culture and turnover intention among nurses.

DESIGN

A descriptive survey was used to collect data. The participants were 170 nurses with more than six months of clinical experience at university hospitals or hospitals with over 500 beds in South Korea.

METHODS

Data were collected using self-report questionnaires. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, and Pearson's correlation. Baron and Kenny's three-step hierarchical regression analysis and the Sobel test were used to determine the mediating effect of workplace incivility on the relationship between nursing organizational culture and nurses' turnover intention.

RESULTS

This study found a full mediating effect of workplace incivility on the association between relationship-oriented culture and turnover intention (Z = -3.02, p = 0.003) and a partial mediating effect of workplace incivility on the association between hierarchy-oriented culture and turnover intention (Z = 2.36, p = 0.018).

CONCLUSION

This study empirically confirmed that nursing organizational culture and workplace incivility directly or indirectly influenced turnover intention, which highlights the seriousness of workplace incivility.

CLINICAL RELEVANCE

This study suggests that there is a need to establish a concrete strategy to avoid a hierarchy-oriented culture and create a relationship-oriented culture. It is important to develop a variety of intervention programs to reduce workplace incivility in order to prevent nurses' turnover.

Association between workplace bullying and nurses' professional quality of life: The mediating role of resilience

AIM

We aim to determine workplace bullying in relation to the professional quality of life of nurses and the mediating role of resilience between workplace bullying and the professional quality of life.

BACKGROUND

Workplace bullying is an increasingly serious problem worldwide and deleteriously affects the occupational health and quality of life of nurses. However, it has not attracted adequate managerial attention.

METHOD

A cross-sectional study was conducted using a sample of 493 clinical nurses from two tertiary grade A hospitals in Guangzhou, China. Data were collected through an online questionnaire survey in July 2020 and analysed with structural equation modelling.

RESULTS

Workplace bullying had negative and direct effects on the professional quality of life of nurses. Resilience mediated the relationship between workplace bullying and the professional quality of life.

CONCLUSION

Resilience is a protective factor that helps nurses cope with workplace bullying. Managers can improve the professional quality of life of nurses by reducing workplace bullying and strengthening the resilience of nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers must take measures to prevent the workplace bullying of nurses. In addition, nurse supervisors should pay attention to the resilience of nurses and strengthen resilience training to help nurses withstand the pressure of workplace bullying and improve their professional quality of life.

Tough Love Lessons: Lateral Violence among Hospital Nurses

Background: Workplace violence is a growing social problem among many professions, but it particularly affects the health sector. Studies have mainly focused on evaluating user violence toward health professionals, with less attention being paid to other sources of conflict, such as co-workers themselves. There are different manifestations of this violence in what has been called a context of tolerated or normalized violence among co-workers. However, its effects are far from being tolerable, as they have an impact on general health and job satisfaction and contribute to burnout among professionals. Based on this idea, and following the line of the previous literature, nursing staff are a population at high risk of exposure to workplace violence. For this reason, the present study aims to evaluate exposure to lateral violence or violence among co-workers in nursing staff in public health services and the relationship of this exposure with some of the most studied consequences. (2) Methods: A cross-sectional associative study was carried out in which scales of workplace violence (HABS-CS), burnout (MBI-GS), job satisfaction (OJS), and general health (GHQ-28) were applied to a sample of 950 nursing staff from 13 public hospitals located in the southeast of Spain. (3) Results: The results show that nursing staff have a high exposure to violence from their co-workers, which is more common in male nurses. Greater exposure is observed in professionals with between 6 and 10 years of experience in the profession, and it is not characteristic of our sample to receive greater violence when they have less experience or are younger. A positive correlation is observed with high levels of burnout and a negative correlation with general health and job satisfaction. (4) Conclusions: The results of this work contribute to increasing the scientific evidence of the consequences of a type of workplace violence frequent among nursing staff and to which less attention has been paid in relative terms to other types of prevalent violence. Organizations should be aware of the importance of this type of workplace violence, its frequency and impact, and implement appropriate prevention policies that include the promotion of a culture that does not reward violence or minimize reporting. A change of mentality in the academic environment is also recommended in order to promote a more adequate training of nursing staff in this field.

Protecting Nurses from Mistreatment by Patients: A Cross-Sectional Study on the Roles of Emotional Contagion Susceptibility and Emotional Regulation Ability

In recent years, patient mistreatment of healthcare workers, especially nurses, has been frequent, endangering the interests of organizations while also threatening nurses’ own development. This study aims to examine from the perspective of nurses’ personal interests whether mistreatment by patients decreases nurses’ workplace well-being and career commitment, and how their susceptibility to emotional contagion and emotional regulation ability might mitigate these negative effects. This study adopted a cross-sectional study design (data were collected through self-reported questionnaires with a two-month time lag between the months of August–October 2017). A total of 289 nurses from three hospitals in Shandong province, China, were recruited to participate in our study. The results reveal that mistreatment by patients is negatively related to nurses’ workplace well-being and career commitment. Emotional contagion susceptibility moderates the relationships between mistreatment by patients and career commitment, while there is no significant buffering effect of mistreatment by patients on workplace well-being. Emotional regulation ability moderates the relationships between mistreatment by patients and both workplace well-being and career commitment. These results suggest that improvements in nurses’ emotional regulation ability and susceptibility to emotional contagion can alleviate the harmful impacts of mistreatment by patients.

A qualitative systematic review on nurses' experiences of workplace bullying and implications for nursing practice

AIMS

To explore nurses' experiences of workplace bullying and ways to prevent such occurrences.

DESIGN

A qualitative systematic review was conducted.

DATA SOURCES

Five electronic databases were searched from each database's inception to December 2020.

REVIEW METHODS

Meta-summary and meta-synthesis were conducted using Sandelowski and Barroso's approach.

RESULTS

Twenty-seven studies were included in this review. The overarching theme, 'The Vicious Cycle of Bullying in Nursing', and four themes were synthesized: (a) different 'faces' of bullying, (b) the hidden drivers of bullying, (c) impact of being bullied and (d) responses to bullying.

CONCLUSION

The nursing code of ethics and anti-bullying policies should be consistently enforced by each organization's upper management. Nurses should be provided a safe space to voice their concerns on bullying within the organization.

The Experience of Clinical Nurses after Korea's Enactment of Workplace Anti-Bullying Legislation: A Phenomenological Study

Workplace bullying is a global issue that has emerged over the past decades and is widespread all around the world. In Korea, there is a high prevalence of bullying in nursing. In 2019, Korea enacted its workplace anti-bullying legislation. This study explores the changes experienced by nurses after the enactment of the legislation and identifies problems and improvements. Qualitative research was conducted using the phenomenological analysis method proposed by Van Kaam. Twelve nurses with experience in working before and after the enactment of the legislation were selected as study participants. They worked in various departments in five general hospitals across Korea. Purposive sampling was used to recruit participants. Data were collected using one-on-one interviews. These data were analyzed by extracting significant statements and classifying them into categories, themes, and subthemes. The analysis yielded 14 subthemes, five themes, and three categories. The three categories were “positive effect of the law”, “need for awareness of the law reform”, and “impracticalities of the law that caused chaos”. There is a difference between the theory of the law and how things happen in practice in actual nursing situations. Nurses have been educated about the new law, but better education with input from nurses themselves is needed. This study lays the groundwork for a quantitative study of the issue.

Preceptorship as part of the recruitment and retention strategy for nurses? A qualitative interview study

AIM

To explore aspects that are important for the integration of preceptorship and processes for recruitment and retention of nurses.

BACKGROUND

The shortage of nurses is a global concern that has a major impact on health care systems around the world. However, earlier research has not considered whether preceptorship of nursing students can be an integral part of recruitment and retention of nurses.

METHOD

A descriptive design with a qualitative approach was used. Semi-structured interviews were conducted with ten preceptors and six ward managers in different health care specialties in Sweden.

RESULTS

Three aspects were found central for integrating preceptorship with recruitment and retention: perceptions of preceptorship, the organisation of preceptorship and the way preceptorship operates in relation to recruitment and retention strategies.

CONCLUSION

The findings suggest that preceptorship and recruitment strategies could both benefit from being integrated.

IMPLICATIONS FOR NURSING MANAGEMENT

It is central for nursing managers to develop organisational practices that enable the integration of preceptorship with recruitment and retention of nurses. This could increase the quality of both preceptorship and the work environment in general.

Creating Respectful Workplaces for Nurses in Regional Acute Care Settings: Protocol for a Sequential Explanatory Mixed Methods Study

Background

Negative workplace behaviour among nurses is an internationally recognised problem, despite the plethora of literature spanning several decades. The various forms of mistreatments and uncaring attitudes experienced by nurses include workplace aggression, incivility, bullying, harassment and horizontal violence. Negative behaviour has detrimental effects on the individual nurse, the organisation, the nursing profession and patients. Multi-level organisational interventions are warranted to influence the “civility norms” of the nursing profession.

Objective

The aim of this study is to investigate the self-reported exposure to and experiences of negative workplace behaviours of nursing staff and their ways of coping in regional acute care hospitals in one Local Health District (LHD) in NSW before and after Respectful Workplace Workshops have been implemented within the organisation.

Methods

This study employs a mixed methods sequential explanatory design with an embedded experimental component, underpinned by Social World’s Theory. This study will be carried out in four acute care regional hospitals from a Local Health District (LHD) in New South Wales (NSW), Australia. The nurse unit managers, registered nurses and new graduate nurses from the medical and surgical wards of all four hospitals will be invited to complete a pre-survey examining their experiences, perceptions and responses to negative workplace behaviour, and their ways of coping when exposed. Face-to-face educational workshops will then be implemented by the organisation at two of the four hospitals. The workshops are designed to increase awareness of negative workplace behaviour, the pathways to seek assistance and aims to create respectful workplaces. Commencing 3 months after completion of the workshop implementation, follow up surveys and interviews will then be undertaken at all four hospitals.

Results

The findings from this research will enhance understanding of negative workplace behaviour occurring within the nursing social world and assess the effectiveness of the LHD’s Respectful Workplace Workshops upon the levels of negative workplace behaviour occurring. By integrating qualitative and quantitative findings it will allow for a dual perspective of the social world of nurses where negative and/or respectful workplace behaviours occur, and provide data grounded in individuals lived experiences, positioned in a macro context

Conclusions

It is expected that evidence from this study will inform nursing practice, and future policy development aimed at creating respectful workplaces.

Trial Registration

Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; 14 December 2018).

International Registered Report Identifier (IRRID)

PRR1-10.2196/18643